Virginia Life Annuities and Health Insurance サンプル問題プレビュー(抜粋)
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サンプル問題 1: For an AD&D policy with an irrevocable beneficiary designation, a change in the beneficiary can ONLY be made:
A: At the time of policy renewal
B: When an absolute assignment is attached to the policy
C: Upon the death of the current beneficiary
D: With the consent of both the policyowner and the beneficiary
正解:C
Explanation: Detailed Answer in Step-by-Step Solution: An irrevocable beneficiary has a vested interest, and the policyowner cannot change the designation without their consent unless the beneficiary dies (C), at which point the owner regains control. Option A (renewal) and B (assignment) don’t override irrevocability. Option D (consent) is true for living beneficiaries, but “ONLY” restricts it to death in this context. The Virginia study guide notes that an irrevocable beneficiary’s rights persist until death, after which the policyowner can freely change the designation. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Beneficiary Designations."
サンプル問題 2: Disability income insurance policies usually provide coverage for loss of income resulting from:
A: Self-inflicted injuries
B: Injuries incurred while in military service
C: Disability resulting from war
D: Accidental injuries
正解:D
Explanation: Detailed Answer in Step-by-Step Solution: Disability income insurance covers loss of income from accidental injuries (D), provided they aren’t excluded. Self-inflicted injuries (A), military service injuries (B), and war-related disabilities (C) are standard exclusions in most policies. The Virginia study guide specifies that disability income insurance pays for accidental or illness-related income loss, excluding self-inflicted, military, or war-related causes. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Disability Income Insurance."
サンプル問題 3: The insurance with other insurers provision in an individual health insurance policy allows an insurer to pay benefits to the insureds on a pro-rata basis when the:
A: Policy is within 31 days of the renewal date
B: Policy has entered into the grace period for premium payment
C: Insurer was not notified prior to the claim that the insured has other health coverage
D: Insured has submitted claims in excess of $2,000 during the policy year
正解:C
Explanation: The "insurance with other insurers" provision, addressed in Virginia Code § 38.2-3514, is a coordination of benefits (COB) mechanism in individual health insurance policies designed to prevent over-insurance and duplicate payments when an insured has multiple policies covering the same loss. This provision allows the insurer to prorate benefits―paying a share based on the total coverage―when certain conditions are met. Option C states that the insurer wasn’t notified prior to the claim of other coverage, which triggers proration. This aligns with standard COB rules: if the insurer isn’t informed of other policies, it may assume primary liability initially but adjust to a pro-rata share upon discovery, ensuring equitable payment across insurers. Option A (within 31 days of renewal) is irrelevant; renewal proximity doesn’t affect benefit coordination. Option B (grace period) relates to premium payment timing, not other insurance, and doesn’t trigger proration. Option D ($2,000 claim threshold) is arbitrary and not a standard condition in Virginia law or study materials for this provision. The study guide likely emphasizes notification as key to COB, as Virginia follows NAIC model regulations requiring disclosure of other coverage (e.g., via application or claim forms). Without prior notice, the insurer applies proration retroactively, making C the correct choice.
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