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Key Facts: Accident & Health Exam

100

Practice Questions

OpenExamPrep

Varies

Passing Score

Applicable jurisdiction

Varies

Study Time

Local outline and diagnostic results

Jurisdiction-specific

Exam Blueprint

Current regulator or vendor outline

$2,100

Part D OOP Cap (2026)

Inflation Reduction Act

$60,370

Median Agent Salary

BLS 2024

There is no single national Accident and Health licensing exam. Some jurisdictions offer a standalone line while others use a combined route. Use the current regulator and testing-vendor bulletin for local logistics and treat this site's topic proportions as an editorial study distribution, not an official blueprint.

Sample Accident & Health Practice Questions

Try these sample questions to review concepts for the Accident & Health exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which of the following is the primary purpose of health insurance?
A.To eliminate the risk of illness
B.To transfer the financial risk of medical expenses to an insurer
C.To guarantee a profit for the insured
D.To replace lost earnings during retirement
Explanation: Health insurance transfers the financial risk of medical expenses from the insured to the insurer in exchange for premium payments. Insurance does not eliminate the risk of illness, never guarantees a profit (that would violate the principle of indemnity), and is distinct from retirement income products like annuities.
2An insurable risk must meet several criteria. Which of the following is NOT a requirement of an insurable risk?
A.The loss must be due to chance
B.The loss must be definite and measurable
C.The loss must be intentionally caused
D.The loss must not be catastrophic to the insurer
Explanation: An insurable risk must be due to chance (accidental), not intentional. Intentional acts are excluded from coverage in virtually every health and disability policy. The other listed elements — definite, measurable, and non-catastrophic — are all standard insurability requirements along with statistical predictability.
3The principle that prevents an insured from profiting from a loss is known as:
A.Adhesion
B.Indemnity
C.Subrogation
D.Utmost good faith
Explanation: The principle of indemnity restores the insured to their financial position prior to the loss — no better, no worse. This prevents profiting from a covered event. Adhesion describes the take-it-or-leave-it nature of policy contracts, subrogation lets the insurer pursue third parties who caused a loss, and utmost good faith requires honesty from both parties.
4Which of the following best describes adverse selection?
A.When an insurer refuses to issue a policy to a healthy applicant
B.The tendency of higher-risk individuals to seek insurance more often than lower-risk individuals
C.When an insured selects a policy with the lowest premium
D.The insurer's selection of which claims to pay first
Explanation: Adverse selection is the tendency of those with greater-than-average loss exposure to seek insurance more eagerly than standard risks. Underwriting and waiting periods exist to control adverse selection. If unchecked, the risk pool would skew toward poor risks and threaten the insurer's solvency.
5Which underwriting source is governed by the Fair Credit Reporting Act (FCRA)?
A.The application
B.The Medical Information Bureau (MIB) report
C.An attending physician's statement
D.A paramedical exam
Explanation: Consumer reports such as the MIB report and inspection reports are regulated by the FCRA. The Act requires the insurer to notify the applicant when a consumer report is ordered and to disclose adverse underwriting decisions based on the report. The application, APS, and paramedical exams are not consumer reports under FCRA.
6The Medical Information Bureau (MIB) primarily exists to:
A.Pay medical claims for member companies
B.Provide a database of coded medical information to detect application fraud
C.Negotiate provider networks for HMOs
D.Set premium rates for member insurers
Explanation: The MIB is a nonprofit information exchange used by member life and health insurers to detect fraud or material misstatements on applications. It contains coded summaries — not full medical records — of conditions reported on prior applications. It does not pay claims, set rates, or negotiate networks.
7Which of the following individual health policy provisions limits how long an insurer can contest the policy for misstatements on the application?
A.Grace period
B.Time limit on certain defenses (incontestability)
C.Reinstatement
D.Entire contract
Explanation: Under the Uniform Individual Accident and Sickness Policy Provisions, the Time Limit on Certain Defenses (also called incontestability) bars the insurer from voiding a policy or denying a claim because of misstatements after the policy has been in force for two years (three years in some states), except for fraudulent misstatements where allowed.
8The standard grace period on an individual health insurance policy with monthly premiums is:
A.7 days
B.10 days
C.31 days
D.60 days
Explanation: Under the Uniform Individual Accident and Sickness Policy Provisions Law (NAIC Model #180), the grace period scales with the premium mode: 7 days for weekly premium policies, 10 days for monthly premium policies, and 31 days for all other modes (quarterly, semiannual, annual). A monthly-premium policy therefore has a 10-day grace period.
9A policy is described as 'guaranteed renewable.' This means the insurer:
A.Cannot change the premium for any reason
B.May refuse to renew the policy at the end of any policy period
C.Must renew the policy until the insured reaches a stated age but may raise premiums by class
D.May cancel the policy at any time with 30 days' notice
Explanation: A guaranteed renewable policy obligates the insurer to renew until the policyholder reaches a stated age (often 65), but premiums may be increased on a class basis — never for an individual. Noncancelable policies, by contrast, lock in both renewal and the premium. Optionally renewable lets the insurer refuse renewal at the anniversary.
10Under the Notice of Claim provision in a health policy, written notice of claim must be given to the insurer within:
A.10 days after the loss
B.20 days after the loss or as soon as reasonably possible
C.60 days after the loss
D.90 days after the loss
Explanation: The Notice of Claim provision requires written notice within 20 days after the loss occurs or as soon as reasonably possible. Proof of Loss must be filed within 90 days. Claims are paid within a stated period after proof — typically 60 days for periodic disability benefits.

About the Accident & Health Exam

Accident and Health or Sickness producer authority is administered by individual states and jurisdictions. This resource teaches cross-jurisdiction core concepts, but the actual exam route, outline, item count, time, cut score, vendor, education, and post-exam licensing steps must be confirmed with the applicable regulator.

Exam sponsor: State Insurance Commissioner. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Question count not published by the exam provider

Time Limit

Varies by jurisdiction

Passing Score

Varies by jurisdiction

Exam / Certification Fees

Varies by jurisdiction

Exam sponsor website

Reported exam pass rate: Not available as a single national figure. Licensing programs and reporting differ by jurisdiction Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Editorial coverage

Health Insurance Basics

Insurance principles, underwriting, MIB, UPPL provisions, deductibles, coinsurance, and cost-sharing

Editorial coverage

Medical Expense Insurance

HMO, PPO, POS, EPO, HDHP, HSA/FSA/HRA, basic and major medical, COB, and ACA EHBs

Editorial coverage

Disability Income Insurance

Own-occupation vs any-occupation, elimination and benefit periods, residual benefits, BOE, and SSDI

Editorial coverage

Group Health Insurance

Group underwriting, contributory vs noncontributory plans, COBRA, HIPAA portability, and ERISA

Editorial coverage

Medicare, Medicaid & ACA Marketplace

Medicare Parts A/B/C/D, Medigap, enrollment periods, Medicaid, premium tax credits, and metal tiers

Editorial coverage

Long-Term Care Insurance

Tax-qualified LTC, ADL benefit triggers, levels of care, inflation protection, partnership programs

Editorial coverage

Regulations & Ethics

Twisting, rebating, state-specific premium-handling duties, Medicare marketing rules, MHPAEA parity, and producer conduct

Preparing for the Accident & Health Exam

What You Need to Know

  • Passing score: Varies by jurisdiction
  • Assessment: Question count not published by the exam provider
  • Time limit: Varies by jurisdiction
  • Exam / certification fees: Varies by jurisdiction Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Accident & Health: Suggested Study Strategy

1Memorize Medicare Parts A/B/C/D coverage and the IEP, AEP (Oct 15-Dec 7), and Medigap 6-month open enrollment windows
2Master COBRA continuation periods cold: 18 months (termination), 29 months (SSA disability), 36 months (divorce/death of employee)
3Know the IRS HSA/HDHP limits for the current year (2026: $4,400/$8,750 contribution, $1,700/$3,400 minimum deductible)
4Understand ACA fundamentals: 10 EHBs, dependent coverage to age 26, metal tiers (60/70/80/90), and Silver-tier CSRs at 100-250% FPL
5Distinguish prohibited practices: twisting (misrepresentation in replacement), rebating (gifts to induce purchase), and coercion

Frequently Asked Questions

What is the Accident & Health exam pass rate?

There is no single national pass-rate figure. Reporting varies by state and exam route, and many regulators do not publish a current rate. Use any published jurisdiction-specific data only for that jurisdiction.

How hard is the Accident & Health insurance exam?

Difficulty varies by jurisdiction, exam route, and prior insurance knowledge. Use the current local outline and diagnostic practice results to identify weak areas; there is no reliable national first-attempt success claim or universal study-hour target.

How many questions are on the Accident & Health exam?

There is no universal format. For example, jurisdictions can use a standalone Accident and Health exam or a combined Life, Accident, and Health route. Check the current regulator or vendor bulletin for the exact item count, time, and cut score.

What topics are covered on the Accident & Health exam?

Common concepts include policy provisions, medical expense and managed-care plans, disability income, group health, federal programs, long-term care, and local law. Exact subjects and weights come from the applicable jurisdiction's current outline.

How long should I study for the Accident & Health exam?

Build a plan from your jurisdiction's current outline, required education, and diagnostic results. Prelicensing hours and exam routes differ substantially, and no single practice percentage guarantees readiness for every jurisdiction.

What career paths does an Accident & Health license open?

The producer authority may support work with health, disability, or related products, but a license alone does not automatically authorize every product. Appointments, product training, federal registration, and state-specific requirements may also apply.