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| Section | Weight | Objectives |
|---|---|---|
| Nevada Statutes, Rules and Regulations | ~32% | - General State Insurance Regulations
|
| Accident and Health โ General Knowledge | ~68% | - Insurance Concepts and Underwriting
|
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NEW QUESTION # 126
Under an Accidental Death and Dismemberment policy, in which of the following circumstances will an autopsy NOT be performed?
Answer: A
Explanation:
The correct answer is B. An AD & D policy may give the insurer the right to conduct an autopsy when death occurs, provided the autopsy is not prohibited by law. The autopsy provision helps the insurer determine whether the cause of death falls within the policy's accidental-death coverage and whether an exclusion applies. A beneficiary's refusal does not necessarily defeat the insurer's contractual right if applicable law permits the examination. The fact that death resulted from illness rather than an accident may affect whether an AD & D benefit is payable, but it does not itself state the legal restriction on performing an autopsy.
Likewise, an accidental cause of death is precisely the type of circumstance in which the insurer may need medical evidence to verify coverage. The insurer's right is not unlimited: it must comply with legal requirements, including restrictions imposed by statute, court order, or other controlling authority. The exam rule is straightforward: the insurer may conduct an autopsy at its own expense unless doing so is prohibited by law. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Accidental Death and Dismemberment; Autopsy Provision.
NEW QUESTION # 127
A Nevada producer wants to solicit an individual disability-income policy. Which license authority is required?
Answer: B
Explanation:
A producer soliciting an individual disability-income policy must hold Nevada accident and health insurance authority. Nevada defines this line as insurance for sickness, bodily injury, or accidental death and permits it to include disability-income benefits. Disability-income insurance replaces a portion of earned income when an insured becomes disabled under the policy definition; it is therefore within the accident-and-health line rather than the property, casualty, or personal-lines authorities.
Nevada requires a person to be licensed for the relevant class of insurance before selling, soliciting, or negotiating insurance in the state. The licensing distinction matters because a life authority and an accident- and-health authority are separately identified lines of authority. Although life insurance may include additional disability-income benefits when permitted as part of its statutory definition, a producer selling an individual health or disability-income policy should not assume that life authority alone authorizes the transaction.
The producer must also comply with appointment requirements when acting as an insurer's agent, continuing education and renewal requirements, and all applicable trade-practice rules. Selling without the proper authority can result in administrative discipline and a monetary penalty. On examination questions, identify the coverage being sold first; then match it to the appropriate Nevada line of authority.
References/topics from the Study Guide: Producer Licensing; Lines of Authority; Accident and Health Insurance; Disability Income; NRS 683A.201; NRS 683A.261.
NEW QUESTION # 128
In a variable annuity, who bears the investment risk associated with the separate-account investment performance?
Answer: B
Explanation:
In a variable annuity, the contract owner bears the investment risk because contract values are tied to the performance of selected investment options held in a separate account. If those investments perform well, the accumulation value may increase. If they decline, the account value may decrease. The insurer does not guarantee a fixed return on the separate-account portion of the contract, although the contract may include certain insurance guarantees, such as a death-benefit feature or optional living benefits.
This is the central distinction between fixed and variable annuities. A fixed annuity generally credits interest at a guaranteed minimum rate and may declare additional interest under the contract terms. The insurer bears the investment risk for its general account. A variable annuity offers market-based investment choices and transfers market risk to the owner. Because variable annuity values are securities-linked, the producer must also satisfy applicable securities-registration and licensing requirements in addition to life insurance authority.
The suitability analysis is important. Variable annuities may be appropriate for a consumer seeking long-term growth potential who understands market volatility and has an appropriate time horizon. They are not automatically appropriate for a person who requires principal stability, liquidity, or predictable fixed returns.
References/topics from the Study Guide: Fixed Annuities; Variable Annuities; Separate Accounts; General Accounts; Investment Risk; Suitability.
NEW QUESTION # 129
Which type of health insurance is designed primarily to reimburse medical expenses such as hospital, surgical, and physician charges?
Answer: A
Explanation:
Medical expense insurance is designed to reimburse or pay covered health-care expenses arising from illness or injury. These expenses may include hospital room and board, surgical services, physician services, diagnostic testing, outpatient treatment, prescription drugs, and other covered medical care. Benefits are subject to the policy's deductible, copayment, coinsurance, network rules, exclusions, benefit limits, and medical-necessity standards.
Disability income insurance serves a different purpose. It replaces a portion of the insured's earned income when the insured becomes disabled under the policy definition. It does not ordinarily reimburse hospital or physician bills. Accidental death insurance pays a benefit upon qualifying accidental death and does not serve as general medical coverage. Credit life insurance is designed to help satisfy a debt when the debtor dies.
An examination question may describe a policy as basic hospital, surgical, physician expense, major medical, comprehensive major medical, or managed care. Each is within the broader medical-expense category, although benefits and delivery systems differ. The producer should help clients understand the distinction between coverage for medical bills and coverage for lost income. A client can need both forms of protection because medical expenses and inability to earn income are separate financial risks.
References/topics from the Study Guide: Medical Expense Insurance; Hospital Expense; Surgical Expense; Major Medical; Disability Income Insurance.
NEW QUESTION # 130
Group coverage for a handicapped dependent child may be continued if the primary insured submits the required proof to the insurance company within what MAXIMUM period of time after the child reaches the limiting age?
Answer: D
Explanation:
A group health policy that terminates dependent-child coverage at a stated limiting age must continue coverage for an eligible dependent child who remains incapable of self-sustaining employment because of a qualifying disability and who remains dependent on the insured group member for support and maintenance.
To preserve that continuation right, the required proof must be furnished within 31 days after the child reaches the policy's limiting age.
This is a time-sensitive protection. The purpose is to prevent automatic termination of coverage solely because a dependent reaches the normal age limit when the child remains disabled and financially dependent.
After initial proof is provided, the insurer may require continuing proof of incapacity and dependency, but it may not demand that proof more often than permitted by law.
The 31-day rule should be distinguished from notice periods for newborn coverage, conversion rights, premium grace periods, and claim notices. Each insurance provision may use a different time period, so examination questions often test the exact statutory deadline.
Study Guide references/topics: group health dependents; limiting age; continuation of coverage; NRS 689B.
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NEW QUESTION # 131
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