17 Free Louisiana Life & Health Practice Questions: Individual Health Provisions and Disability (2026)

Question 1 (Chapter 7)

An individual's health policy lapses for non-payment. The insured submits a reinstatement application and pays the premium on June 1st. The insurer does not notify the insured of any decision. On what date is the policy automatically reinstated under Louisiana's uniform provisions?

• A) June 1st
• B) June 11th
• C) July 1st
• D) July 16th

Question 2 (Chapter 7)

A producer tells a client that a specific surgery will be covered, even though the policy explicitly excludes it. The client buys the policy based on this statement. When the claim is denied, the client points to the producer's promise. Which provision prevents the producer's oral statement from being part of the policy?

• A) Insuring Clause
• B) Consideration Clause
• C) Legal Actions
• D) Entire Contract

Question 3 (Chapter 7)

Which of the following disability definitions is considered the most restrictive for the insured?

• A) Any-occupation
• B) Own-occupation
• C) Presumptive disability
• D) Residual disability

Question 4 (Chapter 7)

In a Disability Buy-Sell agreement, what is the typical length of the elimination period?

• A) 1 to 2 years
• B) 30 days
• C) 90 days
• D) There is no elimination period

Question 5 (Chapter 7)

Which provision in a medical plan limits the total out-of-pocket expenses an insured must pay in a given year?

• A) Deductible
• B) Coinsurance
• C) Elimination Period
• D) Stop-Loss Provision

Question 6 (Chapter 7)

A claimant in Shreveport suffers a loss covered under an individual accident and health policy. They provide a 'Notice of Claim' within 20 days. According to the Uniform Required Provisions, within how many days of the loss must the claimant typically provide 'Proof of Loss' to the insurer?

• A) 15 days
• B) 45 days
• C) 180 days
• D) 90 days

Question 7 (Chapter 7)

Which specific clause in a health and accident policy identifies the parties to the contract, the scope of coverage, and the insurer's promise to pay benefits?

• A) The Consideration Clause
• B) The Entire Contract Provision
• C) The Benefit Clause
• D) The Insuring Clause

Question 8 (Chapter 7)

A construction worker in Lake Charles has a disability income policy. He is involved in an accident that results in the total loss of sight in both eyes. Even though he can still work in a different capacity, the insurer pays the full monthly benefit. This is an example of:

• A) Residual Disability
• B) Partial Disability
• C) Recurrent Disability
• D) Presumptive Disability

Question 9 (Chapter 7)

A dentist in Metairie purchases a Business Overhead Expense (BOE) policy. If the dentist becomes disabled, which of the following is TRUE regarding the tax treatment of this policy?

• A) Premiums are not deductible, but benefits are tax-free.
• B) Both premiums and benefits are tax-free.
• C) The policy is only available to businesses with more than 50 employees.
• D) Premiums are tax-deductible as a business expense, but benefits are taxable as income.

Question 10 (Chapter 7)

An insured has a Major Medical plan with a $1,000 deductible, 80/20 coinsurance, and a $5,000 'Stop-Loss' limit (out-of-pocket maximum, including the deductible). If the insured incurs $30,000 in covered medical expenses, how much will the insured pay in total?

• A) $1,000
• B) $6,800
• C) $5,000
• D) $7,000

Question 11 (Chapter 7)

A 45-year-old accountant has a disability income policy with a 'Any-Occupation' definition of total disability. He suffers a severe hand injury that prevents him from accounting but allows him to work as a greeter at a retail store. Will he receive benefits?

• A) Yes, because he cannot perform his own occupation.
• B) Yes, because he is partially disabled.
• C) No, because he is capable of performing some gainful occupation.
• D) No, because the injury is not presumptive.

Question 12 (Chapter 7)

A producer explains the 'Entire Contract' provision to a client. Which of the following would NOT be considered part of the entire contract?

• A) The policy document
• B) The original application
• C) A verbal promise made by the producer during the sales presentation
• D) Attached riders

Question 13 (Chapter 7)

A producer is explaining a 'Guaranteed Renewable' policy. Which of the following is TRUE?

• A) The insurer can cancel the policy if the insured develops a chronic illness.
• B) The insurer cannot cancel the policy, but they can increase premiums for a whole class of insureds.
• C) The premium is guaranteed never to change.
• D) The policy can only be renewed if the insured is still healthy.

Question 14 (Chapter 7)

An insured has a disability income policy with a 'Cost of Living Adjustment' (COLA) rider. Why is this rider beneficial during a long-term disability?

• A) It increases the monthly benefit to keep up with inflation.
• B) It allows the insured to increase their coverage amount every year.
• C) It waives the premium if the insured's cost of living increases.
• D) It provides a lump sum payment upon the onset of disability.

Question 15 (Chapter 7)

An individual in Shreveport purchases a comprehensive individual health insurance policy. Which of the following is a common general exclusion found in most health insurance policies?

• A) Treatment for a common cold.
• B) Injuries sustained during declared or undeclared war.
• C) Emergency room visits for sudden illness.
• D) Routine physical examinations.

Question 16 (Chapter 7)

A large employer in New Orleans offers a 'Short-Term Disability' (STD) plan to its employees. Which of the following is a typical characteristic of an STD plan?

• A) It provides benefits for disabilities lasting several years, often until retirement age.
• B) It usually has a very long elimination period, often 90 to 180 days.
• C) It typically covers disabilities lasting a few weeks to up to two years.
• D) Benefits are always 100% of the employee's pre-disability income.

Question 17 (Chapter 7)

A patient in Baton Rouge visits a specialist, receives treatment, and then submits the bill to their insurance company for reimbursement. The insurance company pays a portion of the bill, and the patient is responsible for the remainder. This payment structure is characteristic of which medical plan concept?

• A) Prepaid plan.
• B) Fee-for-service plan.
• C) Managed care plan.
• D) Point-of-Service (POS) plan.