NJ Health and Accident Questions and Answers Verified 100% Correct

NJ Health and Accident Questions and Answers Verified 100% Correct What amount will be paid under a policy where the insured misstated his/her age? - ANSWER -An amount the premium would have purchased at the correct age All Medicare Supplement policies MUST contain which provision? - ANSWER Pre-existing conditions may only be excluded from coverage for a maximum of 6 months Low-frequency diseases can be exclusively covered by what kind of health insurance policies? - ANSWER -Limited policies In group medical expense health insurance plan, coverage for alcoholism is treated as? - ANSWER -Treated as any other illness, sickness, or disease An insurance producer is issued a(n) ______ as evidence of authority - ANSWER -license Which of the following is NOT included under a health benefit plan? - ANSWER -Hospital indemnity plan Once an accident and health insurance policy has been in force for ___ year(s), the policy may NOT be contested by the insurer - ANSWER -2 years A medicare supplement policy must NOT contain benefits which - ANSWER duplicate Medicare benefits The Commissioner may - ANSWER -establish continuing education requirements Signatures for an insurance application MUST be obtained by the producer from all of the following sources EXCEPT - ANSWER -the beneficiary David submits a $500 claim for medical expenses. There is a past due amount owed for insurance premiums of $200. As a result, the insurer only pays $300 for the claim. The deduction came as a result of which provision? - ANSWER -unpaid provision Who is the individual paid on a fee-for-service basis? - ANSWER -Provider A producer's secretary who solicits prospects on the telephone - ANSWER -must be licensed as a producer Insurance advertisements in a local newspaper are regulated by? - ANSWER Department of Banking and Insurance Johan the producer charged a fee to a sales prospect for analyzing insurance coverages. According to NJ law, a reasonable relationship must exist between the fee and the - ANSWER -Substance of the services performed What is the free-look period of a Medicare Supplement policy? - ANSWER -30 days Which of the following is an example of defamation? - ANSWER -Using derogatory about an insurance company's financial condition All of the following are included as part of a contract in the entire contract provision EXCEPT the - ANSWER -changes made by the producer A health insurance policy that allows an insurer to change the policy owner's premiums, but NOT cancel the policy is called a(n) - ANSWER -guaranteed renewable policy Richard owns an insurance policy that is renewable only at the option of the insurance company. His policy is considered to be - ANSWER -Optionally renewable According to the principle of Utmost Good Faith, the insured will ANSWER questions on the application to the best of their knowledge and pay the required premium, while the insurer will deal fairly with the insured and it's - ANSWER promise made An insurer must furnish to a claimant forms for filling proof of loss within ____ days upon receiving a notice of claim - ANSWER -15 days A person who is a nonsmoker, of average weight, and in excellent health would most likely be in which risk classification? - ANSWER -Preferred An agent is an individual that represents whom? - ANSWER -Licensed producer who has written contract to represent an insurer Disability Income plans which require that the insurer can NEVER change or alter premium rates are usually considered - ANSWER -Noncancellable In NJ, group health insurance may be offered to all of these groups EXCEPT - ANSWER -College seminar participants Jerry voluntarily terminated his producer's license. If he changes his mind, his license may be reinstate during the same license period IF - ANSWER -he completes a new license application An insured MUST submit proof of loss on a health insurance claim within how many days after the date of loss? - ANSWER -90 days In contrast to a guaranteed renewable policy, a noncancellable policy - ANSWER -may never raise premiums A medical provider that accepts Medicare Assignment must - ANSWER -accept payment based upon a defined Medicare schedule as payment in full Fraternal Benefit Society has each of the following characteristics EXCEPT - ANSWER -Exist For Profit