NJ HEALTH AND ACCIDENT INSURANCE EXAM
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In order for insurance contracts to be legally binding,
they must have 4 essential elements: - .....ANSWER
...✔✔ 1. agreement
2. Consideration
3. Competent parties
4. legal purpose
consideration - .....ANSWER ...✔✔ The binding force
in a contract that requires something of value to be
exchanged for the transfer of risk. The consideration on
the part of the insured is the representations made in the
application and the payment of premium; the
consideration on the part of the insurer is the promise to
pay in the event of loss.
conditional contract - .....ANSWER ...✔✔ Certain
conditions must be met by all parties to the contract
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when a loss occurs in order for the contract to be legally
enforceable.
unilateral contract - .....ANSWER ...✔✔ only one of
the parties to the contract is legally bound to do
anything; the insurer is legally bound to pay losses
covered by a policy force
contract of adhesion - .....ANSWER ...✔✔ prepared
by the insurer and accepted or rejected by the other
party
warranty - .....ANSWER ...✔✔ An absolutely true
statement upon which the validity of the insurance policy
depends.
representations - .....ANSWER ...✔✔ statements
believed to be true to the best of one's knowledge
Material Misrepresentation - .....ANSWER ...✔✔ A
statement that, if discovered, would alter the
underwriting decision of the insurance company.
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Fair Credit Reporting Act - .....ANSWER ...✔✔
established procedures that consumer-reporting
agencies must follow in order to ensure that records are
confidential, accurate, relevant, and properly used
Medical Information Bureau - .....ANSWER ...✔✔
owned by member insurance companies. It is a nonprofit
trade organization that receives adverse medical
information from insurance companies and maintains
confidential medical impairment info on individuals
necessary signatures - .....ANSWER ...✔✔ 1. the
agent
2. the applicant
3. the proposed insured
Blue Cross and Blue Shield - .....ANSWER ...✔✔ not
insurance companies
Medical Savings Account - .....ANSWER ...✔✔ An
employer-funded account linked to a high deductible
medical insurance plan.
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Flexible Spending Account - .....ANSWER ...✔✔
employees deposit a certain amount of their paycheck
into an account before paying income taxes. Then during
the year, the employee can be directly reimbursed from
the account for eligible health care and dependent care
expenses.
who limits the annual contribution for Dependent Care
Accounts to a specified amount that gets adjusted
annually for cost of living? - .....ANSWER ...✔✔ IRS
Health Reimbursement Account (HRA) - .....ANSWER
...✔✔ an account into which employers place
contributions that employees can use to pay for medical
expenses. Usually combined with a high-deductible
health insurance policy
Health Savings Account (HSA) - .....ANSWER ...✔✔ a
tax-free savings account—funded by employees,
employer, or both—to spend on routine medical costs.
Usually combined with a high-deductible policy to pay
for catastrophic care
consumer-driven health plan (CDHP) - .....ANSWER
...✔✔ Type of medical insurance that combines a