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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


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