Practice tests
A brain surgeon has an accident and develops tremors in her right arm. Which disability income policy definition of totally disability will cover her for all loses?
"own occupation"- less restrictive than other definitions
A producer was found guilty of a 3rd violation of the insurance code. What would be the monetary penalty he will have to pay?
$10,000
The comish believes that an insurance rule or regulation has been violated, and decides to call a disciplinary hearing. How many days before a hearing must the comish issue a notice to the person charged with a violation
10 days
Applicants for an individual producer license must submit proof of completing 24 hours of continuing education credits during the previous
2 years
If a producer is convicted of a crime they must notify the comish within
30 days
Within how many days must a producer report claims to the insurer
5 business days
how many days dos a producer have to remit the college ted premiums of the insurer
5 business days
A medicare supplement contract cannot define a "pre-existing condition" more restrictively than a condition for which medical advice was given or treatment recommended within how many months of the effective date of coverage
6 months
A medicare supplement policy cannot deny or limit coverage for a claim for losses incurred more than how many months from the effective date of coverage.
6 months
Benefit periods for individual short-term disability policies will usually continue from
6 months- 2 years
Most policies will pay the accidental death benefits as long as the death is caused by the accident and occurs within
90 days
All of the following are advertisements except
A discussion of an insurers policies on the radio
all of the following are correct about the required provisions of a health insurance policy except
A reinstated policy provides immediate coverage for an illness
Which of the following candidates for a resident producer license may not be exempted from the examination period
A resident producer licensed for property and casualty insurance applying for a life insurance policy
Which of the following would be required to be licensed as an insurance producer
A salaried employee who advertises and solicits insurance
Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
A statement that is sufficiently clear to identify the insured and the nature of the claim
In which Medicare supplemental policies are the core benefits found
All plans
Under HIPAA, which of the following is incorrect regarding eligibility requirements for conversation to an individual policy
An individual who was previously covered by group health insurance for 6 months is eligible
In replacement situation, all of the following must be considered except
Assests
Which of the following is not true in regards to the Key Person disability income policy
Benefits are not considered taxable income to the business
Which of the following must an insurer obtained in order to transaction insurance within a given state?
Certificate of authority
Which of the following establishes minimum, standards for any policy that will be marketed as Medicare supplement policy
Comish
Contracts that are prepared by one party and submitted to the other party on a take-it-or-leave-it basis are classified as
Contracts of adhesion
Which of the following is not true regarding basic surgical expense coverage
Coverage is unlimited
if an insured changes his premium payment method mode from monthly to annually, what happens to the total premium
Decreases
Group disability income insurance premiums paid by the employer are
Deductible by the employer as an ordinary business expense
Rob is being treated by a physical therapist in his apartment for a disorder which, if he were not treated there, would have to be treated on an inpatient basis in the hospital. What kind of care is this
Home Health Care
Which of the following refers to nursing and other health care services rendered to a person in his or her residence on a part time or intermediate basis
Home Health Care
Which of the following entitles has the authority to make changes to an insurance policy?
Insurers executive officer
Which of the following is INCORRECT concerning Medicaid
It is solely a federally administered program
What significance did US v South-Eastern Underwriters have on the insurance industry?
It reversed the decision of Paul v Virginia, determining that insurance Is interstate commerce and should be regulated federally.
The company has issued a policy and delivered it to producer B on may 1st, Monday. By what date must the policy be delivered too the insured?
May 10th (within 10 calendar days)
An insured is killed when a drunk drivers car slams into his tuck. His beneficiary receives triple the amount of the stated death benefit. What provision allows this?
Multiple indemnity rider
An applicant for a health insurance policy returns a completed application to her agent, along with a check for the first premium. She receives a conditional receipt weeks later. Which of the following has the insurer done by this point?
Nether approved nor issued the policy
Which renewal option does not guarantee renewal and allows the insurance company to refuse renewal of a policy at any premium due date
Optional renewable
What is the major difference between a stock company and a mutual company
Ownership
Prior to purchasing a Medigap policy, a person must be enrolled in which of the following
Parts A and B or Medicare
All of the following is not a requirement for a nonresident license
Passing the NJ licensing examination
which of the following provision would prevent an insurance company from paying a reimbursement claim to someone other than the policy owner
Payment of claims
Certain conditions, such as dismemberment or total amputation and permanent blindness, will automatically qualify the insured for full disability benefits. Which disability policy provision does this describe
Presumptive Disability
Any inducement offered to the insured in the sale of an insurance policy that is not specified in the policy is an unlawful practice known as
Rebating
In the event of a loss, business overhead insurance will pay for...
Rent
Which of the following is commonly provided in an institutional setting
Skilled care
Which of the following terms describes the specified dollar amount beyond which the insured no longer-participates in the sharing of expenses
Stop-loss limit
Which of the following is an example of a producer being involved in an unfair trade practice of rebating
Telling a client that his first premium will be waived if he purchases the insurance policy today
Insurable interest can be best described by which of the following
The applicant must experience a financial loss due to an accident or sickness that befalls the insured
What program was established by NJ to guarantee access to health coverage for individuals and small employers, regardless of health status, age, claims history, or other risk factors
The individual health coverage plan
In order for an insured under medicare part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met
The insured must have first been hospitalized for 3 consecutive days
The insuring clause of a disability policy usually states all of the following except
The method of premium payment
In terms of parties to a contract, which of the following does not describe a competent party
The person must have at least completed secondary education
An insured is upset that her new health insurance policy was delivered to her by certified mail and not through her agent. Which of the following is true?
There is nothing wrong with this form of policy delivery
Which of the following is included in the term "insurance-related conduct"?
Transmitting funds between procedures and the insurance company
In which situation would Social security supplement or social security riders not provide for the payment of income benefits
When the amount payable under social security is more than the amount payable under the rider
How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company
Within 90 days or as soon as reasonably possible, but not exceed a year
What is reinsurance
an agreement between a ceding insurer and a assuming insurer
While a claim is pending, an insurance company may require
an independent examination as often as reasonably required
Another term used to describe "non-deducible" is
first dollar basis
A health insurance policy lapses but is reinstated within an acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective
immediately
in an optionally renewable policy, the insurer has which of the following options
increase premiums
Underwriting a group health insurance plan that is paid for by the employer requires all of the following except
individual members of the group may select the level of benefits for their own coverage
Who does an insurance agent represent?
insurer
in the event of loss, after a notice of claim is submitted to the insurer, who is responsible for providing claims forms and to which party
insurer to the insured
The mode of premium payment
is defined as the frequency and the amount of the premium payment
A guaranteed renewable disability insurance policy
is renewable at the insureds option to a specified age
What statement best describes the free look provision
it allows the insured to return the policy within 10 days for a full refund of premiums if dissatisfied for any reason
Qualified medical expenses paid for participants in a medical savings account are
not taxable
Which of the following licenses is required for a surplus lines producer
property and casualty
The transfer of an insured right to seek damages from a negligent part to the insurer is found in which of the following clauses
subrogation