Insurance Licensing Updated InsNV_Health02 Exam Questions and Answers by payton

A Medicare Supplement insurer must provide an Outline of Coverage to the applicant at the time the application is presented. The outline is a consumer-disclosure document designed to summarize the policy’s principal benefits, premiums, limitations, exclusions, and other important features before the applicant makes a final purchasing decision.

The outline is not the insurance contract itself. The policy contains the full contractual rights and obligations, but the outline allows an applicant to compare Medicare Supplement plans in a clear and standardized format. It helps the consumer understand how the policy works with Original Medicare and whether it duplicates other existing coverage.

If the issued policy differs from the coverage described in the original outline, the insurer must provide a substitute outline describing the policy actually issued when delivering it. That later document does not change the initial requirement: the first outline is provided at application.

The premium-payment date and claim-submission date occur too late to serve the purpose of pre- sale disclosure. The key examination concept is timing: applicants receive the Outline of Coverage before purchasing the Medicare Supplement policy.

Study Guide references/topics: Medicare Supplement insurance; consumer disclosures; Outline of Coverage; NAC 687B.250 .

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The correct answer is D. Underwriting for an individual disability income policy focuses on facts that affect the proposed insured’s probability of disability, ability to work, existing income protection, and potential for overinsurance. Marital status and occupation may be relevant to financial and occupational underwriting. Medical history is directly relevant because past and current health conditions can affect eligibility, exclusions, ratings, or benefit limitations. Other disability policies already in force are important because insurers must evaluate the total amount of disability benefits relative to earned income and avoid excessive coverage. The spouse’s occupation ordinarily does not determine the proposed insured’s disability risk or benefit eligibility and is therefore the least relevant item. Insurers also may request information about income, employer, job duties, hazardous activities, tobacco use, prior claims, and other sources of disability income. The producer must obtain complete and accurate answers from the applicant, explain questions when necessary, and avoid making assumptions or completing answers without the applicant’s direction. Study Guide References/Topics: Completing the Application, Underwriting, and Delivering the Policy; Disability Income Underwriting; Application Information.

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Major medical insurance is designed to provide broad protection against substantial medical expenses. It commonly covers hospital, surgical, physician, diagnostic, and other medically necessary services, subject to deductibles, coinsurance, exclusions, and stated policy limits. Therefore, choice D is correct. A major medical policy is not limited to in-hospital expenses; that description is more characteristic of basic hospital coverage. It also is generally broader—not more limited—than a basic hospital, medical, or surgical policy. A 30-day elimination period is associated more closely with disability income insurance and does not define major medical coverage. The phrase “reasonable and necessary” is important because it allows the insurer to evaluate whether a service was medically appropriate and whether the charge falls within the policy’s payment standard. Major medical policies are comprehensive, but they are not unlimited: coverage remains subject to deductibles, coinsurance, exclusions, maximum benefits, network terms, and utilization requirements. Study Guide References/Topics: Types of Health Insurance Policies; Major Medical Expense Insurance; Medical Expense Coverage.

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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 .