NJ Accident And Health Producer Practice Questions With 100% Verified Answers

NJ Accident And Health Producer Practice Questions With 100% Verified Answers Q.A Basic Hospital Policy pays expenses for: - hospital room and board -physician office visits -routine medical treatment -surgical services - ANSWERS--hospital room and board BASIC HOSPITAL EXPENSE COVERS HOSPITAL ROOM AND BOARD WITH DAILY LIMIT OF COVERAGE. BASIC SURGICAL PROCEDURES AND BASIC MEDICAL COVERS OFFICE VISITS AND ROUTINE MEDICAL TREATMENT Q.a group conversion option may be used in all the following instances EXCEPT: -loss of coverage due to loss of employment -a life changing event, such as marriage, divorce, or childbirth -the termination of the master policy -loss of eligibility on the part of a class of insureds. - ANSWERS-- a life changing event such as marriage, divorce, or childbirth CONVERSION PRIVILEGE ALLOWS EMPLOYEES TO CONVERT FORM GROUP TO INDIVIDUAL POLICY WITHOUT PROOF OF INSURABILITY UPON TERMINATION OF ELIGIBILITY OR GROUP PLAN Q.A life insurance policy may be returned for a cancellation and a full refund if it is returned NO later than -30 days after receipt by the policyholder -30 days after the issue -10 days after issue -20 days after receipt by the policyholder - ANSWERS--20 days after receipt by the policyholder Q.A producer who makes false statements about the financial condition of an insurer may be found guilty of -fraud -unfair discrimination -defamation -twisting - ANSWERS--defamation DEFAMATION IS AN ORAL OR WRITTEN STATEMENT MALICIOUSLY CRITICAL OF THE FINANCIAL CONDITION OF A PERSON OR COMPANY Q.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 - ANSWERS-for claims involving periodic payments INSURERS MUST PAY LUMP SUM CLAIMS IMMEDIATELY AFTER RECEIVING PROOF OF LOSS Q.All life insurance and health insurance contracts contain all of the following EXCEPT: -insuring clause -conditions -inmaterial representations -policy face - ANSWERS--immaterial representations are statements that do not affect the acceptance or rating of risk Q.All of the following are elements of an uninsurable loss EXCEPT: -expected losses are measurable -expected losses will be accidental -types of losses that occur can be expected -affordable premiums can be charged - ANSWERS--affordable premiums can be charged INSURABLE LOSSES CAN BE EXPECTED, MUST BE MEASURABLE, GENERATE AFFORDABLE PREMIUMS, AND ARE ACCIDENTAL IN NATURE Q.All of the following are requirements to qualify for SS disability benefits EXCEPT when: -totally and permanently disabled -unable to work in the occupation in which the worker was trained or educated -the disability is expected to last for 12 months or end in death -credited with the appropriate number of quarters coverage - ANSWERS--unable to work in the occupation in which the worker was trained or educated SS BENEFITS ELIGIBILITY IS BASEED ON 40 QUARTER CREDITS, LENGTH OF DISABILITY Q.An insurance policy that is intended to restore to the insured to the same financial status as before the loss is a contract of: -adhesion -good faith -indemnity