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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Insurance Regulation and General Principles | 20% | - Insurance Concepts
|
| Topic 2: Life Insurance Products and Provisions | 30% | - Types of Life Insurance Policies
|
| Topic 3: Underwriting, Marketing and Sales Practices | 15% | - Sales and Customer Service
|
| Topic 4: Accident and Health Insurance | 35% | - Government Health Programs
|
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NEW QUESTION # 59
Long-term care policies MUST cover which of the following conditions?
Answer: C
Explanation:
Long-term care (LTC) insurance is intended to cover services needed when an insured cannot perform activities of daily living (ADLs) or suffers a cognitive impairment that requires substantial supervision for health and safety. A core regulatory and policy design principle is that LTC benefits must be available for qualifying impairments regardless of whether the cause is physical or cognitive . Alzheimer's disease is a leading cause of cognitive impairment and is specifically recognized in LTC training materials as a condition LTC policies must cover when it results in the required level of functional or cognitive limitation. In practice, Alzheimer's often triggers eligibility through the cognitive impairment standard, even when the insured can still perform some ADLs, because supervision is needed to protect the individual from threats to health and safety.
The other options are commonly associated with policy exclusions rather than required coverage. LTC policies frequently exclude losses related to war or acts of war , and they may exclude intentionally self- inflicted injuries . Alcoholism or drug addiction is not treated as a mandatory covered condition in the same way; coverage depends on policy terms and is often limited or excluded. Therefore, the condition LTC policies must cover is Alzheimer's disease .
NEW QUESTION # 60
An insured owns a whole life policy that has accumulated cash value. Which of the following statements is true about the policy ' s cash value?
Answer: D
Explanation:
The correct answer is B. The growth of the policy's cash value is not subject to income tax while the policy is in force. Whole life insurance is a form of cash value life insurance . As premiums are paid, part of the premium funds the death benefit and expenses, while part builds cash value inside the policy. Under standard life insurance taxation principles, that internal cash value buildup generally grows on a tax-deferred basis , meaning it is not taxed annually while it remains within the policy. The NAIC explains that whole life policies build cash value over time and that this value grows without being taxed currently, and IRS guidance similarly distinguishes taxable situations from ordinary in-force policy growth.
The other choices are incorrect. A is wrong because whole life cash value is not normally taxed each calendar year. C is more characteristic of variable life , where values fluctuate with investment performance. D is incorrect because traditional whole life generally provides guaranteed minimum cash values under the contract, subject to policy terms and continued premium payment; New York DFS whole life product guidance reflects that whole life operates on a guaranteed basis and includes cash surrender value provisions.
NEW QUESTION # 61
Upon receipt of notice of claim, the insurance company will furnish to the claimant such forms for filing proof of loss within how many days?
Answer: B
Explanation:
In Accident and Health insurance policies, the Claims Provisions section outlines the procedures that must be followed when a loss occurs. One of the standard provisions concerns the insurer's responsibility after receiving a notice of claim from the insured or beneficiary. Once the insurer receives this notice, the company must provide the claimant with the necessary claim forms used to submit proof of loss . According to standard policy provisions used in health insurance contracts, the insurer is required to furnish these forms within 15 days after receiving the notice of claim.
These forms allow the claimant to provide detailed information regarding the loss, such as the nature of the injury or illness, dates of treatment, medical provider information, and other documentation required to process the claim. If the insurer fails to provide the forms within the required 15-day period , the claimant may still satisfy the proof-of-loss requirement by submitting a written statement describing the occurrence, character, and extent of the loss within the time allowed by the policy. This rule ensures that claim processing cannot be delayed simply because the insurer did not send the official forms in time.
NEW QUESTION # 62
Which of the following is a life insurance contract written on the life of an individual?
Answer: C
Explanation:
The correct answer is D. Single-Life Insurance. A single-life insurance policy is a contract that covers one individual only . The death benefit is paid when that one insured person dies, provided the policy is in force.
This is the most basic and common form of life insurance coverage and is used when protection is needed on the life of one person, such as a wage earner, business owner, or parent. Because the contract is based on only one insured life, underwriting, premium calculation, and benefit payment are all tied to that single person's age, health, and policy terms.
The other choices are incorrect. A. Insurance is too broad and is not a specific type of life insurance contract.
B). Survivorship Policy covers two lives and typically pays upon the second death , not on a single individual alone. C. Joint Life Contract also covers two people , usually paying on the first death . Since the question asks for a policy written on the life of an individual , the proper term is Single-Life Insurance .
NEW QUESTION # 63
An annuitant dies during the accumulation period. What happens to the cash value in the annuity?
Answer: D
NEW QUESTION # 64
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