NJ Health Insurance Exam Questions with Correct Answers 100% Verified by Experts|
2025/2026 Latest Update
agent or producer legal representative of an insurance company: the classification of
producer usually includes agents & brokers; agents are the agents of the insurer
applicant or proposed insured a person applying for insurance
consent permission to do something
insurable interest the policy owner facing the possibility of losing something of value in the
event of loss; proven by love and affection, economic or financial loss, required at time of policy
issuance
insurance policy a contract between policy owner (and/or insured) & an insurance company
which agrees to pay the insured or the beneficiary for loss caused by specific events
insured a person covered by an insurance policy; may or may not be the policy owner
insurer (principal) the company who issues an insurance policy
policy owner the person entitled to exercise the rights and privileges in the policy
premium the money paid to the insurance company for the insurance policy
completing application and delivering the policy producers 1st major role in transacting
insurance
steps of application process completing the form
,collecting the premium
delivering the policy
contract law for contracts to be legally binding, they must have:
1. agreement - offer & acceptance
2. consideration
3. competent parties
4. legal purpose
acceptance occurs when insurers underwriter approves application and issues a policy
consideration binding force in any contract, something of value each party gives to each
other
insured consideration the payment of premium and the representations made in the
application
insurer consideration the promise to pay for losses
conditional contract requires that certain conditions must be met by the policy owner and
the company in order for the contract to be executed, and before each party fulfills its
obligations
unilateral contract only one of the parties to the contract is legally bound to do anything
contract of adhesion prepared by one of the parties (insurer) and accepted or rejected by
the other party (insured)
,warranty an absolutely true statement upon which the validity of the insurance policy
depends
representations statements believed to be true to the best of one's knowledge, but they are
not guaranteed to be true; answers the insured gives to the questions on the insurance
application
misrepresentations untrue statements on the application that could void the contract
material misrepresentation a statement that, if discovered, would alter the underwriting
decision of the insurance company. considered fraud if intentional
fair credit reporting act established procedures that consumer-reporting agencies must
follow in order to ensure that records are confidential, accurate, relevant, and properly used;
protects consumers against the circulation of inaccurate or obsolete personal or financial
information
acceptability of a risk determined by checking the individual risk against many factors
directly related to the risk's potential for loss
paramedical report completed by a paramedic or a registered nurse; requested by insurer
attending physicians statement (APS) from a medical practitioner who treated the applicant
for a prior medical problem; may be required by underwriter
medical information bureau report (MIB) underwriter usually requests in addiction to APS
report, membership corporation owned by member insurance companies; insurers cannot
refuse coverage solely on the basis of adverse information on an MIB report
, medical information bureau nonprofit trade organization to collect, maintain, and make
available to insurance companies important underwriting information on applicants for life and
health insurance; systematic method for companies to compare information collected on a
potential insured with info other insurers may have discovered
beginning of application a form provided by the company and completed by the agent as
questions are asked of the applicant and the responses are recorded, then submitted to the
company for its approval or rejection
agent, applicant, proposed insured the parties that must sign the application form
agent obligated to check the application to make certain that all questions have been
answered and all necessary signatures have been collected
policy delivery may be accomplished without physically delivering it in the policy owner's
possession, but should be personally delivered whenever possible
agents responsibility provide insured with an explanation of the policy's main benefits and
provisions, explain any changes or amendments to the policy and obtain insureds signature
replacement agents responsibility to carefully compare the benefits, limitations and
exclusions found in the current and proposed replacement policy. must make sure current
policy is not cancelled before new policy is issued (cannot be a coverage gap)
insurers entities that make up the medical information bureau
agents whose responsibility is it to determine that all the questions on an insurance
application are answered?
2025/2026 Latest Update
agent or producer legal representative of an insurance company: the classification of
producer usually includes agents & brokers; agents are the agents of the insurer
applicant or proposed insured a person applying for insurance
consent permission to do something
insurable interest the policy owner facing the possibility of losing something of value in the
event of loss; proven by love and affection, economic or financial loss, required at time of policy
issuance
insurance policy a contract between policy owner (and/or insured) & an insurance company
which agrees to pay the insured or the beneficiary for loss caused by specific events
insured a person covered by an insurance policy; may or may not be the policy owner
insurer (principal) the company who issues an insurance policy
policy owner the person entitled to exercise the rights and privileges in the policy
premium the money paid to the insurance company for the insurance policy
completing application and delivering the policy producers 1st major role in transacting
insurance
steps of application process completing the form
,collecting the premium
delivering the policy
contract law for contracts to be legally binding, they must have:
1. agreement - offer & acceptance
2. consideration
3. competent parties
4. legal purpose
acceptance occurs when insurers underwriter approves application and issues a policy
consideration binding force in any contract, something of value each party gives to each
other
insured consideration the payment of premium and the representations made in the
application
insurer consideration the promise to pay for losses
conditional contract requires that certain conditions must be met by the policy owner and
the company in order for the contract to be executed, and before each party fulfills its
obligations
unilateral contract only one of the parties to the contract is legally bound to do anything
contract of adhesion prepared by one of the parties (insurer) and accepted or rejected by
the other party (insured)
,warranty an absolutely true statement upon which the validity of the insurance policy
depends
representations statements believed to be true to the best of one's knowledge, but they are
not guaranteed to be true; answers the insured gives to the questions on the insurance
application
misrepresentations untrue statements on the application that could void the contract
material misrepresentation a statement that, if discovered, would alter the underwriting
decision of the insurance company. considered fraud if intentional
fair credit reporting act established procedures that consumer-reporting agencies must
follow in order to ensure that records are confidential, accurate, relevant, and properly used;
protects consumers against the circulation of inaccurate or obsolete personal or financial
information
acceptability of a risk determined by checking the individual risk against many factors
directly related to the risk's potential for loss
paramedical report completed by a paramedic or a registered nurse; requested by insurer
attending physicians statement (APS) from a medical practitioner who treated the applicant
for a prior medical problem; may be required by underwriter
medical information bureau report (MIB) underwriter usually requests in addiction to APS
report, membership corporation owned by member insurance companies; insurers cannot
refuse coverage solely on the basis of adverse information on an MIB report
, medical information bureau nonprofit trade organization to collect, maintain, and make
available to insurance companies important underwriting information on applicants for life and
health insurance; systematic method for companies to compare information collected on a
potential insured with info other insurers may have discovered
beginning of application a form provided by the company and completed by the agent as
questions are asked of the applicant and the responses are recorded, then submitted to the
company for its approval or rejection
agent, applicant, proposed insured the parties that must sign the application form
agent obligated to check the application to make certain that all questions have been
answered and all necessary signatures have been collected
policy delivery may be accomplished without physically delivering it in the policy owner's
possession, but should be personally delivered whenever possible
agents responsibility provide insured with an explanation of the policy's main benefits and
provisions, explain any changes or amendments to the policy and obtain insureds signature
replacement agents responsibility to carefully compare the benefits, limitations and
exclusions found in the current and proposed replacement policy. must make sure current
policy is not cancelled before new policy is issued (cannot be a coverage gap)
insurers entities that make up the medical information bureau
agents whose responsibility is it to determine that all the questions on an insurance
application are answered?
