NJ Accident and Health Insurance Exam
Questions and Answers
1. H has suffered a covered disability away from her job and will
shortly begin collecting benefits. The insurer sends a letter to H
stating that she will not receive any benefit amounts greater than
her income. This clause is known as
A: Over-insurance clause
B: free look
C: relation of earning to insurance
D: relation of economic value
ANS: C: relation of earning to insurance
2. The insured should be aware of the issue date upon delivery a
policy and the date should be listed on:
A: the policy summary
B: the first page of the
contract C: the delivery
receipt
D: upon conditional receipt
ANS: B: the first page of the contract
3. The policy has all of the following rights EXCEPT:
,A: Right to solely renew a guaranteed renewable
policy. B: Right to terminate a policy
C: Unilateral right to renew an Optionally renewable policy
D: Right to assign a contract
ANS: C: Unilateral right to renew an Optionally renewable policy
4. The part of a contract that specifies which expenses may or
may not be covered is known as the:
A: Exclusion
B: Eligible Expense
provision C: Insuring
Agreement
D
Consideration Clause
ANS: B: Eligible Expense provision
5. Which of the following is considered to be a mandatory provision
in a health policy?
A: Time Limit on Certain
Defenses B
Change of Occupation
C: Illegal Occupation
D: Intoxicant/Narcotic Usage
ANS: A: Time Limit on Certain Defenses
,6. Which of the following may be considered an eligible expense
found in a health policy?
A
Cosmetic Surgery
B: Premium
payment C
Cold cream
D
Bus fare to receive treatment for a covered loss
ANS: D
Bus fare to receive treatment for a covered loss
7. K has a policy that covers doctors visits but limits the number of
visits per calendar year and pays a limited indemnification limit
per visit. K has:
A
Basic Medical Expense
B: Physician Nonsurgical
Coverage C
Basic Surgical Policy
D
Basic Hospital Coverage
ANS: B: Physician Nonsurgical Coverage
8. All of the following are CORRECT about Medicare EXCEPT:
, A
An insured who is age 30 but collecting Social Security disability for the
last two years is eligible for Medicare.
B
An insured who is age 60 and is at the end stage of renal failure is
eligible for Medicare.
C
An insured who turns age 65 and is still employed is eligible for
Medicare.
D
An insured who has Medicare Part A is eligible to enroll for Medigap
policies within six months of enrolling in Part A.
ANS: D
An insured who has Medicare Part A is eligible to enroll for Medigap policies within six
months of enrolling in Part A.
9. Under the Claim Forms provision in an Accident and Health
policy, an insur- ance company must supply an insured with claim
forms within a MAXIMUM of how many days after receiving notice
of the loss?
A: 10
B: 15
C: 20
D: 30
ANS: B: 15
Questions and Answers
1. H has suffered a covered disability away from her job and will
shortly begin collecting benefits. The insurer sends a letter to H
stating that she will not receive any benefit amounts greater than
her income. This clause is known as
A: Over-insurance clause
B: free look
C: relation of earning to insurance
D: relation of economic value
ANS: C: relation of earning to insurance
2. The insured should be aware of the issue date upon delivery a
policy and the date should be listed on:
A: the policy summary
B: the first page of the
contract C: the delivery
receipt
D: upon conditional receipt
ANS: B: the first page of the contract
3. The policy has all of the following rights EXCEPT:
,A: Right to solely renew a guaranteed renewable
policy. B: Right to terminate a policy
C: Unilateral right to renew an Optionally renewable policy
D: Right to assign a contract
ANS: C: Unilateral right to renew an Optionally renewable policy
4. The part of a contract that specifies which expenses may or
may not be covered is known as the:
A: Exclusion
B: Eligible Expense
provision C: Insuring
Agreement
D
Consideration Clause
ANS: B: Eligible Expense provision
5. Which of the following is considered to be a mandatory provision
in a health policy?
A: Time Limit on Certain
Defenses B
Change of Occupation
C: Illegal Occupation
D: Intoxicant/Narcotic Usage
ANS: A: Time Limit on Certain Defenses
,6. Which of the following may be considered an eligible expense
found in a health policy?
A
Cosmetic Surgery
B: Premium
payment C
Cold cream
D
Bus fare to receive treatment for a covered loss
ANS: D
Bus fare to receive treatment for a covered loss
7. K has a policy that covers doctors visits but limits the number of
visits per calendar year and pays a limited indemnification limit
per visit. K has:
A
Basic Medical Expense
B: Physician Nonsurgical
Coverage C
Basic Surgical Policy
D
Basic Hospital Coverage
ANS: B: Physician Nonsurgical Coverage
8. All of the following are CORRECT about Medicare EXCEPT:
, A
An insured who is age 30 but collecting Social Security disability for the
last two years is eligible for Medicare.
B
An insured who is age 60 and is at the end stage of renal failure is
eligible for Medicare.
C
An insured who turns age 65 and is still employed is eligible for
Medicare.
D
An insured who has Medicare Part A is eligible to enroll for Medigap
policies within six months of enrolling in Part A.
ANS: D
An insured who has Medicare Part A is eligible to enroll for Medigap policies within six
months of enrolling in Part A.
9. Under the Claim Forms provision in an Accident and Health
policy, an insur- ance company must supply an insured with claim
forms within a MAXIMUM of how many days after receiving notice
of the loss?
A: 10
B: 15
C: 20
D: 30
ANS: B: 15
