17 Free Kansas Accident & Health Insurance Exam Practice Questions (2026)
How to Use This Accident & Health Question Set
The accident and health questions in this set draw on the accident and health general knowledge sections of Pearson VUE's content outline for the combined KS Life and Accident & Health Producer exam (12-KS-05): Types of Policies at 16, Policy Provisions, Clauses and Riders at 15, Social Insurance at 6, Other Insurance Concepts at 5 and Field Underwriting Procedures at 8. On that exam they sit beside four life general knowledge sections and the three sections of Kansas law. The exam is 154 items, 140 scored plus 14 unscored pretest, in 150 minutes for $64, with one score for the whole exam and a pass mark of 70 percent.
A candidate who wants only the Accident & Health line can book the single-line exam (12-KS-02) instead: 95 items, 84 scored plus 11 pretest, in 90 minutes for $57, with the same 70 percent standard. Either exam is taken in person at a Pearson VUE test center. Kansas requires no pre-licensing course, and initial resident applicants are fingerprinted for a criminal history check as a standard step of the application.
The 17 questions are drawn from Chapters 6 and 7 of LanePrep's Kansas Life & Health quiz bank, and none repeats a question from the free 25-question sample across the whole exam: 11 on accident and health policy types, provisions and riders (Chapter 6) and 6 on social insurance, other health concepts and field underwriting (Chapter 7). On the combined exam those chapters are worth 31 and 19 of the 140 scored items, and Chapter 6 is the heaviest chapter in the course. The grouping is LanePrep's own, not Pearson VUE's: Chapter 6 teaches the Types of Policies section together with Policy Provisions, Clauses and Riders, and Chapter 7 teaches Social Insurance, Other Insurance Concepts and Field Underwriting Procedures. The Kansas law questions are in the free 25-question set. Every question is labeled with its chapter, so each miss points you to the audio lesson to replay.
For context, the NAIC reports pass rates for the combined exam, the exam this course follows, of 56.8 percent in 2024 and 58.8 percent in 2025, counting all candidates and both testing modes together.
Answer each one before you open the explanation. The explanation is folded underneath every question. A guess you have to defend is worth more than an answer you only agree with.
Practice Questions 1-6: The Time Limit on Certain Defenses, Intermediate Care, Key Employee Disability, HRAs, Point of Service Plans and Pre-Authorization
Chapter 6 opens the Health set with a policy provision, a long-term care level of care and three plan and product types. It asks what an insurer can do about an undisclosed condition once the Time Limit on Certain Defenses provision applies, and what Intermediate Care means in a long-term care policy. It then asks which policy protects a corporation against the disability of its top sales manager, what is true of a Health Reimbursement Account, and which two plan types a Point of Service plan combines. Question 6 closes the section with the likely consequence of scheduling elective surgery without pre-authorization.
Question 1 (Chapter 6)
An applicant for an individual health policy fails to disclose a chronic back condition on the application. Three years later, they file a claim related to that condition. Under the 'Time Limit on Certain Defenses' provision, what action can the insurer take?
- A) The insurer can deny the claim only if they can prove the omission was a fraudulent misstatement
- B) Void the policy and refund all premiums
- C) Deny the claim because the condition was pre-existing and undisclosed
- D) The insurer must pay the claim because the two-year contestability period has passed
Show answer & explanation
Answer: A
Under the 'Time limit on certain defenses' provision in K.S.A. 40-2203(A)(2), after two years from the date of issue no misstatements, except fraudulent misstatements, made by the applicant in the application may be used to void the policy or to deny a claim for a loss or disability that begins after the two years. A claim made three years after the application therefore cannot be denied just because a chronic back condition was left off the application, and a pre-existing condition that the policy does not exclude by name or specific description cannot be the ground either. The insurer can deny the claim only if it proves that the omission was a fraudulent misstatement.
Question 2 (Chapter 6)
A Long-Term Care (LTC) policy provides coverage for 'Intermediate Care.' What does this typically mean?
- A) Continuous 24-hour nursing care under the direction of a physician
- B) Assistance with Activities of Daily Living (ADLs) provided by non-medical staff
- C) Care provided in the insured's home by family members
- D) Occasional nursing or rehabilitative care provided by medical personnel
Show answer & explanation
Answer: D
Intermediate care is occasional nursing or rehabilitative care provided by skilled medical personnel for stable conditions. Skilled care (A) is 24/7, and Custodial care (B) is assistance with ADLs provided by non-medical personnel.
Question 3 (Chapter 6)
A corporation in Lawrence wants to protect itself against the financial loss that would occur if its top-performing sales manager became disabled. Which policy should the company purchase?
- A) Group Long-Term Disability
- B) Business Overhead Expense
- C) Workers' Compensation
- D) Key Employee Disability Insurance
Show answer & explanation
Answer: D
Key Employee Disability insurance is owned by the business, and the benefits are paid to the business to cover the costs of recruiting and training a replacement or to offset lost profits while the key employee is disabled.
Question 4 (Chapter 6)
An employer in Topeka establishes a Health Reimbursement Account (HRA) for its employees. Which of the following is a true characteristic of an HRA?
- A) Employees must contribute at least 2% of their salary via payroll deduction.
- B) It must be paired with a High Deductible Health Plan (HDHP).
- C) Remaining funds must be forfeited to the state at the end of the year.
- D) It is funded entirely by employer contributions.
Show answer & explanation
Answer: D
HRAs are employer-funded plans that reimburse employees for taxed-qualified medical expenses. Unlike HSAs, they do not require an HDHP, and unlike FSAs, they are funded solely by the employer, not through employee salary reductions.
Question 5 (Chapter 6)
A Point of Service (POS) plan is often described as a hybrid of which two types of plans?
- A) Major Medical and Basic Hospital
- B) Medicare and Medicaid
- C) HSA and HRA
- D) HMO and PPO
Show answer & explanation
Answer: D
POS plans combine features of HMOs (using a Primary Care Physician as a gatekeeper for in-network care) and PPOs (allowing the insured to go out-of-network for a higher cost).
Question 6 (Chapter 6)
An insured's medical policy requires 'Pre-authorization' for elective surgeries. If the insured schedules a knee replacement without notifying the insurer first, what is the likely consequence?
- A) The claim will be paid in full regardless.
- B) The benefit may be reduced or the claim denied.
- C) The insurer will cancel the policy for breach of contract.
- D) The surgeon will be fined by the Kansas Department of Insurance.
Show answer & explanation
Answer: B
Pre-authorization (or prior approval) allows the insurer to determine if a procedure is medically necessary. Failure to obtain it often results in a financial penalty, such as a 50% reduction in benefits or a complete denial of the claim.
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Practice Questions 7-12: Cancellable Policies, Partial Disability, Non-Occupational Coverage, the AD&D Time Limit, Skilled Nursing Care and the Taxation of Disability Benefits
Chapter 6 continues with renewability, disability income and long-term care: the policy an insurer may cancel at any time with written notice, what a partial disability benefit typically pays, and how a group policy written on a non-occupational basis responds to an injury that happens off the job. Two more questions follow: how an AD&D policy pays when the insured dies some weeks after a car accident, and which level of long-term care describes round-the-clock care under a physician's supervision. Chapter 7 begins with how the benefits of an individual disability income policy are taxed when the insured paid the premiums with after-tax dollars.
Question 7 (Chapter 6)
A policyholder has a health insurance policy that the insurer may cancel at any time, provided they give written notice and refund any unearned premium. What type of renewability is this?
- A) Noncancellable
- B) Guaranteed Renewable
- C) Cancellable
- D) Conditionally Renewable
Show answer & explanation
Answer: C
A 'Cancellable' policy allows the insurer to cancel the policy at any time for any reason, as long as they provide proper notice and return unearned premiums. This is the least favorable renewability provision for the insured.
Question 8 (Chapter 6)
An insured has a disability income policy that defines 'Partial Disability' as the inability to perform one or more important duties of their occupation. How much does a partial disability benefit typically pay?
- A) 100% of the total disability benefit
- B) 50% of the total disability benefit for a limited time
- C) A percentage based on the exact loss of income
- D) Only the cost of medical prescriptions
Show answer & explanation
Answer: B
Partial disability benefits are typically intended to encourage people to return to work part-time. They usually pay a flat 50% of the total disability benefit for a short duration (e.g., 3 to 6 months).
Question 9 (Chapter 6)
A project manager in Wichita is covered by a group disability income policy provided by her employer. She is injured while rock climbing on her personal time and is unable to work for three months. If her policy is written on a 'non-occupational' basis, how will the insurer respond?
- A) The insurer will deny the claim because the injury did not occur at work.
- B) The insurer will only pay if the insured can prove the injury was not her fault.
- C) The insurer will pay the claim because non-occupational policies cover disabilities occurring off the job.
- D) The insurer will pay the claim only if she has exhausted her Workers' Compensation benefits first.
Show answer & explanation
Answer: C
Non-occupational coverage is designed specifically to cover disabilities that occur outside of the workplace. Since Workers' Compensation covers on-the-job injuries, most group disability plans are non-occupational to avoid duplication of benefits. Occupational coverage (covering both on and off the job) is more common in individual policies.
Question 10 (Chapter 6)
An insured has an Accidental Death and Dismemberment (AD&D) policy. He is involved in a car accident and dies from his injuries 60 days later. How will the policy pay?
- A) It will pay nothing because he did not die at the scene of the accident.
- B) It will pay the Capital Sum because the death was delayed.
- C) It will pay the Principal Sum because the death occurred within 90 days of the accident.
- D) It will pay only the return of premiums paid.
Show answer & explanation
Answer: C
Most AD&D policies require that death occur within 90 days of the accident for the Principal Sum to be payable. Since 60 days is within that window, the full death benefit is paid.
Question 11 (Chapter 6)
An elderly man requires 24-hour care that can only be performed by licensed medical professionals under the direct supervision of a physician. Which level of care in a Long-Term Care policy does this describe?
- A) Intermediate Care
- B) Custodial Care
- C) Skilled Nursing Care
- D) Home Health Care
Show answer & explanation
Answer: C
Skilled Nursing Care is daily nursing and rehabilitative care that can only be performed by, or under the supervision of, skilled medical personnel and is based on a doctor's orders.
Question 12 (Chapter 7)
An individual purchases an individual Disability Income policy and pays the premiums with after-tax dollars. If they become disabled and receive monthly benefit payments, how are those benefits treated for federal income tax purposes?
- A) Fully taxable as ordinary income
- B) Only the portion exceeding the cost basis is taxed
- C) Tax-deferred until retirement
- D) Tax-free
Show answer & explanation
Answer: D
When an individual pays for a disability income policy with after-tax dollars (non-deductible premiums), the benefits received are tax-free. If an employer pays the premium and does not include it in the employee's gross income, the benefits would be taxable.
Practice Questions 13-17: The Social Security Disability Definition, Contracts of Adhesion, the Notice Regarding Replacement, Creditable Coverage and the Fair Credit Reporting Act
Chapter 7 closes the Health set with social insurance and other insurance concepts: how Social Security defines disability for SSDI benefits, why an insurance contract is called a contract of adhesion, and the notice a producer gives an applicant who is replacing a health policy. The last two questions cover a retiree who drops employer coverage for Medicare Part D and the rights a consumer keeps under the Fair Credit Reporting Act after a denial based on a credit report.
Question 13 (Chapter 7)
To qualify for Social Security Disability Income (SSDI) benefits, a worker must meet a very strict definition of disability. Which of the following best describes this requirement?
- A) The inability to perform the worker's 'own occupation' for at least 12 months.
- B) A partial disability that reduces the worker's income by at least 50%.
- C) A temporary disability that prevents work for at least 90 days.
- D) The inability to engage in any 'gainful employment' due to a physical or mental impairment expected to last at least 12 months or result in death.
Show answer & explanation
Answer: D
Social Security uses an 'any occupation' or 'total disability' definition. The impairment must be so severe that the individual cannot perform any substantial gainful work and the condition must be expected to last at least 12 months or end in death. Distractor A describes a private 'own occupation' definition. Distractor B describes residual or partial disability, which Social Security does not cover. Distractor C is too short; the minimum expected duration is 12 months.
Question 14 (Chapter 7)
An insurance contract is considered a 'Contract of Adhesion' because:
- A) The insurer writes the contract and the applicant must 'adhere' to it as-is.
- B) The values exchanged are unequal.
- C) Only the insurer makes a legally binding promise.
- D) It is dependent on the occurrence of an uncertain event.
Show answer & explanation
Answer: A
Adhesion means the contract is drafted by one party (the insurer) and the other party (the applicant) has no power to negotiate the terms. Because of this, courts usually rule in favor of the insured if the contract language is ambiguous.
Question 15 (Chapter 7)
A Kansas producer is helping a client replace an existing health insurance policy. Which of the following is a primary duty of the producer during this process?
- A) Contacting the existing insurer to cancel the old policy immediately.
- B) Waiving the new policy's probationary period to ensure continuous coverage.
- C) Providing the applicant with a 'Notice Regarding Replacement' signed by the applicant and the producer.
- D) Collecting a double premium to cover the transition period.
Show answer & explanation
Answer: C
When replacement is involved, the producer must provide a 'Notice Regarding Replacement' to the applicant. This disclosure warns the applicant about potential loss of benefits, new waiting periods, and the importance of not canceling the old policy until the new one is issued.
Question 16 (Chapter 7)
A 66-year-old retiree is covered by a group health plan through their former employer's retiree benefits. The retiree decides to drop this coverage and enroll in Medicare Part D. To avoid a late enrollment penalty, what must the retiree prove regarding their previous group coverage?
- A) That the previous coverage was fully insured by a Kansas-domiciled insurer.
- B) That the previous coverage was 'creditable,' meaning it was at least as good as Medicare's standard prescription drug coverage.
- C) That the previous coverage included a zero-dollar deductible for generic medications.
- D) That the retiree had been enrolled in the group plan for at least 10 years prior to retirement.
Show answer & explanation
Answer: B
To avoid the Medicare Part D late enrollment penalty, an individual must have 'creditable coverage' from another source (like an employer plan) that is actuarially equivalent to or better than Part D. If they go 63 days or more without creditable coverage after their initial enrollment period, a penalty is added to their future Part D premiums.
Question 17 (Chapter 7)
An applicant is denied health insurance because of a negative credit report. Under the Fair Credit Reporting Act, the applicant has the right to all of the following EXCEPT:
- A) Be told the name and address of the reporting agency.
- B) Obtain a summary of the information in the report.
- C) Require the insurance company to change its underwriting rules.
- D) Request a reinvestigation of incorrect information.
Show answer & explanation
Answer: C
The FCRA gives consumers rights regarding the accuracy and privacy of their data, but it does not give them the power to force an insurance company to alter its internal underwriting standards or risk appetite.
The Mistakes That Cost Marks
Misreading the Time Limit on Certain Defenses. This provision belongs to the uniform provisions of K.S.A. 40-2203 for individual accident and health policies. Once the stated time limit has passed, a misstatement in the application can no longer be used to void the policy or deny a claim unless the misstatement was fraudulent. So in question 1 the insurer can deny the claim for the undisclosed back condition only if it can prove the omission was a fraudulent misstatement. Voiding the policy and refunding premiums, denying the claim because the condition was pre-existing and undisclosed, and paying automatically because the contestability period has passed are the distractors. The same statute sets the grace period: not less than 7 days for weekly premiums, 10 days for monthly premiums and 31 days for all other premium modes.
Blurring the levels of long-term care. Intermediate care is occasional nursing or rehabilitative care provided by skilled medical personnel for stable conditions, which is the definition question 2 asks for. Skilled nursing care is daily nursing and rehabilitative care that can be performed only by, or under the supervision of, skilled medical personnel and is based on a doctor's orders; that is the level in question 11, where licensed professionals provide round-the-clock care under a physician's direct supervision. Custodial care is assistance with the activities of daily living by non-medical staff, and home health care describes a setting rather than a level of care. The distractors in question 2 swap these definitions, and care given by family members in the home is not intermediate care. Kansas gives a long-term care policy a longer right to return than the 10-day free look on an ordinary life policy: 30 days from delivery, with the premium refunded within 10 business days of the insurer's receipt of the returned policy (K.A.R. 40-4-37f).
Picking the wrong business product, plan type or utilization-review consequence. Key Employee Disability insurance is owned by the business, and the benefit is paid to the business to cover the cost of recruiting and training a replacement or to offset lost profits while the key person is disabled. Business Overhead Expense pays the ongoing costs of running the business, group long-term disability protects employees' income, and Workers' Compensation covers on-the-job injuries. A Health Reimbursement Account is funded entirely by employer contributions and reimburses employees for qualified medical expenses. Unlike an HSA it does not require a High Deductible Health Plan, and unlike an FSA it is not funded through the employee's salary. A Point of Service plan is a hybrid of an HMO and a PPO: like an HMO it uses a Primary Care Physician as gatekeeper for in-network care, and like a PPO it lets the insured go out of network at a higher cost. Pre-authorization lets the insurer decide beforehand whether a procedure is medically necessary. An insured who skips it risks a reduced benefit or a denied claim, not a cancelled policy or a fine on the surgeon.
Mixing up renewability classes and disability definitions. A policy the insurer may cancel at any time, with written notice and a refund of any unearned premium, is Cancellable, the least favorable renewability. Noncancellable, Guaranteed Renewable and Conditionally Renewable policies each limit the insurer's right to end coverage. Partial disability, defined as the inability to perform one or more important duties of the occupation, typically pays a flat share of the total disability benefit for a limited time, an incentive to return to part-time work. It does not pay the full benefit, a percentage based on the exact income lost or only the cost of prescriptions. A group disability policy written on a non-occupational basis covers disabilities that occur off the job, so the project manager injured while rock climbing is paid. Workers' Compensation covers on-the-job injuries, which is why most group disability plans are non-occupational, and she need not prove the injury was not her fault or exhaust workers' compensation first. In an AD&D policy the Principal Sum is the accidental death benefit, and most policies pay it only if death follows the accident within a stated window. Question 10 describes a death inside that window, so the Principal Sum is paid, not the Capital Sum, nothing or a return of premiums.
Getting the tax treatment backwards. When an individual pays the premiums on a disability income policy with after-tax dollars, the benefits are received tax-free. If an employer pays the premium and does not include it in the employee's taxable income, the benefits are generally taxable instead. Question 12 describes the first case, so the answer is not fully taxable income, taxation of only the part above a cost basis or deferral until retirement.
Using the wrong disability definition and the wrong reason for adhesion. Social Security uses a strict any-occupation, total disability definition for SSDI: the worker must be unable to engage in any substantial gainful employment because of a physical or mental impairment expected to last for an extended period or to result in death. An own-occupation test, a partial disability and a temporary disability do not meet it. An insurance contract is a contract of adhesion because the insurer writes it and the applicant must accept it as written, with no power to negotiate the terms, which is why courts usually rule in favor of the insured when the wording is unclear. Unequal values, a one-sided promise and dependence on an uncertain event describe other characteristics of insurance contracts, not adhesion.
Skipping the replacement notice and misreading creditable coverage and credit-report rights. When a client replaces an existing health policy, the producer must give the applicant a Notice Regarding Replacement, signed by the applicant and the producer, which warns of the possible loss of benefits and new waiting periods. The producer does not cancel the old policy immediately, waive the new policy's probationary period or collect a double premium. A retiree who drops employer group coverage and enrolls in Medicare Part D avoids the late enrollment penalty only by showing that the earlier coverage was creditable, meaning it was actuarially equivalent to or better than Medicare's standard prescription drug coverage. The insurer's domicile, a zero-dollar generic deductible and the length of enrollment in the group plan do not decide it. Under the Fair Credit Reporting Act, a consumer denied coverage because of a credit report may be told the name and address of the reporting agency, obtain a summary of the information in the report and ask for a reinvestigation of incorrect information. The consumer cannot require the insurer to change its underwriting rules, which makes that option the exception in question 17.
Your Next Step
How did you score?
13 or more correct: That is a strong result on the accident and health sections. Take the Life insurance exam set next, then read how to pass the Kansas Life & Health exam on the first try for the full study plan.
9-12 correct: You have a base but not yet a margin. Note which chapter each miss came from and replay that chapter's audio lesson before you retest.
Under 9 correct: Begin with Chapter 6 of the LanePrep Kansas Life & Health course and work through Chapter 7 before you test yourself again. A free preview is available at /ks/l-and-h/preview.
Want a sample across the whole exam instead? The free practice set has 25 questions.
Exam format, fees and content outline item counts from Pearson VUE's Kansas Insurance Licensing Candidate Handbook (publication 121700, July 2026) and Kansas Insurance Content Outlines (publication 121703, effective March 1, 2025); passing score from K.A.R. 40-7-13; individual accident and health uniform provisions from K.S.A. 40-2203; long-term care right to return from K.A.R. 40-4-37f; free-look period from K.A.R. 40-2-15; pass rates from the NAIC compiled pass-rate workbooks for 2024 and 2025. Read October 2026.
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