Die Insurance Licensing NY-Life-Accident-and-Health Prüfungsfragen und Antworten (NY-Life-Accident-and-Health) von ExamFragen ist eine Garantie für eine erfolgreiche Prüfung! Bisher fällt noch keiner unserer Kandidaten durch! Falls jemand bei der Zertifizierungsprüfung durchfallen sollte, zahlen wir 100% Material-Gebühr zurück. Wir übernehmen die volle Geld-zurück-Garantie auf Ihre Zertifizierungsprüfungen! Unsere NY-Life-Accident-and-Health Fragen und Antoworten (New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55) sind aus dem Fragenpool, alle sind echt und original.
| Section | Weight | Objectives |
|---|---|---|
| New York State Regulations | 20-25% | - Consumer protection regulations - Fiduciary responsibilities - Licensing requirements and procedures - NYS Insurance Law requirements - Advertising regulations - Replacement and churn rules |
| Life Insurance Fundamentals | 25-30% | - Beneficiary designations - Policy riders and endorsements - Policy types and provisions - Dividends and nonforfeiture options - Policy reinstatement |
| Accident and Health Insurance | 25-30% | - Long-term care insurance basics - Disability income insurance - Medical expense coverage - Major medical coverage - Health insurance policy types (individual, group, HMOs) - Dental and vision insurance basics |
| General Insurance Principles | 15-20% | - Agent/broker duties and ethics - Underwriting principles - Fair claims settlement practices - Insurance contract fundamentals - Ethical sales practices |
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93. Frage
The statement, " Any person who knowingly and with intent to defraud any insurer or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty... " MUST appear in all New York
Antwort: A
Begründung:
The correct answer is applications for insurance and on all claim forms . Under New York insurance law , insurers are required to include a fraud warning statement on certain insurance documents to help prevent fraudulent insurance activities. This warning informs applicants and claimants that knowingly providing false information or concealing material facts for the purpose of misleading an insurer constitutes insurance fraud , which is a criminal offense and may also lead to civil penalties.
The regulation specifically requires that this fraud notice appear on all insurance applications and claim forms used within the state. The purpose is to ensure that individuals are clearly informed of the legal consequences of submitting false information when applying for insurance coverage or when filing a claim. By placing the warning directly on these documents, New York aims to discourage fraudulent behavior and strengthen compliance with insurance regulations.
The other options are incorrect because the fraud warning requirement does not apply broadly to general insurance communications, public documents, or credit applications. Instead, the law targets the two most critical documents where fraud might occur- insurance applications and claim forms .
94. Frage
In a health insurance policy, an insured has an out-of-pocket limit of $10,000, a deductible of $500, and an
80%/20% coinsurance. The insured incurs $50,000 of covered losses in an accident. How much will the insurer have to pay?
Antwort: C
Begründung:
The correct answer is $39,600 . To determine the insurer's payment, the deductible and coinsurance provisions must be applied to the total covered medical expenses. First, the insured must pay the $500 deductible . Subtracting this amount from the total covered losses of $50,000 leaves $49,500 of eligible expenses subject to coinsurance.
Under an 80/20 coinsurance arrangement , the insurer pays 80% of the covered expenses and the insured pays
20% . Applying the insurer's portion to the remaining amount:
80% × $49,500 = $39,600 .
Therefore, the insurer's payment equals $39,600 , while the insured would pay the deductible plus their coinsurance share. Although the policy mentions a $10,000 out-of-pocket limit , the insured's cost in this situation (the $500 deductible plus 20% of the remaining expenses) does not exceed that limit , so the limit does not affect the calculation.
Thus, after applying the deductible and coinsurance provisions, the insurer pays $39,600 , making Option B the correct answer.
95. Frage
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?
Antwort: D
Begründung:
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.
96. Frage
If a partner of a company becomes permanently disabled, which type of plan will allow the other partner to acquire the disabled partner's interest in the company?
Antwort: C
Begründung:
A disability buy-sell agreement (often funded with disability buyout insurance) is specifically designed to address the business ownership problem created when an owner/partner becomes totally and permanently disabled . The agreement establishes, in advance, the terms under which the non-disabled partner(s) can purchase the disabled partner's ownership interest , providing an orderly transfer of control and a fair method to determine the buyout price. The insurance component supplies the cash needed to complete the purchase so the remaining partner is not forced to borrow, liquidate assets, or disrupt operations to raise funds. By contrast, long-term disability and employee disability coverage are aimed at replacing personal income for the disabled individual, not transferring ownership interests. Business overhead expense insurance reimburses ongoing fixed business expenses (rent, utilities, certain salaries) during the owner's disability; it helps keep the business running but does not create a mechanism for one partner to acquire the other partner's share.
Therefore, the provision that enables acquisition of the disabled partner's interest is the disability buy-sell agreement.
97. Frage
With the majority of companies, within how many days does the free-look provision allow the insured the right to return the life insurance policy for full premium?
Antwort: A
Begründung:
The free-look provision in life insurance policies allows a policyowner a specific period after receiving the policy to review the contract and decide whether to keep it. During this period, the policyowner may return the policy to the insurer or the agent and receive a full refund of any premium paid , with the contract treated as if it had never been issued. For most life insurance policies, the standard free-look period used by the majority of insurers is 10 days , making B the correct answer.
The purpose of the free-look provision is to protect consumers by giving them time to carefully review the policy provisions, benefits, exclusions, riders, and premium obligations after delivery. If the policyholder finds that the policy does not meet their expectations or financial needs, they can cancel without penalty during the free-look timeframe.
In many licensing materials and insurer training programs, including those aligned with New York Life Accident and Health study outlines, 10 days is the commonly tested free-look period for traditional life insurance policies. Some situations-such as replacement policies or certain senior policies-may allow longer review periods depending on state regulations, but 10 days remains the standard benchmark used in exam questions.
98. Frage
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