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| Section | Objectives |
|---|---|
| General Insurance Regulation | - Nevada Insurance Department and Regulatory Authority
|
| Producer Duties and Ethics | - Ethical Responsibilities
|
| Health Insurance Policy Provisions | - Mandatory and Optional Provisions
|
| Insurance Basics | - Insurance Contracts
|
| Accident and Health Insurance Fundamentals | - Types of Health Insurance Policies
|
| Government Health Insurance Programs | - Medicare
|
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NEW QUESTION # 58
A Major Medical policy insured is injured in an auto collision during a police chase. The occupants in the police car are killed. The insured is convicted of reckless driving and manslaughter. If the insured files a claim, the insurance company will MOST likely take which of the following actions?
Answer: C
Explanation:
Major medical coverage pays covered medical expenses resulting from accidental injury or sickness, subject to the policy's stated exclusions and limitations. The facts establish reckless and criminal conduct, but they do not establish an intentional self-inflicted injury or identify a policy exclusion that removes coverage.
Therefore, choice A is the best answer: the insurer will pay the covered benefits according to the policy.
Insurance examination questions require careful separation of criminal conduct from intentional injury.
Reckless driving and a resulting conviction do not automatically mean that the insured intended to injure himself. A health insurer may deny a claim only when a valid policy exclusion, limitation, misrepresentation defense, or other contract basis applies. The insurer does not reduce benefits merely to "partial benefits" because of the conviction, and it does not return all premiums after denying a properly covered accidental- injury claim. The controlling analysis is the policy language, including exclusions for intentional self-inflicted injury, war, occupational losses, or other listed circumstances. Study Guide References/Topics: Policy Provisions, Clauses, and Riders; Major Medical Insurance; Exclusions and Limitations.
NEW QUESTION # 59
In Nevada, which life insurance policy is subject to a 30-day right to surrender for a premium refund after delivery?
Answer: C
Explanation:
A replacement life insurance policy delivered in Nevada must provide a 30-day period during which the policyowner may surrender the policy to the insurer with a written request for cancellation and receive a refund of premiums paid, including policy fees or other charges. This longer review period recognizes the special risks associated with replacement transactions. Replacing existing coverage can cause the consumer to lose favorable values, restart contestability or suicide periods, incur surrender charges, or exchange a policy that better serves the client's long-term needs.
For a nonreplacement life policy, annuity contract, or pure endowment contract, Nevada generally requires a
10-day right of surrender after delivery. The applicable statute excludes industrial life insurance from this requirement. The producer must therefore identify whether a proposed transaction is a replacement and follow the related disclosure and recordkeeping requirements. The free-look period is a consumer-protection right; it does not excuse a producer from determining suitability or accurately comparing existing and proposed coverage before the sale.
On an examination question, the key distinction is not whether the policy is whole life, term life, or universal life. The key is whether it is a replacement contract or policy.
References/topics from the Study Guide: Replacement; Free-Look Provision; Nevada Consumer Protections; NRS 688A.165.
NEW QUESTION # 60
Insurance for the primary purpose of repaying a loan in the event of disability is referred to as:
Answer: B
Explanation:
Credit Accident and Health insurance is insurance on a debtor that provides indemnity for payments or debt becoming due on a specific loan or credit transaction while the debtor is disabled as defined by the policy. Its primary purpose is to protect the borrower and creditor by helping repay the outstanding debt when disability prevents the borrower from working or making scheduled payments.
The coverage may pay periodic loan installments during a qualifying disability or, depending on policy design, provide benefits related to the unpaid debt. It is connected to a specific credit obligation rather than serving as broad disability-income protection. The benefit is limited by the loan terms, policy provisions, waiting period, disability definition, and maximum benefit duration.
Guaranteed Asset Protection, or GAP, generally addresses the difference between an automobile's outstanding loan balance and its actual cash value after a covered total loss. Credit life insurance pays or reduces debt upon the debtor's death, not disability. "Loan Repayment policy" is not the standard statutory insurance term.
The examination distinction is that disability-related loan protection is Credit Accident and Health insurance, while death-related loan protection is Credit Life insurance.
Study Guide references/topics: credit insurance; disability protection; credit accident and health insurance; debtor; NRS 690A.0135 .
NEW QUESTION # 61
Which person is the measuring life whose survival determines the timing and duration of annuity payments?
Answer: C
Explanation:
The annuitant is the person whose life expectancy is used to determine the amount, timing, or duration of annuity payments. The annuitant is not necessarily the contract owner or the beneficiary. In many personally owned annuities, one person may occupy more than one role, but examination questions frequently separate them. The owner controls contractual rights, including premium payments, beneficiary changes, withdrawals when permitted, and surrender decisions. The annuitant is the measuring life. The beneficiary receives remaining contract value or death proceeds if the owner or annuitant dies, depending on the contract design.
During the accumulation period, the owner pays premiums or transfers funds into the annuity. During the annuitization period, the accumulated value is converted into a stream of income payments. The annuitant's age and selected payout option influence the payment calculation. A life-income option normally provides larger periodic payments for an older annuitant because the expected payment period is shorter.
Do not confuse the annuitant with the insured under life insurance. Life insurance is designed primarily to create a death benefit upon the insured's death. An annuity is designed primarily to provide income during life, although death-benefit provisions may apply before annuitization.
References/topics from the Study Guide: Annuities; Parties to an Annuity; Accumulation Period; Annuitization Period; Payout Options.
NEW QUESTION # 62
An insurance company MUST take which of the following actions to terminate a producer ' s appointment?
Answer: D
Explanation:
When an insurer terminates the appointment, employment, or other relationship of a producer, it must notify the Nevada Insurance Commissioner. The notice must be made in the form prescribed by the Commissioner within 30 days after the effective date of termination.
An appointment is the insurer's authorization for a licensed producer to act as its agent. Ending an appointment does not automatically cancel the producer's underlying license. A producer may remain properly licensed and may be appointed by another insurer or operate as a broker when permitted by law.
Therefore, option B is incorrect.
The insurer must provide the required notice to the Commissioner; it is not required to obtain a hearing before ending the appointment. The producer is sent a copy of the insurer's notification after the Commissioner is notified, but the statute does not require the insurer to provide 30 days' advance notice to the producer. The producer has an opportunity to file written comments concerning the report with the Commissioner.
The reporting rule supports regulatory oversight and helps the Division identify whether a termination involved conduct that may warrant disciplinary action.
Study Guide references/topics: producer appointments; appointment termination; insurer reporting duties; NRS 683A.331 .
NEW QUESTION # 63
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