17 Free Utah Life & Health Practice Questions: Accident and Health Basics and Disability (2026)
How to Use This Accident and Health Basics and Disability Set
This set covers Chapter 5, Accident and Health Insurance Basics and Disability Income Insurance. On the combined exam's outline it maps to Accident and Health Insurance Basics, weighted 12%, the single largest section of the exam, and Disability Income and Related Insurance, weighted 2%.
The questions cover individual policy provisions, limited benefit policies, how disability benefits are taxed and how disability definitions pay out. Work them before opening the answers.
Practice Questions 1-6: Provisions, Indemnity Benefits and Disability Basics
The incontestability provision, a hospital indemnity calculation, taxation of employer-paid group long-term disability, residual disability, the Social Security waiting period and the grace period.
Question 1 (Chapter 5)
Under Utah Administrative Rule R590-126, which of the following is a required uniform provision in individual accident and health policies regarding the time limit on certain defenses?
- A) The insurer may contest the validity of the policy after two years from the date of issue for non-payment of premiums only.
- B) The insurer has up to three years to assert a defense based on misrepresentation in the application.
- C) The incontestability period does not apply if the insured commits fraud during the claim process.
- D) After the policy has been in force for two years during the insured's lifetime, the insurer shall have no right to contest the policy for any cause whatsoever, except non-payment of premiums.
Show answer & explanation
Answer: D
R590-126 adopts the NAIC model provision for incontestability, which states that after two years of the policy being in force during the insured's lifetime, the insurer cannot contest the policy for any reason except non-payment of premiums. Option A is incorrect because the incontestability period applies broadly, not just to non-payment of premiums, and the time frame is two years, not two years only for non-payment. Option B is incorrect as the defense period is limited to two years, not three. Option C misstates the law: fraud in a claim does not revive the incontestability period; the two-year period is based on the policy's duration, not claim conduct.
Question 2 (Chapter 5)
A Utah resident buys a hospital indemnity policy that pays $100 per day for hospitalization. The insured is hospitalized for four days due to a covered accident, with actual hospital charges of $1,200. How much will the insurer pay under the policy?
- A) $100, because hospital indemnity policies pay only for the first day of hospitalization.
- B) $1,200, because the policy reimburses actual hospital expenses up to the daily limit.
- C) $0, because the actual charges exceed the daily benefit, triggering a co-pay provision.
- D) $400, based on the daily benefit multiplied by the number of days hospitalized.
Show answer & explanation
Answer: D
Hospital indemnity policies pay a fixed, predetermined amount per day of hospitalization, regardless of actual expenses incurred. The benefit is calculated as the daily benefit amount ($100) multiplied by the number of days hospitalized (4), resulting in $400. These policies are not indemnity-based in the sense of reimbursing actual costs; they are 'indemnity' only in name, providing a set cash benefit. Option A is incorrect because benefits are payable for each day, not just the first. Option B is incorrect because hospital indemnity does not reimburse actual expenses. Option C is incorrect as there is no co-pay or expense-triggered reduction in standard hospital indemnity policies under R590-126.
Question 3 (Chapter 5)
Which of the following best describes the 'loss of income' principal type of benefit in accident and health insurance?
- A) Reimbursement for hospital room and board expenses incurred during a covered sickness or injury.
- B) A lump-sum payment upon the accidental death or dismemberment of the insured.
- C) Payment for diagnostic tests and physician visits related to a covered illness.
- D) Weekly indemnity payments designed to replace a portion of the insured's wages when they are unable to work due to a covered disability.
Show answer & explanation
Answer: D
The 'loss of income' benefit refers to disability income or weekly indemnity payments that replace a portion of lost wages when the insured is unable to work due to a covered sickness or injury. Option A describes medical expense coverage (hospitalization). Option B describes accidental death and dismemberment (AD&D) benefits. Option C describes medical expense coverage for outpatient services. Only option D correctly defines loss of income as wage replacement.
Question 4 (Chapter 5)
Which of the following best describes 'residual disability' benefit in an individual disability income policy?
- A) A benefit paid when the insured can work but suffers a loss of income due to a disability, even if they are able to perform some duties of their occupation.
- B) A benefit paid only when the insured is completely unable to work in any occupation.
- C) A lump-sum payment for the loss of use of a limb or eye due to an accident.
- D) A benefit that increases annually to keep pace with inflation, regardless of the insured's income.
Show answer & explanation
Answer: A
Residual (or partial) disability benefits are paid when the insured is able to work but experiences a loss of income (typically a defined percentage, e.g., 20% or more) due to a disability, allowing them to work in a limited capacity or in a different role. Option B describes total disability, not residual. Option C describes accidental death and dismemberment (AD&D) benefits. Option D describes a cost-of-living adjustment (COLA) rider, which is separate from the residual disability benefit itself.
Question 5 (Chapter 5)
Which statement accurately describes the five-month waiting period for Social Security Disability Insurance (SSDI) benefits?
- A) Benefits begin immediately upon approval, but the first five months are paid at a reduced rate.
- B) The waiting period applies only to Supplemental Security Income (SSI), not to SSDI.
- C) SSDI benefits are payable for the first five months of disability, after which a new application is required.
- D) The five-month waiting period starts on the date the disability begins and must be completed before any SSDI benefits are payable.
Show answer & explanation
Answer: D
For SSDI, there is a five-month full calendar month waiting period that begins with the first full month after the onset of disability. No SSDI benefits are payable for any month during this waiting period. Benefits start with the sixth full month of disability. Option A is incorrect because benefits are not paid at all during the waiting period, not at a reduced rate. Option B is incorrect; the five-month waiting period applies to SSDI, not SSI (which has no such waiting period). Option C reverses the rule; benefits are not paid for the first five months and then stopped—they begin after the waiting period ends.
Question 6 (Chapter 5)
Under Utah Administrative Rule R590-126, which of the following is a required provision regarding the grace period for premium payment in individual accident and health policies?
- A) A 7-day grace period for all premium payments
- B) A 31-day grace period for all premium payments
- C) A 10-day grace period for weekly premium payments, 31-day for monthly
- D) No grace period is required if the policy is guaranteed renewable
Show answer & explanation
Answer: C
R590-126-9 requires a grace period of 10 days for weekly premium payments and 31 days for monthly premium payments in individual accident and health policies. Option A is incorrect because 7 days is not the standard for any payment frequency under this rule. Option B is incorrect because it applies only to monthly payments, not all payments. Option D is incorrect because guaranteed renewable policies still require a grace period for premium payments as mandated by R590-126.
Get the 25-question sample set by email
Want a full-exam practice set to study offline? Drop your email — we'll send 25 questions across every content area, each with the answer and explanation.
No spam. Just the questions and one optional follow-up.
Practice Questions 7-12: Limited Benefit Policies, Claims and Renewability
A specified disease policy claim, notice of claim, guaranteed renewability, employee-paid disability taxation, cancelling for nonpayment and the replacement disclosure.
Question 7 (Chapter 5)
A Utah resident buys a specified disease policy that covers only kidney failure. The policy has a $10,000 benefit amount. Six months after the policy is issued, the insured is diagnosed with end-stage renal disease and begins dialysis. The insurer denies the claim, stating the condition manifested before the policy's effective date. Which of the following best describes the basis for this denial under R590-126?
- A) The policy excludes all diseases diagnosed within the first year of coverage.
- B) Kidney failure is not considered a 'specified disease' under Utah law.
- C) The claim is denied due to a pre-existing condition exclusion, as the condition existed prior to the policy's effective date.
- D) The insured failed to provide proof of loss within the required time frame.
Show answer & explanation
Answer: C
Under R590-126, limited benefit policies such as specified disease policies commonly exclude coverage for pre-existing conditions—health issues that existed before the policy's effective date. The denial is based on the insurer's determination that the end-stage renal disease manifested prior to coverage, triggering the pre-existing condition exclusion. Option A is incorrect because there is no universal first-year disease diagnosis exclusion in R590-126. Option B is incorrect because kidney failure can be a covered specified disease if the policy explicitly includes it. Option D is incorrect because the scenario does not mention any issue with proof of loss timing; the denial is based on pre-existing condition.
Question 8 (Chapter 5)
Under Utah Administrative Rule R590-126, which of the following is a required provision regarding the notice of claim in individual accident and health policies?
- A) Notice of claim must be given to the insurer within 20 days after a loss.
- B) Notice of claim must be given to the insurer within 60 days after a loss.
- C) Notice of claim must be given to the insurer within 30 days after a loss.
- D) Notice of claim must be given to the insurer within 90 days after a loss.
Show answer & explanation
Answer: A
A is correct. The uniform notice-of-claim provision for individual accident and health policies requires written notice within 20 days after the occurrence or start of a covered loss, or as soon thereafter as is reasonably possible. B, C and D state longer periods; the 90-day figure belongs to the proof-of-loss provision, not the notice of claim.
Question 9 (Chapter 5)
Under Utah Administrative Rule R590-126, which of the following statements is true regarding the renewal provision for guaranteed renewable individual accident and health policies?
- A) The insurer may increase premiums based on the insured's age or change in health status.
- B) The insurer has the right to non-renew the policy for any reason with 30 days' notice.
- C) The insurer must renew the policy but may increase premiums only on a class basis.
- D) The policy automatically terminates if the insured files two claims in a policy year.
Show answer & explanation
Answer: C
For guaranteed renewable policies under R590-126, the insurer must renew the policy to the guaranteed renewable age or for life, but may change premiums only if the change applies to all policies in the same class. Option A is incorrect because premium increases cannot be based on individual health status. Option B is incorrect as the insurer cannot non-renew a guaranteed renewable policy except for nonpayment of premium. Option D is incorrect as there is no such automatic termination provision for filing claims.
Question 10 (Chapter 5)
Which of the following statements is true regarding the taxation of disability income benefits when the employee pays the premium for a group long-term disability (LTD) plan with after-tax dollars?
- A) The benefits are fully taxable as ordinary income.
- B) The benefits are partially taxable based on the employee's tax bracket.
- C) The benefits are received income-tax-free because the premium was paid with after-tax dollars.
- D) The benefits are tax-free only if the disability is work-related.
Show answer & explanation
Answer: C
When an employee pays the premium for group LTD with after-tax dollars, the benefits are received income-tax-free. This is because the premium was not deducted from pre-tax income, so the benefit is not considered taxable income. Option A is incorrect as it describes the tax treatment when the employer pays the premium. Option B is incorrect as there is no partial taxation based on tax bracket in this scenario. Option D is incorrect as work-relatedness does not determine taxability in this context.
Question 11 (Chapter 5)
Under Utah Administrative Rule R590-126, which of the following is a required provision regarding the insurer's right to cancel an individual accident and health policy for nonpayment of premium?
- A) The insurer may cancel immediately if premium is not paid by the due date.
- B) The insurer may cancel after providing 10 days' notice following the grace period.
- C) The insurer may cancel after providing notice following the grace period if premium remains unpaid.
- D) The insurer may cancel only at the end of the policy year.
Show answer & explanation
Answer: C
R590-126-9 allows the insurer to cancel the policy for nonpayment of premium, but only after the grace period has expired and after providing notice to the insured. Option A is incorrect because cancellation cannot occur during the grace period. Option B specifies 10 days' notice, which is not required by R590-126. Option D is incorrect because cancellation is not limited to the policy year end.
Question 12 (Chapter 5)
A Utah producer is helping a client replace an existing individual major medical policy with a new comprehensive major medical policy. Under R590-126-9 and R590-233, which of the following disclosures is the producer REQUIRED to provide to the applicant?
- A) A written notice that the replacement policy may contain a new pre-existing condition limitation and a new contestability period
- B) A comparison of premium rates only
- C) A verbal explanation that the new policy's benefits are identical to the old policy
- D) A signed statement from the applicant waiving all rights under the existing policy
Show answer & explanation
Answer: A
Utah Administrative Rules R590-126-9 and R590-233 require producers to provide a written disclosure notice when replacing accident and health coverage, specifically warning that the new policy may impose a new pre-existing condition limitation period and a new contestability period, which could reduce or eliminate coverage for conditions previously covered. Option B is insufficient. Option C is factually incorrect and not a required disclosure. Option D is not a regulatory requirement and would be inappropriate.
Practice Questions 13-17: Disability Definitions, Taxation and Accident-Only Benefits
Own-occupation and any-occupation definitions applied to real occupations, a mixed group and individual taxation question, premium changes on a renewable policy and an accident-only dismemberment benefit.
Question 13 (Chapter 5)
A Utah resident purchases an individual disability income policy with an 'own occupation' definition of disability and a 90-day elimination period. The insured, a surgeon, develops a hand tremor that prevents performing surgery but can still teach medical students full-time. After the elimination period, what benefit is the insured eligible for?
- A) No benefit, because the insured is still working and earning income
- B) Full monthly benefit, because the insured cannot perform the material duties of their own occupation as a surgeon
- C) Partial benefit equal to 50% of the monthly benefit
- D) Benefit only if the insured also qualifies for Social Security disability
Show answer & explanation
Answer: B
An 'own occupation' disability definition pays benefits if the insured cannot perform the material and substantial duties of their specific occupation, even if they can work in another capacity. The surgeon cannot perform surgery (their own occupation) but can teach — this constitutes total disability under an own-occupation definition. Option A describes an 'any occupation' definition. Option C describes residual/partial disability, which applies when the insured can still perform some duties of their own occupation. Option D is incorrect; private disability benefits are not contingent on SSDI approval.
Question 14 (Chapter 5)
A Utah resident is covered under a group short-term disability (STD) plan where the employer pays 100% of the premium. The employee also has an individual disability income policy paid with after-tax dollars. The employee becomes disabled and receives benefits from both policies. Which of the following statements is correct regarding the taxation of these benefits?
- A) The group STD benefit is taxable; the individual policy benefit is tax-free
- B) Both the group STD and individual policy benefits are taxable
- C) The group STD benefit is tax-free; the individual policy benefit is taxable
- D) Both benefits are tax-free because they are for disability
Show answer & explanation
Answer: A
Employer-paid group disability premiums result in taxable benefits to the employee. Individual disability income premiums paid with after-tax dollars produce tax-free benefits. This is a fundamental tax distinction. Option B incorrectly taxes the individual policy benefit. Option C reverses the tax treatment. Option D ignores the premium-payer rule.
Question 15 (Chapter 5)
Under Utah Administrative Rule R590-126, which of the following is a required provision regarding the insurer's right to change premiums on an individual accident and health policy that is not guaranteed renewable?
- A) The insurer may change premiums only on the policy anniversary date with 45 days' notice to the insured.
- B) The insurer may change premiums at any time with 30 days' notice to the insured.
- C) The insurer may change premiums only on the policy anniversary date, provided the change is based on the insured's age and is applied uniformly to all in the same class.
- D) The insurer may not change premiums after the policy is issued.
Show answer & explanation
Answer: C
For non-guaranteed renewable individual accident and health policies under R590-126, the insurer may change premiums only on the policy anniversary date. The change must be based on factors such as age and must be applied uniformly to all insureds in the same class. Option A is incorrect because notice is not specified as 45 days in R590-126 (it is 30 days for some provisions, but not for premium changes). Option B is incorrect because premium changes are not allowed at any time—they are restricted to the anniversary date. Option D is incorrect because non-guaranteed renewable policies do allow premium changes under specific conditions.
Question 16 (Chapter 5)
A Utah resident purchases an individual disability income policy with an 'any-occupation' definition of disability and a 6-month elimination period. The insured, a construction worker, suffers a back injury that prevents heavy lifting but allows light desk work. After the elimination period, what benefit is the insured eligible for?
- A) Full disability benefit because they cannot perform their regular occupation.
- B) Partial disability benefit based on lost income.
- C) No benefit because they can perform some gainful occupation.
- D) Full benefit only if they are totally unable to work in any occupation.
Show answer & explanation
Answer: C
Under an 'any-occupation' definition of disability, benefits are payable only if the insured is unable to perform the duties of any gainful occupation for which they are reasonably suited by education, training, or experience. Since the insured can perform light desk work, they are not disabled under this definition and are not eligible for benefits. Option A is incorrect because inability to perform the regular occupation is insufficient under any-occupation. Option B is incorrect as partial disability benefits typically require an own-occupation policy or a residual disability rider, which is not indicated here. Option D describes the correct standard but incorrectly concludes eligibility; the insured can work, so no benefit is payable.
Question 17 (Chapter 5)
A Utah resident purchases an accident-only policy that provides a $300 lump-sum benefit for accidental death and a $150 benefit for loss of one hand. The insured loses one hand in a home workshop accident that is determined to be accidental. The insurer pays the claim. What is the most likely basis for this payment?
- A) The loss is a covered accidental dismemberment under the policy's terms.
- B) The loss occurred during the policy's incontestability period.
- C) The insured had no pre-existing conditions affecting the hand.
- D) The accident occurred while the insured was engaged in occupational duties.
Show answer & explanation
Answer: A
Accident-only policies pay a lump-sum benefit for specific losses like loss of a hand if the loss is due to an accident and falls within the policy's defined dismemberment benefits. The insured lost one hand in an accidental manner, triggering the $150 benefit. Option B is incorrect as the incontestability period relates to the insurer's right to deny based on misrepresentation, not the cause of loss. Option C is incorrect because pre-existing conditions are not a factor in accidental dismemberment claims under accident-only policies. Option D is incorrect as occupational vs. nonoccupational status does not affect the payout for accidental dismemberment in an individual accident-only policy; the policy covers accidents regardless of context unless specifically excluded.
The Mistakes That Cost Marks
Getting the premium-payer tax rule backwards. If the employer pays the premium and it is not taxed to the employee, the benefit is taxable. If the employee pays with after-tax dollars, the benefit is tax-free. Questions 3, 10 and 14 all rest on this.
Own occupation against any occupation. An own-occupation definition pays when you cannot do your own job even if you can work elsewhere. An any-occupation definition does not pay if you can do some gainful work you are suited for.
Confusing a hospital indemnity benefit with reimbursement. It pays a fixed daily amount times the days in hospital, whatever the bill says.
Mixing notice of claim with proof of loss. They are separate provisions with separate time periods.
Mistaking residual for total disability. Residual pays for lost income when you can still work in part.
Missing the renewability classes. Guaranteed renewable lets the insurer change premiums only on a class basis, not for one insured's health.
Your Next Step
Missed more than a few? Go back to the audio for Chapter 5, then retest. When you are ready for the whole exam, the course preview lets you try LanePrep's Utah Life and Accident & Health course, and the free Utah practice question set samples every part of the outline. To see how this topic fits the exam, read the format and outline page.
Free: 25 Utah L&H practice questions
Liked this article? Get 25 exam-style questions emailed to you — with full answer explanations, no credit card. Closest thing to studying offline.
No spam. Just the questions and one optional follow-up.
Study this topic with LanePrep
Listen to these audio chapters on your commute — no screen required.
Related Articles
How to Pass the Utah Life & Health Exam on the First Try (2026)
8 min read
$157 All-In: Utah Life & Health License Cost 2026
8 min read
25 Free Utah Life, Accident & Health Exam Practice Questions (2026)
25 min read
17 Free Utah Life & Health Practice Questions: General Insurance and Life Basics (2026)
17 min read
17 Free Utah Life & Health Practice Questions: Life Policies, Provisions and Riders (2026)
16 min read