Questões de Types of Policies (Health)

1. TDI-PEARSONVUE — 2026

A disability income policy includes a 'recurrent disability' provision with a 6-month period. The insured returns to work after 4 months of disability, then becomes disabled again from the same cause after 3 months. How is this treated?

1. A)As a new disability with a new elimination period
2. B)As a continuation of the prior disability
3. C)As a partial disability only
4. D)Coverage is forfeited

Gabarito: B

A recurrent disability clause treats a subsequent disability from the same or related cause as a continuation of the prior disability if it occurs within the specified period (commonly 6 months). This means no new elimination period applies. If the gap exceeds 6 months, it would be treated as a new disability.

2. TDI-PEARSONVUE — 2026

A disability income policy includes a presumptive disability provision. Which of the following conditions would trigger automatic payment of full benefits regardless of the insured's ability to work?

1. A)Loss of hearing in one ear
2. B)Total and permanent loss of sight in both eyes
3. C)Partial paralysis of one leg
4. D)Chronic back pain preventing heavy lifting

Gabarito: B

Presumptive disability provisions automatically consider certain severe losses (such as loss of sight in both eyes, both hands, both feet, or any two limbs) as total disability regardless of actual ability to work.

3. TDI-PEARSONVUE — 2026

A long-term care policy with an inflation protection rider offers 5% compound annual inflation protection. If the initial daily benefit is $100, what will the daily benefit be after 2 years?

1. A)$110.00
2. B)$110.25
3. C)$115.00
4. D)$121.00

Gabarito: B

With 5% compound inflation: Year 1 = $100 × 1.05 = $105; Year 2 = $105 × 1.05 = $110.25. Compound inflation applies the percentage to the increased amount each year.

4. TDI-PEARSONVUE — 2026

A Medicare supplement policy must provide coverage for the Medicare Part A deductible in which standardized plan?

1. A)Plan A
2. B)Plan F
3. C)Plan K
4. D)All standardized plans

Gabarito: B

Plan F provides the most comprehensive coverage, including the Medicare Part A deductible. Plan A provides basic benefits only. Other plans provide varying levels of coverage based on NAIC standardization.

5. TDI-PEARSONVUE — 2026

Thomas has a disability income policy with an 'own occupation' definition of total disability. He is a surgeon who suffers a hand injury and can no longer perform surgery, but he takes a teaching position at a medical school. Under this definition, Thomas is considered:

1. A)Not disabled because he is employed
2. B)Partially disabled and receives reduced benefits
3. C)Totally disabled and eligible for full benefits
4. D)Residually disabled based on income loss

Gabarito: C

Under an 'own occupation' definition, an insured is considered totally disabled if unable to perform the substantial and material duties of their own occupation, even if able to work in another capacity. Thomas cannot perform surgery, his own occupation.

6. TDI-PEARSONVUE — 2026

A disability income policy defines the elimination period as 90 days. The insured becomes disabled on March 1 and remains continuously disabled. When will benefit payments begin?

1. A)March 1, retroactively after the elimination period
2. B)April 1, 30 days after disability begins
3. C)May 30, after 90 days of continuous disability
4. D)June 1, the first day of the month following the elimination period

Gabarito: C

The elimination period is the waiting period during which no benefits are paid. Benefits begin after the elimination period is satisfied—in this case, after 90 consecutive days of disability (approximately May 30).