Difficulty: Mixed
What is an insurance deductible?
A Insured’s initial share of loss
B Premium paid yearly
C Policy benefit amount
D Insurer’s fee
Answer: A. Insured’s initial share of loss. A deductible is an amount the insured pays toward an eligible claim.
When does a deductible usually apply?
A At every premium date
B On eligible claim costs
C When naming a beneficiary
D After policy expiry
Answer: B. On eligible claim costs. A deductible applies to covered losses as described in the contract.
What is another term often used for deductible?
A Premium
B Rider
C Excess
D Limit
Answer: C. Excess. Some insurance markets use excess to describe the insured’s claim contribution.
How can a higher deductible affect premium?
A It always raises premium
B It removes coverage
C It guarantees claim payment
D It may lower the premium
Answer: D. It may lower the premium. Higher deductibles may reduce premiums, depending on policy and insurer.
What should a buyer consider before choosing a higher deductible?
A Ability to pay after loss
B Only the logo
C Agent’s preferred plan
D Claim-free guarantee
Answer: A. Ability to pay after loss. Choose a deductible the policyholder could afford if a claim occurs.
What is a fixed deductible?
A Percentage of all premiums
B Set monetary amount
C Named-peril list
D Benefit recipient
Answer: B. Set monetary amount. A fixed deductible is stated as a specific amount.
What is a percentage deductible?
A Set premium date
B Fixed benefit amount
C Share calculated as percentage
D Policy renewal
Answer: C. Share calculated as percentage. Some deductibles are calculated as a percentage of a defined value.
What is a catastrophe deductible?
A Annual premium payment
B Claim-free discount
C Travel medical limit
D Special deductible for specified events
Answer: D. Special deductible for specified events. Some property policies apply a separate deductible to catastrophe losses.
What does a per-claim deductible mean?
A Applies to each eligible claim
B Applies once for life
C Only affects premium
D Names a beneficiary
Answer: A. Applies to each eligible claim. A per-claim deductible is applied to each claim as the policy states.
What is an annual health deductible?
A Premium due each month
B Amount before plan shares costs
C Annual benefit payout
D Hospital network fee
Answer: B. Amount before plan shares costs. Some health plans require eligible costs to reach a yearly deductible before cost-sharing changes.
Can deductible rules differ between health plans?
A No, all plans match
B Only premiums vary
C Yes, check plan terms
D Every service qualifies
Answer: C. Yes, check plan terms. Plan wording sets deductible amounts, eligible expenses, and exceptions.
What is a family deductible?
A Separate premium for each doctor
B Policy’s total annual limit
C One hospital bill
D Shared threshold for covered family
Answer: D. Shared threshold for covered family. Some family plans use a shared deductible across covered members.
How does a copayment differ from a deductible?
A Fixed service fee versus threshold
B They are always identical
C Both are premiums
D Neither affects costs
Answer: A. Fixed service fee versus threshold. Copays are fixed fees; deductibles are amounts paid before plan contributions.
What is coinsurance?
A Fixed monthly premium
B Percentage share of eligible costs
C Policy start date
D Annual deductible
Answer: B. Percentage share of eligible costs. Coinsurance is a percentage share of eligible costs.
Which cost is separate from deductible?
A Eligible claim expense
B Cost-sharing amount
C Insurance premium
D Out-of-pocket expense
Answer: C. Insurance premium. Premiums pay for coverage; deductibles apply to eligible claims.
Does paying a deductible guarantee the insurer pays the full bill?
A Yes, every bill
B Only in-network costs
C Only after renewal
D No, limits still apply
Answer: D. No, limits still apply. Exclusions, sublimits, limits, and coinsurance may still apply.
What happens if an eligible loss is below deductible?
A Insured may pay it all
B Insurer pays full amount
C Premium is refunded
D Limit increases
Answer: A. Insured may pay it all. Below the deductible, the insured may bear the eligible cost.
For a $1,500 eligible loss and $700 deductible, what remains before limits?
A $700
B $800
C $1,500
D $2,200
Answer: B. $800. Subtract the $700 deductible from the $1,500 eligible loss.
Does a deductible usually increase the policy limit?
A Yes, it doubles it
B Only on renewal
C No, it affects claim sharing
D It names the insured
Answer: C. No, it affects claim sharing. A deductible changes who pays part of a claim.
Where should a policyholder find the deductible amount?
A A repair shop sign
B A social-media post
C Another policy
D Policy schedule and wording
Answer: D. Policy schedule and wording. The schedule and wording state applicable deductibles.
Can one policy have different deductibles?
A Yes, by coverage or event
B No, always one
C Only life policies
D Deductibles never vary
Answer: A. Yes, by coverage or event. Different coverage sections or events may have separate deductibles.
What should be checked for a windstorm deductible?
A Beneficiary’s address
B Event definition and calculation basis
C Premium receipt color
D Hospital hours
Answer: B. Event definition and calculation basis. Special event deductibles depend on policy definitions and calculation rules.
What is an aggregate deductible?
A Premium installment
B Per-person benefit
C Total threshold across claims
D One-time policy fee
Answer: C. Total threshold across claims. An aggregate deductible accumulates eligible losses toward a threshold.
Can a deductible apply to only some coverage sections?
A No, all sections identical
B Only premiums qualify
C Every claim is excluded
D Yes, policy terms decide
Answer: D. Yes, policy terms decide. Deductibles may differ by coverage section.
What is an out-of-pocket maximum?
A Plan cap on eligible cost-sharing
B Premium refund amount
C Annual benefit limit
D Deductible alone
Answer: A. Plan cap on eligible cost-sharing. Some health plans cap specified cost-sharing for eligible services.
Does an out-of-pocket maximum include every expense?
A Yes, every payment
B No, plan rules specify
C Only premiums
D All excluded services
Answer: B. No, plan rules specify. Plan rules define which payments count toward its maximum.
Do premiums usually count toward a health deductible?
A Always, everywhere
B Only after claims
C Often they do not
D They are the same
Answer: C. Often they do not. Premiums are generally separate from deductible accumulation; confirm plan terms.
Can excluded services count toward a deductible?
A Yes, always
B Only at renewal
C All exclusions count
D Usually not, check wording
Answer: D. Usually not, check wording. Excluded services may not qualify toward deductible totals.
Why track eligible expenses against a deductible?
A Know remaining threshold
B Guarantee approval
C Remove all copays
D Change policy terms
Answer: A. Know remaining threshold. Tracking helps estimate how much deductible remains.
Which record can help verify deductible credit?
A A restaurant receipt
B Insurer’s claim statement
C Unrelated bank notice
D Travel itinerary
Answer: B. Insurer’s claim statement. Insurer statements show how claims were processed.
What if deductible credit looks wrong?
A Ignore the statement
B Pay an unknown caller
C Contact insurer with records
D Change claim documents
Answer: C. Contact insurer with records. Ask the insurer to review the calculation.
How might an annual deductible reset?
A After every appointment
B Only at retirement
C It never resets
D At plan-defined renewal date
Answer: D. At plan-defined renewal date. Health deductibles commonly reset on a plan-defined cycle.
Do all health deductibles reset on January 1?
A No, plan year varies
B Yes, everywhere
C Only group plans
D Deductibles never reset
Answer: A. No, plan year varies. The plan year and reset date depend on the contract.
What can an in-network deductible mean?
A Premium for network hospital
B Separate threshold for network care
C A claim exclusion
D Policyholder’s income
Answer: B. Separate threshold for network care. Some plans distinguish in-network and out-of-network cost-sharing.
Why check network status before treatment?
A It changes policy title
B It guarantees all costs
C Deductible rules may differ
D It sets the diagnosis
Answer: C. Deductible rules may differ. Network status can affect eligible charges and cost-sharing.
What does deductible waiver mean?
A Premium is waived forever
B All exclusions removed
C Claim always approved
D Not applied in stated case
Answer: D. Not applied in stated case. A waiver applies only in circumstances stated by the policy.
Can a deductible waiver be assumed?
A No, verify policy terms
B Yes, every claim
C Only after renewal
D It is automatic
Answer: A. No, verify policy terms. Check whether the contract expressly provides a waiver.
How can a deductible influence claim decisions?
A It guarantees every claim
B Small losses may be skipped
C It changes insured identity
D It removes claim deadlines
Answer: B. Small losses may be skipped. A high deductible can make small claims less useful to submit.
Why compare premium savings with deductible size?
A Guarantee savings
B Remove claim limits
C Assess total financial tradeoff
D Avoid insurer contact
Answer: C. Assess total financial tradeoff. Consider premium reduction alongside payment after a loss.
Which policy may use a deductible on property claims?
A Life benefit only
B Travel itinerary
C Beneficiary form
D Home insurance
Answer: D. Home insurance. Property insurance may apply deductibles to eligible damage claims.
Which policy may use deductibles for vehicle damage?
A Motor own-damage cover
B Life insurance only
C Home contents only
D Travel assistance
Answer: A. Motor own-damage cover. Motor own-damage sections may apply deductibles or excess.
Can a deductible apply to health treatment?
A No health plan
B Yes, under some plans
C Only after expiry
D Only for travel
Answer: B. Yes, under some plans. Some health plans include deductibles as cost-sharing.
What detail matters in a deductible calculation?
A Policyholder’s favorite color
B Agent commission
C Covered loss basis
D Hospital opening time
Answer: C. Covered loss basis. The policy defines which covered amount the deductible applies to.
Do all losses count toward the same deductible?
A Yes, globally
B Only life claims
C Deductibles are universal
D Not necessarily
Answer: D. Not necessarily. Separate deductibles may apply to different coverages or events.
What should be compared between deductibles?
A Amount, scope, and reset
B Logo, font, and color
C Only payment app
D Agent’s address
Answer: A. Amount, scope, and reset. Compare amount, application, and how it accumulates.
Which deductible is easier to budget for?
A The largest available
B One the insured can afford
C An unknown percentage
D A deductible chosen by friend
Answer: B. One the insured can afford. Affordability matters because the deductible may be due after a loss.
Does a deductible replace exclusions?
A Yes, it removes them
B Only for claims
C No, both still apply
D Exclusions are premiums
Answer: C. No, both still apply. A deductible and exclusions are separate policy features.
How can a policyholder confirm a deductible?
A Trust a short advert
B Assume no deductible
C Ask an unknown caller
D Ask insurer and read wording
Answer: D. Ask insurer and read wording. Verify the amount and conditions in official materials.
Which statement about deductibles is accurate?
A They share eligible claim costs
B They are premium refunds
C They guarantee coverage
D They name beneficiaries
Answer: A. They share eligible claim costs. Deductibles allocate part of eligible claim costs to the insured.
What clarifies a percentage deductible?
A Agent’s personal estimate
B Stated base and rate
C Policy logo size
D Premium receipt color
Answer: B. Stated base and rate. The contract should state the percentage and the value it applies to.