17 Free Arizona Life & Health Practice Questions: Individual Accident and Health Policy Provisions; Disability Income (2026)
How to Use This Individual Accident and Health Policy Provisions Set
This set draws on two outline sections of the Arizona combined exam: Individual Accident and Health Insurance Policy Provisions at 8%, and Disability Income and Related Insurance at 6%. Together they cover the uniform provisions in a health policy and the way a disability income policy defines, delays and pays a benefit.
The questions below mix required provisions, optional provisions, probationary and elimination periods, Social Security disability, rehabilitation, refund of premium and recurrent disability. Learn which provisions are required and which are optional, because the exam tests the difference.
Practice Questions 1-6: Uniform Provisions and Probationary Periods
Claim forms, legal action timing, change of occupation, sickness and the probationary period, the waiver of premium provision and the illegal occupation provision.
Question 1 (Chapter 7)
Under Arizona's uniform required provisions for individual accident and health policies, how soon must an insurer provide claim forms to the insured after receiving notice of a claim?
- A) Within 5 days
- B) Within 10 days
- C) Within 20 days
- D) Within 15 days
Show answer & explanation
Answer: D
Arizona's uniform required provisions for individual accident and health policies (A.R.S. Title 20) follow the NAIC uniform policy provisions law. One of these provisions stipulates that the insurer must provide claim forms to the insured within 15 days after receiving notice of a claim. If the insurer fails to provide forms within this timeframe, the insured may submit proof of loss in any written format, and the insurer must accept it. Options A, B, and C are incorrect as they do not match the 15-day requirement specified in the uniform provisions.
Question 2 (Chapter 7)
In Arizona, what is the minimum time period that must elapse after filing proof of loss before an insured can bring a legal action against the insurer under an individual accident and health policy?
- A) 30 days
- B) 45 days
- C) 90 days
- D) 60 days
Show answer & explanation
Answer: D
The uniform required provision regarding legal actions stipulates that no legal action may be brought against the insurer until at least 60 days after proof of loss has been filed. This waiting period allows the insurer time to investigate and pay the claim. Options A, B, and C are incorrect as they do not match the 60-day requirement.
Question 3 (Chapter 7)
An Arizona resident has an individual accident and health policy that lapsed due to non-payment of premium. The insured wishes to reinstate the policy. Which of the following is typically required for reinstatement?
- A) Automatic reinstatement after 30 days if the insured expresses intent to continue coverage.
- B) Payment of the overdue premium only; no evidence of insurability is required.
- C) Reinstatement is not permitted once a policy has lapsed for non-payment of premium.
- D) Submission of proof of good health and payment of all overdue premiums, possibly with interest.
Show answer & explanation
Answer: D
Reinstatement of a lapsed individual accident and health policy in Arizona is not automatic. The insured must typically provide evidence of insurability (such as proof of good health), pay all overdue premiums, and may be required to pay interest. The policy is reinstated only after the insurer approves the request. Option A is incorrect because reinstatement is not automatic. Option B is incorrect because evidence of insurability is generally required. Option C is incorrect because reinstatement is permitted under specific conditions.
Question 4 (Chapter 7)
An Arizona resident has an individual accident and health policy with a probationary period of 15 days for sickness coverage. The insured becomes ill on the 10th day after the policy's effective date and files a claim. How will the insurer likely handle this claim?
- A) Pay the claim in full because the illness occurred after the policy was issued.
- B) Pay the claim only if the illness is proven to be accidental in nature.
- C) Delay payment until the insured completes a physical examination requested by the insurer.
- D) Deny the claim because the illness occurred during the probationary period for sickness.
Show answer & explanation
Answer: D
A probationary period in an individual accident and health policy is a timeframe after the policy's effective date during which coverage for sickness is not provided. If the insured becomes ill during this period, the insurer will deny the claim for sickness benefits. Accidental injuries are typically covered immediately, but sickness is subject to the probationary period. In this scenario, the insured became ill on the 10th day, which is within the 15-day probationary period, so the sickness claim would be denied. Option A is incorrect because sickness coverage is not effective during the probationary period. Option B is incorrect because the nature of the illness (accidental vs. sickness) determines coverage, and sickness is not covered during the probationary period. Option C is incorrect because a physical examination is not a prerequisite for paying a claim during the probationary period; the claim is denied based on the timing of the illness.
Question 5 (Chapter 7)
An Arizona resident purchases an individual disability income policy that includes a waiver of premium provision. When does this provision typically become effective?
- A) After the insured has been continuously disabled for a period equal to the policy's elimination period.
- B) Immediately upon the onset of any illness or injury.
- C) Only if the disability is due to an accident, not sickness.
- D) When the insured reaches age 65, regardless of disability status.
Show answer & explanation
Answer: A
The waiver of premium provision in an individual disability income policy typically becomes effective after the insured has been continuously disabled for a period equal to the policy's elimination period. Once this period is satisfied and the insured meets the definition of total disability, the insurer waives the requirement to pay further premiums while the disability continues. Option B is incorrect because the waiver does not apply immediately; it requires satisfaction of the elimination period. Option C is incorrect because the waiver applies to disabilities from both sickness and accident, unless otherwise excluded. Option D is incorrect because the waiver is tied to disability status, not age.
Question 6 (Chapter 7)
An Arizona resident has an individual accident and health policy that contains an illegal occupation provision. The insured sustains a disability while committing a felony. How will this provision likely affect the claim?
- A) The claim will be paid in full because the provision only applies to misdemeanors.
- B) The claim will be paid only if the insured can prove the disability was not related to the felony.
- C) The provision does not apply because Arizona law prohibits illegal occupation provisions in health policies.
- D) The claim will be denied or the benefit amount reduced, as the disability occurred during an illegal occupation.
Show answer & explanation
Answer: D
The illegal occupation provision is a uniform optional provision that allows the insurer to deny or reduce benefits if the disability occurs while the insured is engaged in an illegal occupation, such as committing a felony. The provision does not distinguish between felonies and misdemeanors; it applies to any illegal occupation. The insured does not need to prove the disability was unrelated to the illegal activity for the provision to potentially apply. Arizona law does not prohibit illegal occupation provisions; they are permitted as uniform optional provisions. Therefore, the claim would likely be denied or the benefit reduced due to the disability occurring during the commission of a felony.
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Practice Questions 7-12: Elimination Periods, Social Security and Optional Provisions
The first benefit date after an elimination period, the SSDI waiting period, the rehabilitation benefit, intoxicants and narcotics, misstatement of age and the entire contract provision.
Question 7 (Chapter 7)
An Arizona resident purchases an individual disability income policy with a 90-day elimination period. The insured becomes totally disabled on January 1 and remains disabled through April 30. When will the first benefit payment be made, assuming monthly payments in arrears?
- A) February 1
- B) March 1
- C) April 1
- D) May 1
Show answer & explanation
Answer: D
The elimination period is 90 days from January 1, ending March 31. Benefits begin after the elimination period, so the first day of benefits is April 1. Since payments are made monthly in arrears, the payment for April is made at the end of April, which is May 1. Option A is incorrect as it is during the elimination period. Option B is incorrect as it is one month into the elimination period. Option C is incorrect as it is the last day of the elimination period; benefits have not yet begun.
Question 8 (Chapter 7)
Under Arizona law, what is the waiting period for Social Security Disability Insurance (SSDI) benefits before payments begin?
- A) Benefits begin after a 5-month waiting period from the onset of disability.
- B) There is no waiting period; benefits begin immediately upon approval.
- C) Benefits begin after a 2-year waiting period from the onset of disability.
- D) Benefits begin after a 6-month waiting period from the date of application.
Show answer & explanation
Answer: A
SSDI benefits have a 5-month waiting period from the onset of disability before payments begin. This is a federal rule applied in Arizona. Option B is incorrect as there is a waiting period. Option C is incorrect as the 2-year period relates to Medicare eligibility, not SSDI payments. Option D is incorrect as the waiting period is from the onset of disability, not the application date, and is 5 months, not 6.
Question 9 (Chapter 7)
An Arizona resident purchases an individual disability income policy that includes a rehabilitation benefit. Under what circumstance would this benefit typically be payable?
- A) When the insured is participating in an approved rehabilitation program to return to work.
- B) When the insured is hospitalized due to a disability.
- C) When the insured is diagnosed with a permanent disability.
- D) When the insured is receiving Social Security Disability Insurance benefits.
Show answer & explanation
Answer: A
The rehabilitation benefit provides payments to the insured while they are engaged in an approved rehabilitation program aimed at restoring their ability to work. It is not tied to hospitalization, permanent disability status, or SSDI receipt. Option B is incorrect as hospitalization alone does not trigger the benefit. Option C is incorrect as the benefit is for active rehabilitation, not permanent disability. Option D is incorrect as SSDI receipt does not automatically trigger the rehabilitation benefit under a private policy.
Question 10 (Chapter 7)
An Arizona resident has an individual accident and health policy that contains an intoxicants and narcotics provision. The insured sustains a disability while under the influence of illegal drugs. How will this provision likely affect the claim?
- A) The claim will be paid in full as the provision only applies to alcohol.
- B) The benefit amount will be reduced by 50% due to the intoxicants and narcotics provision.
- C) The insurer may increase the premium retroactively to cover the increased risk.
- D) The claim will be denied because the disability occurred while under the influence of intoxicants or narcotics.
Show answer & explanation
Answer: D
The intoxicants and narcotics provision typically excludes coverage for disabilities that occur while the insured is under the influence of intoxicants or narcotics, including illegal drugs. Therefore, the claim would be denied. Option A is incorrect as the provision applies to both alcohol and drugs. Option B is incorrect as there is no standard 50% reduction; the claim is typically denied. Option C is incorrect as the provision does not allow for retroactive premium increases.
Question 11 (Chapter 7)
An Arizona resident purchases an individual accident and health policy that includes a misstatement of age provision. After a claim is filed, the insurer discovers the insured was actually older than stated on the application. How will this provision most likely affect the claim?
- A) The benefit amount will be adjusted to what the premium paid would have purchased at the correct age.
- B) The claim will be denied in full due to fraud.
- C) The policy will be voided from inception and all premiums refunded.
- D) The insurer must pay the full claim but can increase future premiums.
Show answer & explanation
Answer: A
The misstatement of age provision is a uniform optional provision that allows the insurer to adjust the benefit amount to what the premium paid would have purchased at the correct age, rather than denying the claim or voiding the policy. Options B, C, and D are incorrect: the claim is not denied for fraud (it's an innocent misstatement), the policy is not voided, and premiums are not increased for the existing contract.
Question 12 (Chapter 7)
Which of the following statements accurately describes the 'entire contract' uniform required provision in an individual accident and health policy in Arizona?
- A) The policy, application, and any attached riders or endorsements constitute the entire contract between the parties.
- B) Only the policy itself is considered the contract; the application is used only for underwriting.
- C) The insurer can change the policy terms at any time without the insured's consent.
- D) The insured can alter the policy terms by providing written notice to the insurer.
Show answer & explanation
Answer: A
The 'entire contract' provision states that the policy, the application (if attached), and any riders or endorsements constitute the entire contract between the insurer and the insured. This prevents either party from claiming that external documents or oral agreements modify the policy. Options B, C, and D are incorrect: the application is part of the contract if attached, the insurer cannot unilaterally change terms, and the insured cannot alter terms by notice.
Practice Questions 13-17: Refund, Recurrent Disability and Occupation Changes
Refund of premium, the probationary period again, recurrent disability, a change to a more hazardous occupation, and a second refund of premium wording.
Question 13 (Chapter 7)
Under Arizona's uniform required provisions, what is the maximum time period within which an insured must file proof of loss for a claim under an individual accident and health policy, unless legally incapacitated?
- A) 30 days
- B) 60 days
- C) 180 days
- D) 90 days
Show answer & explanation
Answer: D
The uniform required provision for proof of loss in individual accident and health policies mandates that the insured must file proof of loss within 90 days after the loss occurs. If the insured is legally incapacitated, the timeframe may be extended, but otherwise, failure to file within 90 days may allow the insurer to deny the claim if prejudiced by the delay. Options A, B, and C do not match this 90-day requirement.
Question 14 (Chapter 7)
An Arizona resident has an individual accident and health policy that includes a probationary period of 10 days for sickness. The insured becomes ill and is hospitalized on the 8th day after the policy's effective date. The insurer denies the claim based on the probationary period. Is this denial valid under Arizona law?
- A) No, because probationary periods do not apply to sickness requiring hospitalization.
- B) No, because the probationary period only applies to accidents, not sickness.
- C) Yes, because the illness occurred during the probationary period.
- D) Yes, but only if the policy explicitly states the probationary period applies to all losses.
Show answer & explanation
Answer: C
The probationary period is a standard provision in individual health policies that delays coverage for sickness (not accidents) for a set number of days from the effective date. It applies regardless of whether the sickness requires hospitalization. Arizona law permits this provision as part of the uniform optional provisions. The insurer's denial is valid because the illness occurred during the probationary period. Option A is incorrect; hospitalization does not exempt a claim from the probationary period. Option B is incorrect; probationary periods apply to sickness, not accidents (which are covered immediately). Option D is misleading; while the policy must state the provision, if it does, it is enforceable as written, and the denial is valid.
Question 15 (Chapter 7)
An Arizona resident purchases an individual disability income policy that includes a recurrent disability provision. The insured returns to work after a disability period but becomes disabled again from the same cause within 6 months. Under the recurrent disability provision, how is the second disability typically treated?
- A) As a continuation of the prior disability, so no new elimination period is required.
- B) As a new disability, requiring a new elimination period.
- C) As a partial disability, paying only 50% of the benefit.
- D) As non-occupational disability, regardless of the original duty definition.
Show answer & explanation
Answer: A
A recurrent disability provision states that if disability recurs from the same or related cause within a specified period (often 6 months) after returning to work, it is considered a continuation of the prior disability. Therefore, a new elimination period is not required. Option B is incorrect because it is not treated as a new disability. Option C is incorrect; recurrent disability does not automatically imply partial disability or a 50% benefit. Option D is incorrect; the provision does not change the occupational definition of disability.
Question 16 (Chapter 7)
An Arizona resident purchases an individual disability income policy that includes a change of occupation provision. The insured changes from a sedentary office job to a job as a firefighter after the policy is issued and subsequently becomes disabled due to a heart condition. How will this provision most likely affect the claim?
- A) The benefit amount will be reduced to reflect the increased risk of the new occupation.
- B) The claim will be denied because firefighting is considered a hazardous occupation.
- C) The benefit will be paid based on the insured's earnings in the new occupation, but the premium may be adjusted.
- D) The claim will be paid in full as if the insured were still in the original occupation.
Show answer & explanation
Answer: A
The change of occupation provision typically allows the insurer to adjust the benefit amount (either increase or decrease) based on the risk associated with the new occupation, or to adjust the premium. It does not automatically deny the claim or pay it as if the occupation had not changed. Option A correctly describes a reduction in benefits due to increased risk. Option B is incorrect because the provision does not automatically deny claims for hazardous occupations. Option C is incorrect because benefits are not typically based on new occupation earnings; they are based on pre-disability earnings, adjusted for occupation risk. Option D is incorrect because the provision does not ignore the occupation change.
Question 17 (Chapter 7)
An Arizona resident has an individual disability income policy that includes a refund of premium provision. Under what circumstance is this benefit typically payable?
- A) If the insured becomes disabled and receives benefits for more than 12 months.
- B) If the insured dies from any cause while the policy is in force.
- C) If the insured cancels the policy within the free look period.
- D) If the insured survives to a specified age (e.g., 65 or 70) without having claimed disability benefits.
Show answer & explanation
Answer: D
A refund of premium provision in an individual disability income policy typically returns a portion or all of the premiums paid if the insured reaches a specified age (such as 65 or 70) without having incurred a disability that triggered benefits. It is a form of savings feature, returning premiums if the protection was not needed. Option A is incorrect as receiving benefits usually disqualifies a refund. Option B describes a life insurance feature, not disability income. Option C refers to the free look provision, which is separate and allows return of premium upon cancellation within the look period, not a refund of premium provision.
The Mistakes That Cost Marks
Applying the probationary period to accidents. It delays sickness coverage, not accidental injury (Questions 4 and 14).
Counting the elimination period wrongly. Count the days, find the last day of the period, then add the payment timing. Question 7 uses payments in arrears.
Mixing up required and optional provisions. Entire contract is a required provision; change of occupation, misstatement of age, illegal occupation and intoxicants are optional (Questions 3, 6, 10, 11 and 12).
Treating misstatement of age as fraud. The benefit is adjusted to what the premium would have bought at the correct age (Question 11).
Confusing SSDI with Medicare. The SSDI waiting period runs from the onset of disability, and the two-year period belongs to Medicare eligibility (Question 8).
Treating a recurrence as a new claim. A recurrent disability within the stated period continues the earlier one, with no new elimination period (Question 15).
Your Next Step
Practice by topic until you are comfortably above 70% on mixed questions, then move to the next block. Preview the Arizona Life & Health course to hear how the audio lessons cover this section, and use the Arizona Life & Health practice question hub to find the other topic sets.
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