1.
In insurance, an offer is usually made when
Correct Answer
C. The application is submitted.
Explanation
In insurance, the offer is usually made by the applicant in the form of the application. Acceptance occurs when the underwriter approves the application, provided it's accompanied by the initial premium. Otherwise, acceptance occurs when the insurer receives payment, after the application has been approved.
2.
An insured stated on her application for life insurance that she had never had a heart attack, when in fact she had a series of minor heart attacks last year for which she sought medical attention. Which of the following will explain the reason a death benefit claim is denied?
Correct Answer
B. Material misrepresentation
Explanation
A material misrepresentation will affect whether or not a policy is issued. If the insured had been truthful, it is very likely that the policy would not be issued.
3.
If only one party to an insurance contract has made a legally enforceable promise, what kind of contract is it?
Correct Answer
C. Unilateral
Explanation
In a unilateral contract, only one of the parties to the contract is legally bound to do anything.
4.
Contracts that are prepared by one party and submitted to the other party on a "take it or leave it" basis are classified as
Correct Answer
A. Contracts of adhesion
Explanation
Insurance policies are written by the insurer and submitted to the insured on a "take it or leave it" basis. The insured does not have any input into the contract, but simply adheres to the contract.
5.
The importance of a misrepresentation is determined by
Correct Answer
B. The materiality of a given concealment.
Explanation
The materiality of a given concealment determines the importance of a misrepresentation
6.
An intentional or unintentional concealment entitles the affected party to which of the following?
Correct Answer
C. Rescission of a contract.
Explanation
Concealment, whether intentional or unintentional, entitles the affected party to rescind the insurance policy.
7.
Which of the following is NOT correct regarding false statements by a person engaged in the business of insurance?
Correct Answer
A. Oral statements cannot be considered fraud.
Explanation
According to Title 18, Sections 1033 & 1034 of the U.S. Code, any oral or written statements by any person engaged in the business of insurance that are false or any omissions of material fact are considered unlawful insurance fraud.
8.
Which of the following is NOT a required element of an insurance contract?
Correct Answer
D. Counteroffer
Explanation
Each contract must have the following 4 elements: agreement (offer and acceptance), legal purpose, competent parties, and consideration. Counteroffer, while sometimes used as part of the agreement, is not a required element.
9.
When an insured makes truthful statements on the application for insurance and pays the required premium, it is known as which of the following?
Correct Answer
A. Consideration
Explanation
Consideration is something of value that each party gives to the other. The consideration on the part of the insured is the payment of premium and the representations made in the application.
10.
An insured wants to transfer his personal insurance policy to a friend. Under what conditions would this be possible?
Correct Answer
B. The insured will need a written consent of the insurer.
Explanation
A personal insurance contract is written between an insurance company and an individual, and the company has a right to decide with whom it will and will not do business. An insured can transfer an insurance contract to another person, but he or she must first obtain the written consent of the insurer.
11.
Insurance contracts have unique characteristics not usually found in other types of contracts. They require each party to rely upon the representations of the other and reasonably expect the other is acting without attempts to conceal or deceive. This is known as
Correct Answer
A. Utmost good faith.
Explanation
If it can be shown that either party did not act in "utmost good faith", the other party may void the insurance contract.
12.
Which of the following best describes a misrepresentation?
Correct Answer
B. A statement intended to distract, mislead, or deceive a party to a contract.
Explanation
Misrepresentation is a written or oral statement that is intended to distract, mislead, or deceive a party to a contract.
13.
The key factor of representation that allows the injured party to rescind the contract is
Correct Answer
A. If the representation is false in a material point.
Explanation
If a representation is false in a material point the injured party is entitled to rescind the contract from the time the representation becomes false.
14.
In insurance policies, the insured is not legally bound to any particular action in the insurance contract, but the insurer is legally obligated to pay losses covered by the policy. What contract element does this describe?
Correct Answer
B. Unilateral
Explanation
In a unilateral contract, the insured is not legally bound to do anything. The insurer, however, must pay losses covered by the policy.
15.
The failure to disclose all known facts is called
Correct Answer
B. Concealment
Explanation
Withholding information that is material to the risk to be insured is concealment and makes a policy voidable.
16.
When may a representation be withdrawn?
Correct Answer
C. Prior to the issuance of the policy
Explanation
Once the policy is issued, representations cannot be withdrawn.
17.
Which of the following is an absolute statement to the insurer by the insured upon which the validity of the insurance policy depends?
Correct Answer
C. Warranty
Explanation
A warranty is an absolutely true statement to the insurer by the insured upon which the validity of the insurance policy depends.
18.
Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company?
Correct Answer
C. Aleatory
Explanation
An insurance contract is an aleatory contract in that it requires a relatively small amount of premium for a large risk.
19.
Fraudulent activities in health care are estimated in billions of dollars annually. This results in
Correct Answer
B. Increase in health care costs for everyone.
Explanation
Although there is no exact figure it is believed that fraudulent activities account for billions of dollars annually in added health care cost nationally. This results in a significant increase in health care costs for everyone. (CIC 1871)
20.
Which of the following would be covered by contract law?
Correct Answer
B. An insured suing the insurer for failure to provide promised benefits.
Explanation
Contract law applies to voluntarily undertaken written agreements between parties. The insurer’s failure to provide promised benefits to the insured would be in breach of contract, therefore, covered by contract law. All other scenarios illustrate tort law, which provides a remedy for civil, non-contractual wrong through legal action.
21.
Statements made by an applicant for a life insurance policy that are true to the best of the applicant's knowledge are referred to as
Correct Answer
C. Representations
Explanation
Representations are statements that the applicant believes to be true, but that are not guaranteed.
22.
Under what conditions would a contract between an insurer and prospective insured be legal?
Correct Answer
D. The applicant has been convicted of a felony.
Explanation
When an insurer and insured enter into a contract, both parties must be of legal age and mentally competent. It is legal for a person convicted of a felony to buy an insurance contract. An intoxicated person, however, may not be mentally competent, and a 12-year-old student is considered to be underage in most states.
23.
When an insured makes truthful statements on the application for insurance and pays the required premium, it is known as which of the following?
Correct Answer
C. Consideration
Explanation
Consideration is something of value that each party gives to the other. The consideration on the part of the insured is the payment of premium and the representations made in the application.
24.
Insurance policy is
Correct Answer
B. A written instrument in which a contract of insurance is set forth.
Explanation
An insurance policy must be in writing to be legally binding. As defined by the California Insurance Code, "a policy" is a written instrument in which a contract of insurance is set forth.
25.
An insured wants to transfer his personal insurance policy to a friend. Under what conditions would this be possible?
Correct Answer
D. The insured will need a written consent of the insurer.
Explanation
A personal insurance contract is written between an insurance company and an individual, and the company has a right to decide with whom it will and will not do business. An insured can transfer an insurance contract to another person, but he or she must first obtain the written consent of the insurer.
26.
L’s insurer has made all of the decisions regarding the provisions included in her
policy. L finds an objectionable provision and wants to negotiate it with the insurer but is not allowed to do so. Her only options are to reject the policy or accept it as is. Which contract feature does this describe?
Correct Answer
B. Adhesion
Explanation
A contract of adhesion is prepared by only the insurer; the insured’s only option is to accept or reject the policy as it is written.
27.
What is an injured party entitled to receive if an intentional concealment is discovered?
Correct Answer
B. Rescission of the policy
Explanation
An injured party is entitled to rescind the policy regardless of whether the concealment was intentional or unintentional.
28.
Concealment as defined by the California Insurance Code is
Correct Answer
C. Neglect on the part of insured to communicate all information known to be material to the insurer.
Explanation
Concealment is a legal term for the intentional withholding of information by the insured that is material to the insurer (i.e. critical in making an underwriting decision). Information that is known or should be known, waived by the other party or immaterial to the risk, does not need to be communicated in a contract.
29.
An insured pays a small $100 premium every month, yet the insurer promises to pay a high percentage of all medical costs. What element of an insurance contract does this describe?
Correct Answer
A. Aleatory
Explanation
In an aleatory contract, unequal amounts are exchanged between payments and benefits. In this instance, the insured receives a large benefit for a small price.
30.
Intentionally misrepresenting or concealing a material fact to induce an insurance company to make a contract is known as
Correct Answer
C. Fraud.
Explanation
Fraud is the intentional misrepresentation or intentional concealment of a material fact used to induce another party to make or refrain from making a contract, or to deceive or cheat a party.
31.
What other term is used to refer to unintentional torts?
Correct Answer
C. Negligence
Explanation
an unintentional tort is the result of acting without proper care. This is generally referred to as negligence
32.
The proposed insured makes the premium payment on a new insurance policy. if the insured should dies, the insurer will pay the death benefit to the beneficiary if the policy is approved. this is an example of what kind of contract?
Correct Answer
D. Conditional
Explanation
A conditional contract requires both the insurer and policy owner to meet certain conditions before the contract can be executed, unlike other types of policies, which put the burden of condition on either the insurer or the policy owner.
33.
The written instrument, in which a contract of insurance is set forth, is known as the
Correct Answer
C. Policy
Explanation
A policy is the written instrument that sets forth the terms and conditions of a contract of insurance. It outlines the coverage provided by the insurance company and the obligations of the insured. The policy serves as a legal document that both parties can refer to in case of any disputes or claims. It is a crucial component of the insurance contract as it defines the scope of coverage and the rights and responsibilities of both the insurer and the insured.