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Title: Free PDF Insurance Licensing - PA-Life-Accident-and-Health¨CReliable Pdf Demo Dow [Print This Page]
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Title: Free PDF Insurance Licensing - PA-Life-Accident-and-Health¨CReliable Pdf Demo Dow
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Insurance Licensing Pennsylvania Life, Accident and Health Exam Sample Questions (Q156-Q161):NEW QUESTION # 156
The two perils in health insurance are accident and
Answer: B
Explanation:
In Pennsylvania Accident and Health Insurance terminology, the two fundamentalperilscovered by health insurance policies areaccident and sickness. A peril is defined as the cause of a loss, and health insurance is designed to protect against losses resulting from unexpected injuries or illnesses.
Accident coverage addresses bodily injuries caused by accidental means, such as falls or car accidents.
Sickness coverage addresses illnesses or diseases that manifest after the policy becomes effective.
Pennsylvania insurance study guides emphasize that both perils must be present for a policy to qualify as comprehensive accident and health coverage.
The other options listed are incorrect. Loss is the result of a peril, not a peril itself. Job-related injuries are typically covered under workers' compensation, not individual health insurance. Liability is a legal responsibility exposure, not a health insurance peril.
Therefore, the correct and verified answer issickness, making option B correct.

NEW QUESTION # 157
A Key Person Disability Income Policy pays benefits to the
Answer: C
Explanation:
AKey Person Disability Income Policyis designed to protect a business from the financial loss that may result if a key employee becomes disabled. Under Pennsylvania insurance principles, theemployeris the policyowner, premium payer, and beneficiary of the policy. If the key person becomes disabled, benefits are paid directly to the employer.
These benefits help the business offset lost revenue, cover the cost of hiring temporary replacements, or manage ongoing expenses during the employee's disability. Unlike personal disability income policies, key person disability coverage does not pay benefits to the employee, spouse, or dependents.
Pennsylvania Life and Health Insurance study guides highlight key person disability insurance as a business continuation and risk management tool. Since the purpose of the policy is to protect the business rather than the individual, benefits are paid to the employer. Therefore, option D is the correct and verified answer.

NEW QUESTION # 158
(EXCEPT for fraud, what is the time limit after issue for an insurer to deny an individual health insurance claim based on material misrepresentation in the application for the insurance?
Answer: C
Explanation:
Pennsylvania individual health insurance policies include anincontestability provision. Except in cases of fraud, insurers may deny claims based on material misrepresentationonly within the first three yearsafter the policy is issued. After this period, statements made in the application become incontestable, even if they were inaccurate. This rule protects insureds by providing long-term policy certainty and aligns with Pennsylvania statutory insurance standards. Fraud remains the sole exception, allowing denial at any time. The other options do not reflect the legally mandated incontestability timeframe.

NEW QUESTION # 159
Which is NOT a characteristic of a major medical expense policy?
Answer: A
Explanation:
Amajor medical expense policyunder Pennsylvania Accident and Health Insurance guidelines is designed to provide broad coverage for catastrophic medical costs. These policies are characterized by several standard features, includingdeductibles,coinsurance, andstop-loss limits.
Deductibles require the insured to pay a specified amount before coverage begins. Coinsurance requires the insured to share a percentage of covered expenses after the deductible is met. Stop-loss limits protect the insured by capping out-of-pocket expenses, after which the insurer pays 100% of covered costs.
Anelimination period, however, is not a feature of major medical insurance. Elimination periods apply primarily todisability income policies, where benefits begin only after a waiting period following the onset of disability. Medical expense policies pay based on incurred expenses rather than elapsed time.
Because elimination periods do not apply to major medical expense coverage, option C is the correct and verified answer under Pennsylvania insurance documentation.

NEW QUESTION # 160
What is the annuity payment option that provides an income for a guaranteed period of time whether or not the annuitant is alive?
Answer: B
Explanation:
Theperiod certain annuity payout optionguarantees income payments for a specified period of time, such as
10, 15, or 20 years, regardless of whether the annuitant is alive. Under Pennsylvania annuity principles, if the annuitant dies before the end of the guaranteed period, payments continue to the named beneficiary for the remainder of that period.
This option differs from life income annuities, which pay only while the annuitant is alive, and joint and survivor options, which require two annuitants and continue payments until the second annuitant dies. Refund life options combine lifetime income with a guarantee that at least the premium paid will be returned, but they still depend on the annuitant's lifetime.
Pennsylvania Life, Accident, and Health Insurance study materials emphasize that a period certain annuity does not guarantee income for life; instead, it guarantees income for a set period of time. Because payments are made whether or not the annuitant is alive during that period, option B is the correct and verified answer.

NEW QUESTION # 161
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