Download State Insurance Claims Adjusters Certification Exam: Review of Chapters 4 and 5 and more Exams Insurance law in PDF only on Docsity!
St. John’s University
(New York, NY)
[Risk Management and Insurance Program.]
State Insurance Claims Adjusters Certification
New York, NY Claims Adjuster Exam
Course Title and Number: Claims Adjuster Exam Exam Title: Board Exam Exam Date: Exam 2024- 2025 Instructor: [Insert Instructor’s Name] Student Name: [Insert Student’s Name] Student ID: [Insert Student ID]
Examination
180 minutes
Instructions:
- Read each question carefully.
- Answer all questions.
- Use the provided answer sheet to mark your responses.
- Ensure all answers are final before submitting the exam.
- Please answer each question below and click Submit when you have completed the Exam.
- This test has a time limit, The test will save and submit automatically when the time expires
- This is Exam which will assess your knowledge on the course Learning Resources.
Good Luck!
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State Insurance Claims Adjusters Certification 2024- New York N.Y Independent Adjuster Lisence Exam Series 17-63 Review Chapter 4 and 5 Questions and Correct Answers | 100% Pass Guaranteed | Graded A+ | Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - An employer's health insurance plan states that workers are not eligible to enroll in the plan until after they have been continuously employed for at least 30 days. This period of time is known as the: - =Answer>> probationary period The benefits paid under disability coverage if the insured becomes sick two days after the policy is issued: - =Answer>> Only if the policy has no probationary period for illness Which of the following is not a basis for occupational suitability when determining total disability? - =Answer>> job Interest Benefit periods for individual short term disability policies typically vary from: - =Answer>> 13 weeks to 2 years What provision describes a responsibility of an insured who is making a claim? - =Answer>> Proof of loss What is the minimum number of days the grace period must contain in an accident and sickness policy which provides for a weekly premium payment - =Answer>> 10 days Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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Which mandated provision assures the policyowner that no existing benefits can be denied or compromised even if the insurer makes changes affecting future policies of like kind or type? - =Answer>> Entire contract provision If an insured becomes pregnant having family health insurance coverage, the newborn child becomes insured: - =Answer>> immediately at birth What provision requires the insurance company to pay claims promptly: - =Answer>> Time of payment claim Jim has a health insurance contract which contains a change of occupation provision. He changes jobs and his new position is in a more hazardous occupation. He neglects to notify the insurance company and two months later, is injured at work. What may the company do? - =Answer>> Reduce the benefits to the premium rate applicable to the new occupation. All of the following are optional provisions in individual health insurance policies except: - =Answer>> Notice of claim. How long will coverage remain in effect after the premium due date on an annual premium health insurance policy? - =Answer>> 31 days Standards for health insurance policy provisions have been established by the uniform policy provisions law. A required provision concerning "notice of claim" obligates a policyholder to give the insurer or it's agent notice of a Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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claim within: - =Answer>> 20 Days of a loss, or as soon as reasonably possible If an insured dies, when can the beneficiary expect to receive the proceeds - =Answer>> Immediately after the company receives proof of loss The following statement pertaining to the grace period and reinstatement provisions in health insurance policies is incorrect: - =Answer>> Under a health policy's reinstatement terms, insured losses from accidental injuries and sickness are covered immediately after reinstatement. Under the misstatement of age provision in a health insurance policy, what can a company do if it discovers that an insured gave a wrong age at the time of application? - =Answer>> Adjust the benefits The conformity with state statutes provision in a health insurance policy stipulates that any policy provision that is in conflict with the statutes of the state where the insured resides is: - =Answer>> Automatically amended to conform to the minimum requirements of the states statutes Which section of a health insurance policy specifies the conditions, times, and circumstances under which the insured is not covered by the policy. - =Answer>> Exclusions What type of health insurance policy prevents the company from changing the premium rate or modifying the coverage in any way? - =Answer>> noncancellable Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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proof of loss, except for periodic payments. - =Answer>> 30 days Insureds cannot sue their insurers for payment under an individual health insurance policy until _______ days after a written proof of loss has been submitted or after _______ years from the date of filing the proof of loss. - =Answer>> 60 days, 3 years The following statement about elimination periods in disability income is not correct: - =Answer>> Benefits are not payable during an elimination period, but are paid retroactively to the beginning of the period if the insurance remains disabled throughout the period If an insured can receive more money under loss of time benefits than earnings on the job, or more money for the reimbursement of medical expenses than these services cost, this is called: - =Answer>> Overinsurance A newly insured person asks, "When will my accident and health policy take effect?" The agent should say, - =Answer>> "on the date specified in the policy" The following is not a definition used in partial health policy: - =Answer>> temporary confinement in a hospital total and permanent disability is considered to be: - =Answer>> prevented from engaging in the insureds occupation or doing any job for which the insured is trained. Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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the health insurance provision that permits the insurer to pay limited death benefits to a relative of the insured is: - =Answer>> facility of payment The following generally is not considered to be a presumptive disability - =Answer>> loss of a dominant hand the following term relates to disability income insurance: - =Answer>> residual amount benefit the following is normally classified as earned income for the purpose of calculating disability income benefits - =Answer>> W2 income The following is incorrect regarding recurrent disabilities for disability insurance - =Answer>> recurrent disability policy provisions have no effect on the payment of benefits a disability which prevents a person from performing one or more of their regular duties of that person's job column and which is a condition that will last for the remainder of the persons life is a: - =Answer>> permanent partial disability An office worker whose job consists exclusively of making telephone calls and tabulating numbers has had one arm amputated, after returning to work, the employee is able to perform most of the duties of his job, this person will always work more slowly than he did before the loss, therefore the most accurate description of this type of a loss is: - =Answer>> Permanent partial disability Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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AD&D benefits are paid as a percentage of the principal sum based on the _______ of injury involved: - =Answer>> severity health policy that can be part of a business agreement such as a buy-sell agreement is known as: - =Answer>> business disability buyout insurance disability income policies written with a presumptive disability provision automatically assume that the insured is totally disabled upon the loss of: - =Answer>> 2 limbs, sight, &/or hearing When you own and pay the premium of your disability income insurance, any benefits you receive is - =Answer>> tax free If a disability income policy provides coverage for work related injuries, it is described as: - =Answer>> Occupational The period between a loss and the beginning of benefit payments in disability income insurance is known as: - =Answer>> elimination period In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments: - =Answer>> After an insured has become disabled as defined in the policy Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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The following is not true of a presumptive disability policy - =Answer>> examinations to verify the loss will only be required every 2 years EE purchased dis policy with 30 day waiting period and monthly benefit of $2500. persons job was eliminated and while unemplyed, became paralyzed. After 30 days, this policy: - =Answer>> Will not pay any benefit sum EE has dis income policy paying him $4k a month with a 30 day WP. Bill was disabled for 75 days. - =Answer>> $6k income benefits payable only if a disabilty occurs from non- occupational activites are considered: - =Answer>> non- occupational benefits disability benefits written on a key employee of a business and payable to the business are: - =Answer>> usually received income tax free EE owns an individual disability income policy with a monthly benefit of $3k payable to age 65 following a 60 day waiting period. the company he worked for was sold and the insurance was terminated. EE involved in traffic accident and lost ability to speak. This policy: - =Answer>> Will not pay any benefit for this disability Need Writing 🤔Help? We've Got You Covered! ✍️ 100% NO A I or Plagiarism Guaranteed🤔
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