NJ Accident and Health Producer PRACTICE EXAMS Questions and Answers Latest Updated 2024
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NJ Accident and Health Producer PRACTICE EX
Institution
NJ Accident And Health Producer PRACTICE EX
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 pe...
NJ
Accident
and
Health
Producer
PRACTICE
EXAMS
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
-
correct
answer-for
claims
involving
periodic
payments
INSURERS
MUST
PAY
LUMP
SUM
CLAIMS
IMMEDIATELY
AFTER
RECEIVING
PROOF
OF
LOSS
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
-
correct
answer-The
insurer
and
the
insured
share
expenses
over
the
deductible
COINSURANCE
IS
THE
SHARING
BETWEEN
THE
INSURER
AND
THE
INSURED
OF
COVERED
EXPENSES
THAT
EXCEED
THE
DEDUCTIBLE
AMOUNT.
THE
SHARING
ENDS
WHEN
THE
"STOP
LOSS
LIMIT"
IS
REACHED
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
-
correct
answer--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
Which
of
the
following
coverage
types
pays
a
monthly
cash
benefit
following
the
elimination
period
for
total
disability
due
to
accident
or
sickness?
-credit
disability
-works
comp
disability
-recurrent
disability
-disability
income
-
correct
answer--disability
income
insurance PROVIDES
PAYMENT
OF
REGULAR
PERIODIC
INCOME
SHOULD
THE
INSURED
BECOME
DISABLED
FROM
ILLNESS
OR
INJURY
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
-
correct
answer--elimination
period
THE
TIME
PERIOD
STARTING
AT
THE
TIME
OF
LOSS,
SUCH
AS
A
DISABILITY,
THAT
AN
INSURED
MUST
WAIT
BEFORE
BENEFITS
ARE
PAYABLE
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
-
correct
answer--transferring
the
management
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
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
-residually
disabled
-occupationally
disabled
-
correct
answer--totally
disabled
TOTAL
DISABILITY
IS
DEFINED
AS
THE
INABILITY
OF
INSURED
TO
PERFORM
ALL
THE
DUTIES
OF
HIS
REGULAR
OCCUPATION
FOR
THE
FIRST
24
MONTHS
AFTER
A
LOSS
How
do
most
disability
policies
handle
the
case
of
a
recurrent
disability
occurring
at
least
90
days
after
the
first
claim?
-it
is
excluded
from
coverage
because
benefits
have
already
been
paid
-it
must
be
handled
as
a
new
claim
for
a
new
period
of
disability
-it
is
handled
as
a
continuation
of
the
existing
claim
-it
must
be
handled
as
new
claim
for
a
new
period
of
disability,
requiring
a
new
elimination
period
-
correct
answer--it
must
be
handled
as
a
new
claim
for
a
new
period
of
disability,
requiring
a
new
elimination
period
RECURRENT
DISABILITY
PROVISION
PROTECTS
INSURED
WHO
BECOMES
DISABLED
AGAIN
FOR
THE
SAME
OR
RELATED
CAUSE
WITHIN
A
SPECIFIC
TIME
PERIOD.
MOST
HAVE
A
90
DAY
TIME
PERIOD
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