NJ Accident and Health Producer PRACTICE
EXAMS Actual 2025 Questions and Verified Answers
()/ A+ GRADE COMPLETE.
1. According to the Time Payment of Claims provision, the insurer must make
the payment immediately after receiving proof of loss EXCEPT
- if the insured is able to eventually return to work
-if the death is suicide or due to a pre existing condition
-when the policy is in the incontestability period
-for claims involving periodic payments
Ans>>: for claims involving periodic payments
INSURERS MUST PAY LUMP SUM CLAIMS IMMEDIATELY AFTER RECEIVING
PROOF OF LOSS
2. What does coinsurance mean?
- a policy covers the insured and the any additional named persons
-the insurer and the insured share expenses over the deductible
-the insurer and the insured share ALL expenses
-the policy owner holds multiple policies through the same insurer
,Ans>>: The insurer and the insured share expenses over the deductible
COINSURANCE IS THE SHARING BETWEEN THE INSURER AND THE IN-
SURED OF COVERED EXPENSES THAT EXCEED THE DEDUCTIBLE AMOUNT.
THE SHARING ENDS WHEN THE "STOP LOSS LIMIT" IS REACHED
3. The life insurance policy will not be truly effect until all of the following occur
EXCEPT:
-the statement of good health is obtained by the insurer
-the first premium is collected
-the policy is delivered to the applicant
-the producer has explained the policy to the client
Ans>>: -the producer has explained the policy to the client
EFFECTIVE DATE BASED ON :
-APP DATE
-IF PREMIUM HAS BEEN PAID
-IF A STATEMENT OF GOOD HEALTH MUST BE OBTAINED IF PREMIUM WAS
NOT SUBMITTED WITH APPLICATION
4. Which of the following coverage types pays a monthly cash benefit follow-
ing the elimination period for total disability due to accident or sickness?
-credit disability
-works comp disability
-recurrent disability
-disability income
Ans>>: -disability income insurance
, PROVIDES PAYMENT OF REGULAR PERIODIC INCOME SHOULD THE IN-
SURED BECOME DISABLED FROM ILLNESS OR INJURY
5. The period beginning at the time of an insured loss that an insured must
wait before benefits are payable is called the:
-probationary period
-benefit period
-elimination period
-grace period
Ans>>: -elimination period
THE TIME PERIOD STARTING AT THE TIME OF LOSS, SUCH AS A DISABILITY,
THAT AN INSURED MUST WAIT BEFORE BENEFITS ARE PAYABLE
6. Managed care plans increase efficiency by all of the following EXCEPT:
-transferring the management of costs to the insureds
-controlling inpatient admissions and length of stay
-increasing beneficiary cost sharing
-selectively contracting with health care providers
Ans>>: -transferring the manage- ment of costs to the insureds
MANAGED CARE PLANS ARE DESIGNED TO USE COST SAVING SERVICES
BY USING CLOSED NETWORKS AND MANAGING HEALTH CARE WITH THESE
NETWORKS
7. Under an individual policy, and insured who CANNOT perform the duties of
his/her own occupation for a specific period of time is:
-totally disabled
-permanently disabled
EXAMS Actual 2025 Questions and Verified Answers
()/ A+ GRADE COMPLETE.
1. According to the Time Payment of Claims provision, the insurer must make
the payment immediately after receiving proof of loss EXCEPT
- if the insured is able to eventually return to work
-if the death is suicide or due to a pre existing condition
-when the policy is in the incontestability period
-for claims involving periodic payments
Ans>>: for claims involving periodic payments
INSURERS MUST PAY LUMP SUM CLAIMS IMMEDIATELY AFTER RECEIVING
PROOF OF LOSS
2. What does coinsurance mean?
- a policy covers the insured and the any additional named persons
-the insurer and the insured share expenses over the deductible
-the insurer and the insured share ALL expenses
-the policy owner holds multiple policies through the same insurer
,Ans>>: The insurer and the insured share expenses over the deductible
COINSURANCE IS THE SHARING BETWEEN THE INSURER AND THE IN-
SURED OF COVERED EXPENSES THAT EXCEED THE DEDUCTIBLE AMOUNT.
THE SHARING ENDS WHEN THE "STOP LOSS LIMIT" IS REACHED
3. The life insurance policy will not be truly effect until all of the following occur
EXCEPT:
-the statement of good health is obtained by the insurer
-the first premium is collected
-the policy is delivered to the applicant
-the producer has explained the policy to the client
Ans>>: -the producer has explained the policy to the client
EFFECTIVE DATE BASED ON :
-APP DATE
-IF PREMIUM HAS BEEN PAID
-IF A STATEMENT OF GOOD HEALTH MUST BE OBTAINED IF PREMIUM WAS
NOT SUBMITTED WITH APPLICATION
4. Which of the following coverage types pays a monthly cash benefit follow-
ing the elimination period for total disability due to accident or sickness?
-credit disability
-works comp disability
-recurrent disability
-disability income
Ans>>: -disability income insurance
, PROVIDES PAYMENT OF REGULAR PERIODIC INCOME SHOULD THE IN-
SURED BECOME DISABLED FROM ILLNESS OR INJURY
5. The period beginning at the time of an insured loss that an insured must
wait before benefits are payable is called the:
-probationary period
-benefit period
-elimination period
-grace period
Ans>>: -elimination period
THE TIME PERIOD STARTING AT THE TIME OF LOSS, SUCH AS A DISABILITY,
THAT AN INSURED MUST WAIT BEFORE BENEFITS ARE PAYABLE
6. Managed care plans increase efficiency by all of the following EXCEPT:
-transferring the management of costs to the insureds
-controlling inpatient admissions and length of stay
-increasing beneficiary cost sharing
-selectively contracting with health care providers
Ans>>: -transferring the manage- ment of costs to the insureds
MANAGED CARE PLANS ARE DESIGNED TO USE COST SAVING SERVICES
BY USING CLOSED NETWORKS AND MANAGING HEALTH CARE WITH THESE
NETWORKS
7. Under an individual policy, and insured who CANNOT perform the duties of
his/her own occupation for a specific period of time is:
-totally disabled
-permanently disabled
