NYLAHI New York Life, Accident & Health Insurance exam - Set 4 - Part 1

Test your knowledge of technical writing concepts with these practice questions. Each question includes detailed explanations to help you understand the correct answers.

Question 1: Which required health policy provision sets a waiting period before an insured may sue the insurer and a deadline after which no suit may be brought?

The time of payment provision

The reinstatement provision

The grace period

The legal actions provision

Question 2: Which provision permits the insurer, at its own expense, to examine the insured during a claim and to require an autopsy where state law does not forbid it?

The proof of loss provision

The physical examination and autopsy provision

The insuring clause

The consideration clause

Question 3: Under a health policy, unless the beneficiary was named irrevocably, which provision lets the policyowner name a new beneficiary at any time?

The assignment provision

The entire contract provision

The change of beneficiary provision

The legal actions provision

Question 4: A disability income policy that pays full benefits when the insured cannot perform the duties of their own regular job uses which definition of total disability?

The own-occupation definition

The any-occupation definition

The presumptive definition

The residual definition

Question 5: A stricter disability definition that pays benefits only when the insured cannot work at any job for which they are suited by education or experience is which of the following?

The own-occupation definition

The split definition

The presumptive definition

The any-occupation definition

Question 6: A provision that automatically treats the insured as totally disabled upon the loss of sight, hearing, speech, or the use of two limbs is known as which of the following?

Residual disability

Partial disability

Presumptive disability

Recurrent disability

Question 7: The waiting period at the start of a disability claim during which no benefits are paid, functioning like a deductible measured in time, is known as which of the following?

The probationary period

The elimination period

The benefit period

The grace period

Question 8: The maximum length of time a disability income policy will continue paying benefits for a single period of disability is known as which of the following?

The benefit period

The elimination period

The probationary period

The accumulation period

Question 9: An insured returns to work after a disability but earns much less than before. Which benefit pays an amount proportionate to the income the insured has lost?

The presumptive benefit

The total disability benefit

The waiver of premium benefit

The residual disability benefit

Question 10: The period right after a disability policy takes effect during which sickness-related claims are not yet covered, though accidents may be, is known as which of the following?

The elimination period

The benefit period

The probationary period

The free look period

Question 11: Which disability policy feature keeps the coverage in force without further premium payments once the insured has been totally disabled for the elimination period?

The waiver of premium provision

The residual benefit

The presumptive provision

The recurrent disability provision

Question 12: A disability rider that pays an extra benefit only when the insured fails to qualify for, or receives reduced, Social Security disability benefits is best described as which of the following?

The cost of living rider

The social insurance supplement

The guaranteed insurability rider

The return of premium rider

Question 13: A disability policy that reimburses a disabled business owner for ongoing office expenses such as rent, utilities, and staff salaries is best described as which of the following?

A key person disability policy

A disability buy-sell policy

A residual disability policy

A business overhead expense policy

Question 14: A business buys disability coverage on an essential employee so the firm receives funds to cope if that person becomes disabled. This is best described as which of the following?

Key person disability insurance

Business overhead expense insurance

A disability buy-sell plan

Group long-term disability

Question 15: A policy that funds the purchase of a disabled owner's share of a business by the remaining owners is best described as which of the following?

A business overhead expense policy

A key person policy

A disability buy-sell policy

A residual disability policy

Question 16: Employer-provided disability coverage that replaces income for a brief span, often a few weeks to several months, before long-term coverage begins is best described as which of the following?

Long-term disability insurance

Short-term disability insurance

Business overhead insurance

Presumptive disability insurance

Question 17: A managed care plan that requires members to choose a primary care physician and get referrals before seeing specialists, emphasizing prepaid in-network care, is which of the following?

A preferred provider organization

An indemnity plan

A point-of-service plan

A health maintenance organization

Question 18: A managed care plan that lets members use any provider but rewards them with lower cost-sharing for using its contracted network is best described as which of the following?

A preferred provider organization

A health maintenance organization

An exclusive provider organization

A staff-model HMO

Question 19: A managed care plan that blends HMO and PPO features, using a primary care physician but allowing out-of-network care at higher cost, is best described as which of the following?

An exclusive provider organization

An indemnity plan

A point-of-service plan

A staff-model HMO

Question 20: A managed care plan that covers care only from its own network, with no benefits for out-of-network providers except emergencies, yet does not require referrals, is which of the following?

A point-of-service plan

An exclusive provider organization

A preferred provider organization

A traditional indemnity plan

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