ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER DUMPS FREE DOWNLOAD, TEST ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER PRACTICE

Accident-and-Health-or-Sickness-Producer Dumps Free Download, Test Accident-and-Health-or-Sickness-Producer Practice

Accident-and-Health-or-Sickness-Producer Dumps Free Download, Test Accident-and-Health-or-Sickness-Producer Practice

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q57-Q62):

NEW QUESTION # 57
If an individual's occupation is considered to be illegal:

  • A. It may result in a denial of a disability income claim
  • B. It must be stated as such on an accident and health insurance application
  • C. It results in a substandard rating on an accident and health insurance policy
  • D. It may require a waiver on a disability income insurance policy

Answer: A

Explanation:
Illegal occupations (Insurance Article, § 12-101) can lead to claim denials if disability arises from illegal acts, per public policy. Disclosure isn't mandated, waivers don't apply, and ratings adjust risk, not legality.
References:Maryland Insurance Article, § 12-101; MIA claims policies.


NEW QUESTION # 58
The Maryland Insurance Administration is an agency of the:

  • A. Maryland General Assembly
  • B. Federal government
  • C. State government
  • D. National Association of Insurance Commissioners

Answer: C

Explanation:
The Maryland Insurance Administration (MIA) is a state agency under Insurance Article, § 2-101, regulating insurance within Maryland. The federal government oversees broader laws, the NAIC is a voluntary group, and the General Assembly legislates, but the MIA operates as an executive state entity.
References:Maryland Insurance Article, § 2-101; MIA official structure.


NEW QUESTION # 59
Reasonable and customary charges for health care are based primarily on:

  • A. National physician surveys
  • B. Actuarial tables
  • C. Insurance industry studies
  • D. Average charges within a geographic area

Answer: D

Explanation:
Reasonable and customary charges (Insurance Article, § 15-1005) reflect average fees for procedures in a specific geographic area (e.g., 80th percentile), ensuring fair reimbursement. Actuarial tables, studies, and national surveys aren't the primary basis.
References:Maryland Insurance Article, § 15-1005; MIA health insurance guidelines.


NEW QUESTION # 60
A health maintenance organization (HMO) must provide coverage for all of the following EXCEPT:

  • A. Dental and vision care
  • B. Routine physical examinations
  • C. Emergency services
  • D. Well-baby or well-child care

Answer: A

Explanation:
Maryland HMOs (Health-General Article, § 19-701) must provide basic health services like routine physicals, well-child care, and emergency services. Dental and vision care, however, are not required unless specified as supplemental benefits. State law mandates pediatric care but excludes routine dental and vision from standard HMO coverage unless the plan explicitly includes them.
References:Maryland Health-General Article, § 19-701; Insurance Article, § 15-1201; MIA HMO guidelines.


NEW QUESTION # 61
All of the following are examples of unfair claims settlement practices EXCEPT:

  • A. Denying unsubstantiated claims on a timely basis
  • B. Misrepresenting pertinent facts of coverage
  • C. Refusing arbitrarily and unreasonably to pay claims
  • D. Failing to promptly provide a reason for a claim denial

Answer: A

Explanation:
Unfair practices (Insurance Article, § 27-303) include delays, arbitrary refusals, and misrepresentation.
Denying unsubstantiated claims promptly is fair and expected, not an unfair practice.
References:Maryland Insurance Article, § 27-303; MIA claims regulations.


NEW QUESTION # 62
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