NMLAHIP - New Mexico Life Accident and Health Insurance Producer

Question 1: A disability income policy states that no benefit is payable for a disability caused by sickness that first manifests within a short period immediately following the policy's effective date, though accidental injuries are covered from day one. Which provision does this describe?

The elimination period

The waiver of premium provision

The probationary period

The grace period

Question 2: An insured switches to a job more hazardous than the one listed on the health application, and after the switch suffers a covered loss, so the insurer pays a reduced benefit reflecting the ratio of premium paid to the premium that classification would have required. Which optional provision explains this?

The change of occupation provision

The misstatement of age provision

The illegal occupation provision

The relation of earnings provision

Question 3: An employer pays the entire premium for a disability income policy covering an employee and deducts that premium as a business expense, with the employee never being taxed on the premium as income. If that employee later becomes disabled and collects benefits, how are the benefits generally taxed?

The benefits are always entirely tax free

The benefits are taxed to the employer

The benefits are taxable to the employee

The benefits are a return of capital

Question 4: A disability income policy defines total disability using the phrase substantial and material duties, meaning the insured must be unable to perform the important, income producing tasks of the occupation rather than every minor task connected to the job. What does this phrase primarily limit?

The length of the elimination period

The size of the monthly benefit

The list of covered occupations

The scope of qualifying disabling duties

Question 5: A disability income policy states that it will not pay a benefit for any disability arising out of and in the course of the insured's employment, since injuries of that kind are expected to be handled through a separate employer sponsored benefit. Which type of coverage does this describe?

Nonoccupational coverage

Occupational coverage

Presumptive disability coverage

Business overhead expense coverage

Question 6: When a health insurer approves a claim, it discovers the policyowner still owes a portion of the current premium, so rather than pursuing separate collection, the insurer simply subtracts the unpaid amount from the benefit check before releasing the remainder. Which optional provision permits this deduction?

The grace period provision

The reinstatement provision

The unpaid premium provision

The payment of claims provision

Question 7: An accidental death and dismemberment policy contains a chart listing specific losses, such as one hand, one foot, or sight in one eye, each paired with the fraction of the capital sum payable for that particular loss. What is this chart commonly called?

The elimination period table

The rate classification table

The nonforfeiture options chart

The dismemberment schedule

Question 8: An insured carries similar accident and sickness coverage with several companies without disclosing that fact at application, and once discovered, each insurer becomes liable only for its proportionate share of the loss rather than the full stated benefit, with excess premium refunded. Which optional provision describes this rule?

Insurance with other insurers

Other insurance in this insurer

Coordination of benefits

Unpaid premium provision

Question 9: A policyowner misses the due date for a renewal premium, yet the health policy remains fully in force for a short additional stretch of days, during which any covered loss is still paid once the overdue premium is collected. Which provision keeps the policy active during that stretch?

The reinstatement clause

The elimination period

The grace period

The probationary period

Question 10: A disability income policy pays benefits for any qualifying disability whether the injury or sickness happens on the job, during a commute, or completely away from work, such as during a weekend recreational activity. Which type of coverage does this describe?

Nonoccupational coverage

Group coverage only

Presumptive coverage only

Occupational coverage

Question 11: Shortly after receiving a newly issued health policy, a policyowner decides the coverage is not what was expected and returns it to the insurer within the allowed window, receiving a full refund of every premium dollar paid as though the policy had never existed. Which provision permits this outcome?

The free look provision

The grace period provision

The reinstatement provision

The incontestable clause

Question 12: A section near the beginning of a health policy recites the premium payment and the statements made in the written application as what the applicant gave in exchange for the insurer's promise to provide the coverage described in the contract. Which clause is being described?

The insuring clause

The consideration clause

The entire contract provision

The waiver of premium rider

Question 13: A disability income rider promises to pay a stated additional monthly amount if the insured is disabled but is not approved for Social Security or other government disability benefits, with the rider benefit reduced or eliminated once those government benefits do begin. Which rider does this describe?

The cost of living adjustment rider

The hospital confinement rider

The social insurance supplement rider

The return of premium rider

Question 14: A disability income policy states that if the insured suffers the total and irrecoverable loss of sight in both eyes, the loss of speech, or the loss of use of two limbs, the insured is deemed totally disabled even if some capacity to work remains. Which provision does this describe?

The probationary period provision

The change of occupation provision

The recurrent disability provision

The presumptive disability provision

Question 15: Near the front of a health policy, a short statement identifies the specific perils the insurer agrees to cover and sets out the insurer's basic promise to pay benefits for a loss resulting from those covered causes. Which policy clause makes this foundational promise?

The insuring clause

The consideration clause

The free look provision

The probationary period

Question 16: An insured is covered under two separate group health plans through different employers, and a provision designates one plan as primary payer and the other as secondary payer so that the combined reimbursement never exceeds the actual covered expense incurred. Which provision performs this sequencing function?

Other insurance in this insurer

Coordination of benefits

Insurance with other insurers

Relation of earnings to insurance

Question 17: A disability buyout policy funding a partnership buy-sell agreement carries an elimination period lasting many months longer than a typical individual disability income policy, and it pays the purchase price as a lump sum or installments rather than as ongoing monthly income. Why is the elimination period set so long?

To reduce the business's total premium cost

To match a typical short waiting time

To confirm the disability is truly permanent

To delay payment until the partner retires

Question 18: A disability income policy's waiver of premium provision requires the insured to be disabled for a stated number of months before premiums are waived, but once that threshold is met, the provision also refunds any premiums the insured paid during that qualifying span. What best describes this combined feature?

A permanent exclusion of all future premiums

An elimination period applied to premium billing

A nonforfeiture option converting cash value

A qualifying period with retroactive premium refund

Question 19: A health policy defines the span of time during which it will continue paying benefits for a single covered loss, and once that span expires, no further payments are made for that loss even if the disability or medical condition has not resolved. Which concept describes this defined span?

The benefit period

The elimination period

The probationary period

The grace period

Question 20: Rather than declining an applicant with a known knee problem entirely, an insurer issues the health policy but attaches a document permanently excluding coverage for that specific knee condition, allowing the policy to be issued without a general premium surcharge. Which rider accomplishes this substandard risk solution?

The guaranteed insurability rider

The impairment rider

The future increase option rider

The waiver of premium rider

NMLAHIP New Mexico Life Accident and Health Insurance Producer - Set 4 - Part 1

Question 1: A disability income policy states that no benefit is payable for a disability caused by sickness that first manifests within a short period immediately following the policy's effective date, though accidental injuries are covered from day one. Which provision does this describe?

Question 7: An accidental death and dismemberment policy contains a chart listing specific losses, such as one hand, one foot, or sight in one eye, each paired with the fraction of the capital sum payable for that particular loss. What is this chart commonly called?

Question 9: A policyowner misses the due date for a renewal premium, yet the health policy remains fully in force for a short additional stretch of days, during which any covered loss is still paid once the overdue premium is collected. Which provision keeps the policy active during that stretch?

Question 10: A disability income policy pays benefits for any qualifying disability whether the injury or sickness happens on the job, during a commute, or completely away from work, such as during a weekend recreational activity. Which type of coverage does this describe?

Question 12: A section near the beginning of a health policy recites the premium payment and the statements made in the written application as what the applicant gave in exchange for the insurer's promise to provide the coverage described in the contract. Which clause is being described?

Question 14: A disability income policy states that if the insured suffers the total and irrecoverable loss of sight in both eyes, the loss of speech, or the loss of use of two limbs, the insured is deemed totally disabled even if some capacity to work remains. Which provision does this describe?

Question 15: Near the front of a health policy, a short statement identifies the specific perils the insurer agrees to cover and sets out the insurer's basic promise to pay benefits for a loss resulting from those covered causes. Which policy clause makes this foundational promise?

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