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Posted on: 06/03/25

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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q51-Q56):

NEW QUESTION # 51
Under the notice of claim provision, notice given to a health insurance company's agent is:

  • A. An incomplete preliminary notice of claim
  • B. Not valid notice to the company
  • C. Contrary to the uniform mandatory provisions
  • D. Notice to the company

Answer: D

Explanation:
Detailed Answer in Step-by-Step Solution:
* The notice of claim provision typically deems notice to an agent as notice to the company (B), as agents act on the insurer's behalf.
* Options A (incomplete), C (not valid), and D (contrary) contradict standard practice unless the policy specifies otherwise.
The Virginia study guide, per NAIC model laws, confirms that notice to an agent satisfies the notice of claim requirement, equating it to notice to the insurer. Reference: Virginia Life, Annuities, andHealth Insurance study guide, section on "Health Insurance Claims Provisions."


NEW QUESTION # 52
A group health insurance contract is between the:

  • A. Employer and employees
  • B. Employee and insurance company
  • C. Employer and insurance company
  • D. Employer, employees, and insurance company

Answer: C

Explanation:
Detailed Answer in Step-by-Step Solution:
* A group health insurance contract is a legal agreement between the employer (policyholder) and the insurance company (C), with employees as covered participants, not direct parties to the contract.
* Option A (employer and employees) is the employment relationship, not the insurance contract. Option B (employee and insurer) applies to individual policies. Option D (all three) overcomplicates the contractual relationship.
The Virginia study guide states that group insurance contracts are issued to the employer or group sponsor, who contracts with the insurer, while employees receive certificates of coverage. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Group Insurance."


NEW QUESTION # 53
An insurance contract that identifies individuals by relationship to a particular organization is called:

  • A. Contributory insurance
  • B. COBRA coverage
  • C. Group insurance
  • D. Health insurance

Answer: C

Explanation:
Detailed Answer in Step-by-Step Solution:
* Group insurance (B) covers individuals based on their affiliation with an organization (e.g., employees of a company), not as individuals.
* Contributory insurance (A) refers to group plans where employees pay part of the premium, but it's not the defining feature.
* Health insurance (C) is too broad, and COBRA (D) extends group coverage, not defines it.
The Virginia study guide defines group insurance as coverage tied to membership in an organization, such as an employer or association. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on
"Group Insurance."


NEW QUESTION # 54
Needs analysis is a method of life insurance planning which:

  • A. Eliminates the need for estimating future interest and inflation rates
  • B. Identifies the needs of an individual and the individual's dependents
  • C. Ignores Social Security benefit payments
  • D. Requires the team effort of the agent and home office underwriter

Answer: B

Explanation:
Detailed Answer in Step-by-Step Solution:
* Needs analysis (A) assesses an individual's and dependents' financial requirements (e.g., income replacement, debts) to determine appropriate life insurance coverage.
* It doesn't eliminate interest/inflation estimates (B), require underwriter collaboration (C), or ignore Social Security (D), which is often factored in.
The Virginia study guide describes needs analysis as a planning tool to calculate insurance needs based on personal and family financial obligations, including potential Social Security benefits. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Life Insurance Planning."


NEW QUESTION # 55
In individual health insurance, a proof of loss typically should be submitted to the insurer within:

  • A. 120 days from the date of loss
  • B. 90 days from the date of loss
  • C. 30 days from the date of loss
  • D. 60 days from the date of loss

Answer: B

Explanation:
Detailed Answer in Step-by-Step Solution:
* The proof of loss is a formal statement of a claim, and standard health insurance policies require it within 90 days of the loss (C), unless the policy specifies otherwise or state law extends it.
* Options A (30 days) and B (60 days) are too short for most policies, while D (120 days) exceeds the typical requirement.
The Virginia study guide aligns with the NAIC model laws, stating that proof of loss must typically be filed within 90 days of the loss, though insurers may accept later submissions if not prejudicial. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health InsuranceClaims Provisions."


NEW QUESTION # 56
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