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Free Accident and Health Agent Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Accident and Health Agent practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A self-employed consultant wants monthly income if a disability prevents her from performing her job and earning a living. Which policy best addresses that loss?

    1. A. Business overhead expense disability policy
    2. B. Individual disability income policy
    3. C. Business disability buyout policy
    4. D. Key employee disability income policy

    Answer: B

    Explanation: "provides income if a worker is unable to perform their job duties and earn money due to a disability" Her own earnings are at risk; business overhead and buyout protect different business interests.

    Reference: NAIC, Simplifying the Complications of Disability Insurance — Disability Insurance, paragraphs 1–2

  2. 2A claimant finds an attached endorsement that changes an accident and sickness policy's benefits. Under the entire-contract provision, which papers govern the claim?

    1. A. The policy together with its endorsements and attached papers
    2. B. The policy together with the producer's later oral assurances
    3. C. The application alone, even if the policy has endorsements
    4. D. The insurer's current sales brochure and rate illustration

    Answer: A

    Explanation: "This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance." The attached endorsement is part of the policy contract; later oral assurances or marketing papers do not replace the identified contract papers.

    Reference: NAIC, Uniform Individual Accident and Sickness Policy Provision Law — NAIC Uniform Individual Accident and Sickness Policy Provisions Law, Entire Contract provision

  3. 3A Medicare beneficiary chooses to receive Medicare health and drug benefits through a Medicare-approved private health plan instead of Original Medicare. Which coverage path did the beneficiary choose?

    1. A. Original Medicare Parts A and B alone
    2. B. Medicare Supplement insurance alongside Parts A and B
    3. C. Medicare Advantage, also called Part C
    4. D. Medicaid coverage administered by a state

    Answer: C

    Explanation: "Medicare Advantage offers an alternative to Original Medicare for your health and drug needs. You get benefits through a private health plan that Medicare approved." Part C is Medicare Advantage, the Medicare-approved private-plan alternative. Medigap supplements Original Medicare and Medicaid is a separate program.

    Reference: Medicare.gov, Parts of Medicare — Medicare.gov, Parts of Medicare, Medicare Advantage (Part C)

  4. 4A disability insured can still work part time after an injury, but earnings are substantially below pre-disability income. Which benefit addresses that income gap?

    1. A. A residual disability benefit tied to reduced earnings
    2. B. An accidental death benefit tied to a fatal injury
    3. C. A business overhead benefit tied to office expenses
    4. D. A waiver of premium tied to policy payments

    Answer: A

    Explanation: "Residual Benefit(s) - This coverage fills the gap in income if you are partially disabled, resulting in reduced income." Residual benefits address reduced earnings during partial disability. The other benefits pay for different losses or obligations.

    Reference: NAIC, Simplifying the Complications of Disability Insurance — NAIC, Simplifying the Complications of Disability Insurance, Residual Benefits

  5. 5A producer completes an individual health application for a person who already has accident and sickness coverage. What information should the application elicit about the new policy?

    1. A. Whether the new insurance is intended to replace existing coverage
    2. B. Whether the insurer has already paid the old policy's claims
    3. C. Whether the applicant has received a Medicare card
    4. D. Whether the employer will pay every future premium

    Answer: A

    Explanation: "Ensure individual health applications include a question designed to elicit information as to whether the insurance to be issued is intended to replace any other accident and sickness insurance presently in force." The application should identify whether new coverage is intended to replace an existing accident and sickness policy. That fact then supports the separate replacement-notice step.

    Reference: NAIC, Conducting the Health Examination, Chapter 24 — NAIC Market Regulation Handbook, Health Insurance Examination, Replacement

  6. 6A Tennessee resident applicant is denied a producer license and wants the Department to reconsider. By when must the applicant make the Department's informal appeal?

    1. A. Within 30 days of denial
    2. B. Within 90 days of denial
    3. C. Within one year of the initial application date
    4. D. Within two years of the initial application date

    Answer: C

    Explanation: The Department states, "An appeal must be made within one (I) year of the initial application date." The applicant therefore has one year measured from the original application date.

    Reference: Appeal Process for the Denial of an Insurance Producer License Application — The Appeals Process for Denial of a License Application

  7. 7A Tennessee producer wants to charge a service fee for an individual major medical policy. Which insurer-compensation condition must exist?

    1. A. The insurer is not paying the producer a commission
    2. B. The insurer doubles the commission
    3. C. The insurer pays only a renewal commission
    4. D. The insurer pays the fee directly

    Answer: A

    Explanation: T.C.A. § 56-6-125(b) allows such fees "where the insurer is not paying commission to the insurance producer" and the qualified-agreement conditions are met.

    Reference: Tn Code 2025 Volume 2 — T.C.A. § 56-6-125(b), p. 411

  8. 8A dentist who owns a small practice wants rent, utilities, and staff payroll paid while she recovers from a disabling illness. Which coverage fits those expenses?

    1. A. Group disability income policy
    2. B. Business disability buyout policy
    3. C. Key employee disability income policy
    4. D. Business overhead expense disability policy

    Answer: D

    Explanation: "covers standard business expenses such as payroll, utilities, rent, etc., while the business owner recovers from a disability" The stated expenses keep the practice operating; individual income replaces the owner's earnings and buyout funds an equity purchase.

    Reference: NAIC, Small Business Insurance — Disability Insurance, business overhead paragraph

  9. 9An accident and sickness policy uses the NAIC model's time-limit-on-defenses clause. After the clause's stated period has passed, which application misstatement may still be used to void the policy under that clause?

    1. A. An innocent error about an unrelated prior occupation
    2. B. A nonfraudulent error about a past medical visit
    3. C. A fraudulent misstatement made in the application
    4. D. An inadvertent omission of an old mailing address

    Answer: C

    Explanation: "After three (3) years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for the policy shall be used to void the policy" The model clause preserves the fraud exception after its own stated period. This question asks about the model clause and does not assign its three-year example to Tennessee law.

    Reference: NAIC, Uniform Individual Accident and Sickness Policy Provision Law — NAIC Uniform Individual Accident and Sickness Policy Provisions Law, Time Limit on Certain Defenses provision

  10. 10An applicant with low income asks which public insurance program may provide free or low-cost health coverage to eligible people and families. Which program fits?

    1. A. Medicare Part D prescription coverage
    2. B. Medicaid health coverage
    3. C. Social Security retirement benefits
    4. D. Medigap supplemental insurance

    Answer: B

    Explanation: "Insurance program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities." Medicaid is the public health coverage program described. The other choices have distinct purposes and are not the low-income coverage program in the cited definition.

    Reference: CMS, Medicaid Glossary — HealthCare.gov, Medicaid definition

Topics in this practice bank

These topics describe the available practice for Accident and Health Agent. Review the examination outline and its sources for scope and allocation details.

  • I. Types of Policies
    • A. Disability income
    • A. Disability income — 1. Individual disability income policy
    • A. Disability income — 2. Business overhead expense policy
    • A. Disability income — 3. Business disability buyout policy
    • A. Disability income — 4. Group disability income policy
    • A. Disability income — 5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C. Medical expense insurance — 1. Basic hospital, medical, and surgical policies
    • C. Medical expense insurance — 2. Major medical policies
    • C. Medical expense insurance — 3. Health Maintenance Organizations (HMOs)
    • C. Medical expense insurance — 4. Preferred Provider Organizations (PPOs)
    • C. Medical expense insurance — 5. Point of Service (POS) plans
    • C. Medical expense insurance — 6. Flexible Spending Accounts (FSAs)
    • C. Medical expense insurance — 7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C. Medical expense insurance — 8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E. Group insurance — 1. Differences between individual and group contracts
    • E. Group insurance — 2. General characteristics
    • E. Group insurance — 3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F. Individual/Group Long Term Care (LTC) — 1. Eligibility
    • F. Individual/Group Long Term Care (LTC) — 2. Levels of care
    • G. Other policies
    • G. Other policies — 1. Dental
    • G. Other policies — 2. Vision
    • G. Other policies — 3. Cancer
    • G. Other policies — 4. Critical illness or specified disease
    • G. Other policies — 5. Worksite (employer-sponsored)
    • G. Other policies — 6. Hospital indemnity
    • G. Other policies — 7. Short-term medical
    • G. Other policies — 8. Accident
  • II. Policy Provisions, Clauses, and Riders
    • A. Mandatory and optional provisions
    • A. Mandatory and optional provisions — 1. Entire contract
    • A. Mandatory and optional provisions — 2. Time limit on certain defenses (incontestable)
    • A. Mandatory and optional provisions — 3. Grace period
    • A. Mandatory and optional provisions — 4. Reinstatement
    • A. Mandatory and optional provisions — 5. Notice of claim
    • A. Mandatory and optional provisions — 6. Claim forms
    • A. Mandatory and optional provisions — 7. Proof of loss
    • A. Mandatory and optional provisions — 8. Time of payment of claims
    • A. Mandatory and optional provisions — 9. Payment of claims
    • A. Mandatory and optional provisions — 10. Physical examination and autopsy
    • A. Mandatory and optional provisions — 11. Legal actions
    • A. Mandatory and optional provisions — 12. Change of beneficiary
    • A. Mandatory and optional provisions — 13. Misstatement of age or gender
    • A. Mandatory and optional provisions — 14. Change of occupation
    • A. Mandatory and optional provisions — 15. Illegal occupation
    • A. Mandatory and optional provisions — 16. Relation of earnings to insurance
    • B. Other provisions and clauses
    • B. Other provisions and clauses — 1. Insuring clause
    • B. Other provisions and clauses — 2. Free look
    • B. Other provisions and clauses — 3. Consideration clause
    • B. Other provisions and clauses — 4. Probationary period
    • B. Other provisions and clauses — 5. Elimination period
    • B. Other provisions and clauses — 6. Waiver of premium
    • B. Other provisions and clauses — 7. Exclusions and limitations
    • B. Other provisions and clauses — 8. Preexisting conditions
    • B. Other provisions and clauses — 9. Coinsurance
    • B. Other provisions and clauses — 10. Deductibles
    • B. Other provisions and clauses — 11. Eligible expenses
    • B. Other provisions and clauses — 12. Copayments
    • B. Other provisions and clauses — 13. Pre-authorizations and prior approval requirements
    • B. Other provisions and clauses — 14. Usual, reasonable, and customary (URC) charges
    • B. Other provisions and clauses — 15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C. Riders — 1. Impairment/exclusions
    • C. Riders — 2. Guaranteed insurability
    • C. Riders — 3. Future increase option
    • D. Rights of renewability
    • D. Rights of renewability — 1. Noncancelable
    • D. Rights of renewability — 2. Cancelable
    • D. Rights of renewability — 3. Guaranteed renewable
  • III. Social Insurance
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • IV. Other Insurance Concepts
    • A. Total, partial, recurrent and residual disability
    • B. Owner’s rights
    • C. Dependent children benefits
    • D. Primary and contingent beneficiaries
    • E. Modes of premium payments
    • F. Nonduplication and coordination of benefits (e.g., primary vs. excess)
    • G. Occupational vs. non-occupational
    • H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.)
    • I. Managed care
    • J. Workers Compensation
    • K. Subrogation
  • V. Field Underwriting Procedures
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
    • C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.)
    • D. Submitting application (and initial premium if collected) to company for underwriting
    • E. Policy delivery
    • F. Explaining policy and its provisions, riders, exclusions, and ratings to clients
    • G. Replacement
    • H. Contract law
    • H. Contract law — 1. Elements of a contract
    • H. Contract law — 2. Insurable interest
    • H. Contract law — 3. Warranties and representations
    • H. Contract law — 4. Unique aspects of the insurance contract
    • H. Contract law — 4.a. Conditional
    • H. Contract law — 4.b. Unilateral
    • H. Contract law — 4.c. Adhesion
    • H. Contract law — 4.d. Aleatory
  • VI. Tennessee Laws, and Departmental Rules Common to Life, Accident and Health, Property and Casualty Insurance
    • A. Powers of Commissioner
    • A. Powers of Commissioner — 1. Hearings and judicial review
    • A. Powers of Commissioner — 2. Investigations
    • A. Powers of Commissioner — 3. Regulatory authority
    • A. Powers of Commissioner — 4. Penalties
    • B. Definitions
    • B. Definitions — 1. Insurance Producer
    • B. Definitions — 2. Business Entity
    • B. Definitions — 3. Limited Lines Producer
    • B. Definitions — 4. Unauthorized insurer
    • B. Definitions — 5. Compensation and referrals
    • B. Definitions — 6. Fiduciary
    • B. Definitions — 7. Domestic and Foreign Insurance Companies
    • C. License Requirements
    • C. License Requirements — 1. Insurance Producer
    • C. License Requirements — 2. Agency Appointments/Termination
    • C. License Requirements — 3. Resident/nonresident
    • C. License Requirements — 4. Exceptions
    • C. License Requirements — 4.a. Licenses
    • C. License Requirements — 4.b. Examination
    • C. License Requirements — 5. Temporary license
    • C. License Requirements — 6. License renewal
    • C. License Requirements — 7. General requirements
    • C. License Requirements — 8. Continuing Education
    • D. License Suspension/Revocation
    • D. License Suspension/Revocation — 1. General provisions
    • D. License Suspension/Revocation — 2. Notice
    • E. Unfair Practices
    • E. Unfair Practices — 1. False advertising
    • E. Unfair Practices — 2. Defamation
    • E. Unfair Practices — 3. Boycotting, coercion, and intimidation
    • E. Unfair Practices — 4. Unfair Discrimination
    • E. Unfair Practices — 5. Rebating
    • E. Unfair Practices — 6. Unfair claims settlement practices
    • E. Unfair Practices — 7. Other topics
    • F. Life and Health Guaranty Association
  • VII. Tennessee Laws, and Departmental Rules Pertinent to Accident and Health Insurance Only
    • A. Required provisions
    • B. Policy cancellation, renewal
    • C. Group policies
    • D. Blanket or franchise school insurance
    • E. School accident coverage
    • F. Medicare supplement insurance
    • F. Medicare supplement insurance — 1. Policy Terms/Definitions
    • F. Medicare supplement insurance — 2. Prohibited Policy provisions
    • F. Medicare supplement insurance — 3. Minimum standards
    • F. Medicare supplement insurance — 4. Eligibility
    • G. Long-term Care
    • H. Mandated Coverages (Offerings and Benefits)
    • I. External Review
    • J. Affordable Care Act
    • J. Affordable Care Act — 1. Exchanges/Marketplace (ACA Section 1321)
    • J. Affordable Care Act — 2. Taxes, penalties, and subsidies (ACA Section 1401, 1402)
    • J. Affordable Care Act — 3. Essential health benefits (ACA Section 1302)
    • J. Affordable Care Act — 3.a. Mental health and substance use disorder parity
    • J. Affordable Care Act — 3.b. Pediatric services
    • J. Affordable Care Act — 3.c. Preventive services
    • J. Affordable Care Act — 4. Employer notification responsibilities (ACA Section 1511-1515)
    • J. Affordable Care Act — 5. Fees for individual major medical policy when commission is not paid (56-6-125(b))

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