NJ Health Chapter 1 Field Underwriting Procedures
An insurance contact must contain all of the following to be considered legally binding except A Beneficiary's consent B offer and acceptance C Consideration D Competent parties
A Beneficiary's consent
Representations are written or oral statements made by the applicant that are A considered to be true to the best of the applicants knowledge B Guaranteed to be true C Found to be false after further investigation D immaterial to the actual acceptability of the insurance contract.
A considered to be true to the best of the applicants knowledge
What is the term used for an applicant's written request to an insurer for the company to issue a contract, based on the information provided?
Application
If an underwriter requires extensive information about the applicant's medical history, what report will best serve this purpose?
Attending physician's statement
When an insured makes truthful statements on the application for insurance and pays the required premium, it is known as which of the following? A Acceptance B Consideration C Legal purpose D Contract of adhesion
B Consideration
What is the term used for an applicant's written request to an insurer for the company to issue a contract, based on the information provided? A request for insurance B application C policy request D insurance request form
B application
The insurance policy, together with the policy application and any added riders form what is known as
Entire contract
What is the best way to make a change on an application for insurance?
Start over with a fresh application
Contracts that are prepared by one party and submitted to the other party on a take it to or leave it basis are classified as A unilateral contracts B Aleatory Contracts C Binding Contracts D Contracts of Adhesion
D Contracts of adhesion- Insurance policies are written by the insurer and submitted to the insured on a take-it or leave-it basis. The insured does not have any input into the contract, but simply adheres to the contract.
Which of the following is NOT the consideration in a policy? A Something of value exchanged between parties B The premium amount paid at the time of application C The promise to pay covered losses D The application given to a prospective insured
D The application given to a prospective insured
Which of the following entities can legally bind coverage? A the insured B Federal insurance board C agent D insurer
D insurer
Which of the following entities can legally bind coverage? A the insured B Federal Insurance Board C Agent D insurer
D insurer- only insurers not agents, can bind coverage
What entities make up the Medical Information Bureau?
Insurers
A life insurance policy has a legal purpose if both elements exists?
Insurable interest and consent
Who is responsible for paying the cost of a medical examiner required in the process of underwriting?
Insurer
Who must sign a health insurance application?
The policyowner, the insured (if different), and the agent
When should an agent obtain a Statement of Good Health from the insured
When the premium was paid upon policy delivery and not at the time of application.
Insurable interest can be best described as
applicant must experience a financial loss due to an accident or sickness that befalls the insured
Insurance policies are not drawn up through negotiations, and an insured has little to say about its provisions. What contract characteristic does this describe?
Adhesion
When would a misrepresentation on the insurance application be considered fraud?
If it is intentional and material
Whose responsibility is it to inform an applicant for health insurance about the insurer's information gathering practices?
The agent
If an agent makes a correction on the application for health insurance, who must initial the correct answer?
The applicant
What is the entire contract in health insurance underwriting?
The application and the policy issued
A life insurance policy has a legal purpose if both elements exist?
Insurable interest and consent
When would a misrepresentation on an insurance application be considered fraud?
It it is intentional and material
An insured stated on her application for life insurance that she had never had a heart attach, when in fact she had series of minor heart attacks last year for which she sought medical attention. Which of the following will explain the reason a death benefit claim is denied?
Material misrepresentation
If an insurer decides to obtain medical information from different sources in order to determine the insurability of an applicant, who must be notified of the investigation?
The applicant
In health insurance, the policy itself and the insurance application form what?
The entire contract
Which of the following would provide an underwriter with information concerning an applicant's health history?
The medical information bureau
An absolute true statement upon which the validity of the insurance policy depends.
Warranty
In insurance policies, the insured is not legally bound to any particular action in the insurance contract, but the insurer is legally obligated to pay losses covered by the policy. What contract element does this describe?
Unilateral
In insurance, an offer is usually made when A an agent explains a policy to a potential applicant B an applicant submits an application to the insurer C the insurer approves the application and receives the initial premium D the agent hands the policy to the policyholder
B an applicant submits an application to the insurer-- offer is usually made by the applicant in the form od the application. Acceptance takes place when an insurer's underwriter approves the application and issues a policy
What information are the members of the Medical Information Bureau required to report?
Adverse medical information about the applicants or insured
What information are the members of the Medical Information Bureaus required to report?
Adverse medical information about the applicants or insured
Four essential elements in forming a contract:
Agreement- offer and acceptance Consideration Competent parties Legal purpose
What is the term used for a written request for an insurer to issue an insurance contract based on the provided information?
Application
Which of the following would provide an underwriter the information concerning an applicants health history? A the agents report B the inspection report C The medical information bureau D A medical examination
C The medical information bureau- an agent report and inspection report provide personal information. Medical exams provide information on current health. Only the MIB will provide information about an applicant's medical history.
Which of the following would provide an underwriter with information concerning an applicant's health history? A the agent's report B the inspection report C the medical information bureau C a medical examination
C the medical information bureau
An agent is in the process of replacing the insured's current health insurance policy with a new one. Which of the following would be a proper action?
The old policy should stay in force until the new policy is issued