17 Free Tennessee Life & Health Practice Questions: Accident & Health Concepts, Field Underwriting and Tennessee A&H Rules (2026)

Question 1 (Chapter 6)

Maria has a short‑term injury that prevents her from performing any of the duties of her regular occupation for three months, after which she returns to work part‑time earning 60% of her pre‑injury wages. Which type of disability benefit would most likely apply to the income she earns while working part‑time?

• A) Total disability benefit
• B) Partial disability benefit
• C) Recurrent disability benefit
• D) Residual disability benefit

Question 2 (Chapter 6)

Emily designates her husband as the primary beneficiary and her parents as contingent beneficiaries on her accidental death policy. If Emily predeceases her husband, who will receive the death benefit?

• A) Emily’s estate
• B) The insurer retains the benefit
• C) Emily’s children, if any, even though they are not named
• D) Emily’s parents

Question 3 (Chapter 6)

A disability rider in an accident & health policy states that benefits are payable only for injuries sustained while performing job duties. Which type of coverage is this an example of?

• A) Non‑occupational disability coverage
• B) Residual disability coverage
• C) Total disability coverage
• D) Occupational disability coverage

Question 4 (Chapter 6)

Which of the following elements is NOT a required component of a valid insurance contract under Tennessee contract law?

• A) Specific performance
• B) Offer
• C) Consideration
• D) Mutual assent

Question 5 (Chapter 6)

Which of the following is a prohibited provision in a standardized Medicare Supplement (Medigap) policy?

• A) A clause limiting benefits to services rendered in Tennessee only.
• B) A provision that requires the insured to obtain prior authorization for all services.
• C) A requirement that the insured must maintain continuous coverage for at least two years before filing a claim.
• D) A statement that the policy will not pay for any services received from a provider who does not accept Medicare assignment.

Question 6 (Chapter 6)

Under Tennessee law, which of the following statements accurately describes the insurable interest requirement for an accident and health policy on the life of another person?

• A) Insurable interest exists only if the policyowner is a blood relative of the insured.
• B) Insurable interest is not required for accident and health policies in Tennessee.
• C) Insurable interest exists only if the policyowner pays the premiums.
• D) Insurable interest exists if the policyowner would suffer a pecuniary loss from the insured's sickness, disability, or death.

Question 7 (Chapter 6)

During field underwriting in Tennessee, a producer completes an application for accident and health insurance and collects the initial premium. The application is submitted to the insurer for underwriting. If the policy is approved, when must the producer deliver the policy to the insured under Tennessee field underwriting procedures?

• A) Within 24 hours of approval.
• B) Only after the insured pays the first full year's premium in advance.
• C) Within 10 business days of application submission, regardless of approval status.
• D) Upon receipt of the policy from the insurer, without unnecessary delay.

Question 8 (Chapter 6)

A Tennessee employer with 50 employees offers a group accident and health plan. An employee who works 25 hours per week is denied coverage because the plan requires 30 hours per week for eligibility. The employee claims this violates Tennessee's group policy laws. Is the employee correct?

• A) Yes, because Tennessee law requires group plans to cover all employees working 20 or more hours per week.
• B) Yes, because the Affordable Care Act overrides Tennessee law and requires coverage for all part-time employees.
• C) No, but only if the employer has fewer than 20 employees.
• D) No, because Tennessee law allows group plans to set uniform eligibility requirements based on hours worked.

Question 9 (Chapter 6)

Which of the following is a mandated coverage that must be offered in Tennessee individual and group accident and health policies under Tenn. Code Ann. §§56-7-1002 and 56-7-1003?

• A) Coverage for inpatient mental health services equal to medical/surgical benefits.
• B) Coverage for annual vision exams for adults.
• C) Coverage for dental cleanings for children under age 12.
• D) Coverage for elective cosmetic surgery procedures.

Question 10 (Chapter 6)

Under Tennessee law, which of the following statements is true regarding the external review process for adverse benefit determinations under Tenn. Code Ann. §§56-61-113 and 56-61-116?

• A) The insured must exhaust the insurer's internal appeals process before requesting an external review.
• B) External review is available only for denials of experimental or investigational treatments.
• C) The insurer selects the independent review organization (IRO) that conducts the external review.
• D) External review decisions are not binding on the insurer.

Question 11 (Chapter 6)

A Tennessee employer offers a group health plan requiring employees to work 30 hours per week for eligibility. An employee working 28 hours per week is denied coverage. The employee claims this violates Tennessee's group insurance laws. Is the employee correct?

• A) No, because Tenn. Code Ann. §56-26-127 allows the policy to set eligibility requirements, including minimum hours worked.
• B) Yes, because Tennessee law prohibits any hourly eligibility requirements for group health plans.
• C) Yes, because the employee is close to the threshold and should be covered under Tennessee's 'substantial compliance' rule.
• D) No, but only if the employee works at least 20 hours per week, as that is the state minimum.

Question 12 (Chapter 6)

Which of the following is NOT an element of a valid insurance contract under Tennessee contract law?

• A) Offer and acceptance
• B) Consideration
• C) Insurable interest
• D) Profit motive for the insurer

Question 13 (Chapter 6)

A Tennessee resident has an individual health policy with a residual disability benefit. After a back injury, they return to work in a modified role earning 50% of their pre-disability income. The policy defines residual disability as a loss of income of at least 20% and pays a benefit equal to the percentage of income loss multiplied by the monthly disability benefit of $3,000. What is the monthly residual disability benefit?

• A) $600
• B) $900
• C) $1,500
• D) $3,000

Question 14 (Chapter 6)

A Tennessee resident is covered under both an employer-sponsored group health plan and an individual Medicare Supplement policy. They incur $12,000 in hospital expenses. The group plan pays $8,000. Under coordination of benefits rules, what is the maximum amount the Medicare Supplement policy can pay for these expenses?

• A) $8,000
• B) $4,000
• C) $12,000
• D) $0

Question 15 (Chapter 6)

A Tennessee resident has an individual health policy with a total disability benefit of $2,000 per month. After a back injury, they are unable to perform any duties of their regular occupation for two months, then return to work part-time earning 40% of their pre-disability income. The policy includes a residual disability rider that pays benefits when the insured suffers a loss of income of at least 20% due to disability, calculated as the percentage of income loss multiplied by the monthly disability benefit. What is the monthly residual disability benefit for the third month?

• A) $400
• B) $1,200
• C) $600
• D) $2,000

Question 16 (Chapter 6)

During field underwriting for an individual accident and health policy in Tennessee, a producer collects the initial premium and submits the application to the insurer. The policy is approved. According to Tennessee field underwriting procedures and the Pearson VUE content outline, when must the producer deliver the policy to the insured?

• A) Within 10 days of approval.
• B) Upon receipt of the policy from the insurer, with no specific timeframe mandated by Tennessee law.
• C) Within 30 days of the application date.
• D) Only after the second premium payment is received.

Question 17 (Chapter 6)

John is the policyowner of a group health plan but is not the insured. He wishes to change the primary beneficiary from his spouse to his adult child. Under Tennessee law, which of the following statements is correct?

• A) John may change the beneficiary only if the insured consents in writing.
• B) John must obtain a court order before making any beneficiary change.
• C) John may change the beneficiary only if the insurer approves the change in writing.
• D) John can change the beneficiary without the insured’s consent because the policyowner has that right.