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| Section | Objectives |
|---|---|
| Topic 1: Accident and Health Insurance | - Policy features and provisions
|
| Topic 2: State Regulations (New York) | - Ethics and compliance
|
| Topic 3: Insurance Fundamentals | - Principles of insurance and risk management
|
>> NY-Life-Accident-and-Health New Study Guide <<
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NEW QUESTION # 17
Stranger originated life insurance violates which of the following statutory requirements?
Answer: D
Explanation:
Stranger-originated life insurance (STOLI) arrangements violate the fundamental legal requirement of insurable interest . In life insurance, the policyowner must have a legitimate interest in the continued life of the insured at the time the policy is issued. This usually exists when there is a close family relationship or a lawful economic interest, such as a business relationship where the death of the insured would cause financial loss. STOLI attempts to evade this rule by having a third party with no true insurable interest initiate or finance a policy for the purpose of benefiting from the insured's death.
That is why C. Insurable interest is the correct answer. The problem with STOLI is not trust ownership itself, since trusts may be used legally in life insurance planning when properly established. It is also not primarily about rescission rights or commission sharing. The key statutory violation is that the policy is effectively procured by or for someone who lacks a lawful interest in the insured's continued life. New York licensing materials treat this as contrary to public policy and inconsistent with lawful life insurance underwriting standards.
NEW QUESTION # 18
If a mother and child are without life insurance, what is the MAXIMUM amount of insurance the mother can purchase on the life of her dependent 5-year-old daughter?
Answer: B
Explanation:
The correct answer is $25,000 . Under New York Insurance Law § 3207(b) , life insurance may be written on the life of a minor under age 14 years and 6 months by a person who has an insurable interest in that child or on whom the child depends for support. However, the amount that may be issued is limited. For a minor over age 4 years and 6 months , the maximum is $25,000 or 50% of the life insurance in force on the life of the person effecting the insurance, whichever is greater .
Here, the daughter is 5 years old , so she falls into the "over 4 years and 6 months" category. The mother and child are both described as without life insurance , so there is no insurance in force on the mother's life to create a larger 50% comparison amount. That leaves the statutory base maximum of $25,000 .
The other answers are incorrect because $10,000 is below the permitted maximum, $50,000 exceeds the statutory limit in this fact pattern, and there is definitely not "no limit" under New York law.
NEW QUESTION # 19
Predicting an individual ' s future earning potential and determining how much of that amount would be devoted to his dependents incorporates the
Answer: A
Explanation:
The correct answer is human life value approach . In life insurance planning, the human life value approach is used to estimate the economic value of an insured person's future earnings to those who depend on that income. It focuses on the idea that an individual's life has an insurable value based on the amount of income he or she is expected to earn in the future and the portion of that income that would have been used to support dependents. This method is commonly applied when determining how much life insurance is needed to replace the financial contribution of a wage earner.
Under this approach, factors such as current earnings, future earning capacity, years until retirement, inflation, taxes, and personal living expenses are considered. The amount available to dependents is then projected to help establish an appropriate death benefit.
The other options do not fit this definition. The needs approach centers on the survivors' financial needs after death, not strictly on future income value. "Loss exposure" and "salary projection" are not the standard life insurance need-analysis terms tested for this concept. Therefore, the correct answer is human life value approach .
NEW QUESTION # 20
With regard to Disability Insurance, the waiting period is to
Answer: C
Explanation:
The correct answer is A. exclude payments for a short-term illness. In disability income insurance, the waiting period , also called the elimination period , is the period of time that must pass after a covered disability begins before benefits become payable. Its primary purpose is to prevent the policy from paying for very brief or temporary disabilities and to reduce the insurer's exposure to small, short-duration claims. Because many minor illnesses or injuries resolve quickly, the waiting period acts like a time deductible rather than a dollar deductible.
This makes choice A the best answer. The waiting period is not used to measure the severity of the illness, so B is incorrect. It is also not intended to calculate medical expenses, because disability insurance pays based on loss of income rather than reimbursement of medical bills, making C incorrect. D is also incorrect because policy eligibility is determined through underwriting and contract terms, not by the waiting period itself.
Therefore, the waiting period in disability insurance is mainly used to exclude benefits for short-term illnesses or disabilities and help keep premiums more affordable.
NEW QUESTION # 21
The policy provision describing the responsibilities of the master policyowner is in
Answer: C
Explanation:
The correct answer is A. group health policies . In a group health insurance plan , the actual contract is issued to the master policyowner , usually an employer, association, or trust. Because that party owns the master contract, the policy contains provisions describing the policyowner's responsibilities, such as premium remittance, eligibility administration, enrollment procedures, and notice requirements. Those duties belong in the group policy itself , not in the individual evidence given to insured members.
A certificate of coverage is provided to each covered employee or member to summarize benefits, exclusions, and rights under the group plan, but it is not the master contract and does not serve as the document that sets out the policyowner's contractual responsibilities. Choices C and D are incorrect because individual health or individual medical policies are issued directly to an individual policyowner, so there is no separate "master policyowner" structure as found in group insurance.
On licensing examinations, whenever the question refers to the master policyowner , it is a strong indicator that the subject is group insurance , making group health policies the correct choice.
NEW QUESTION # 22
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