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Nj Health and Accident Insurance Actual Exam Questions and 100% Correct Answers / New Jersey 2025

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 6 pages. Originally published on StudyMerit.

Pages
6
Academic year
2025/2026
Language
English

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NJ Accident and Health State Exam Students also studied Edit Save Chapter 10 - Insurance Law 98 terms cmitschele Preview New Jersey Accident and Health Sta ... 53 terms James_Cox45 Preview NJ Health and accidental Practice fi ... 147 terms GUSTAVO_ESPINOSA7 Preview Prep Re 30 terms step With written proof of loss, how many days to file the claim? How many days before the insured can bring legal action against the insurer? 90 days 60 days No contract is in force until ______ is paid? Initial premium In Key Employee Disability Policy, if the business pays the premium as a tax-deductible expense, any benefits paid are ______? Fully taxable Policies that pay higher benefits, command ______ ? Higher premiums One of the main responsibilities of an underwriter is to protect the insurer against ______? Adverse selection Insurers issue preferred risk policies with reduced premiums with the expectation of ______? Better than normal mortality or morbidity experience Monitoring the insured's hospital stay to ensure everything is going according to schedule and that the insured will be released as planned is called ______? Concurrent review HIPAA provides that the 10% excise of tax for early withdrawal from IRAs will not apply to the extent a withdrawal is used for medical expenses that exceed ______ of the individual's adjusted gross income. 7.5% One of the most important considerations in replacing medical insurance is ______? Exclusions or limitations on a new policy

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Upon policy delivery, if no initial payment is collected with the application, the producer must request ______? The applicant to sign a Statement of Good Health Managed care is provided with which policies, except ______? Covered: - PPO - POS (point-of-service) - HMO Point of service plan is considered what kind of plan? Managed care plan Underwriters acquire information from these sources ______ - MIB - Consumer report - Attending physician statement Main field underwriter task is to ______? Ensure accuracy and completeness of an individual's medical information Sources of information that can assist underwriters are ______? - Agents report - MIB - Inspection reports In a specified disease insurance policy to a new policyowner, the producer can expect to collect all of these, ______? - Initial premium - Signed impairment rider acknowledgment - Good health statement Field underwriting roles include ______? - Providing disclosure to applicant - Collecting initial premium - Policy delivery A statement believed to be true is called ______? Representation An absolutely true statement is called ______? Warranty Making a misrepresentation to an insured concerning a the policy provisions affecting a loss is considered ______? Unfair trade practice Who would be considered for Group Health Insurance coverage? - Private employer - City government - Small employer The New Jersey Banking and Insurance Commissioner's responsibilities include ______? Main: - Conduct investigations - Issue subpoenas - Administer oaths - Issuing licenses to producers - Approve buyer's guide information - Establish continuing education requirements The New Jersey Code defines ______? Solicitation of insurance as the attempt to sell insurance to a person from a particular insurer

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