CERT ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER EXAM & TEST ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER DATES

Cert Accident-and-Health-or-Sickness-Producer Exam & Test Accident-and-Health-or-Sickness-Producer Dates

Cert Accident-and-Health-or-Sickness-Producer Exam & Test Accident-and-Health-or-Sickness-Producer Dates

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Test Accident-and-Health-or-Sickness-Producer Dates - Practice Test Accident-and-Health-or-Sickness-Producer Pdf

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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Exam Sample Questions (Q43-Q48):

NEW QUESTION # 43
In general practice, which one of the following is true of the powers of the Maryland Insurance Administration with respect to access to a producer's business records?

  • A. The Maryland Insurance Administration has no right to access a producer's business records because of privacy considerations
  • B. Authorization must come from the National Association of Insurance Commissioners (NAIC)
  • C. Records must be produced upon the request of the Maryland Insurance Administration
  • D. Records can only be accessed by an order of a state court

Answer: C

Explanation:
The MIA (Insurance Article, § 2-207) can request and access producer records for audits or investigations, overriding privacy for regulatory purposes. Court orders or NAIC approval aren't required, and access is a standard power.
References:Maryland Insurance Article, § 2-207; MIA regulatory authority.


NEW QUESTION # 44
A producer may be guilty of misrepresentation if the producer:

  • A. Denied a claim for failure of the policyholder to prove damages
  • B. Issued a full settlement check expressly releasing the insurer
  • C. Required timely written notice of loss for all claims
  • D. Failed to disclose exclusions of the policy

Answer: D

Explanation:
Comprehensive and Detailed Step by Step Explanation:Misrepresentation involves providing false, misleading, or incomplete information about a policy:
Failed to disclose exclusions of the policy (A):Correct. Not informing the insured about policy exclusions misrepresents the coverage and violates Maryland law.
Denied a claim for failure to prove damages (B):This relates to claims handling and is not misrepresentation.
Required written notice of loss (C):This is a legitimate policy requirement, not misrepresentation.
Issued a full settlement check (D):Standard claims settlement practice when agreed upon; not related to misrepresentation.
References:Maryland Insurance Article §27-303, Misrepresentation and False Advertising Standards, COMAR 31.15.03.


NEW QUESTION # 45
Which type of coverage bases benefit eligibility on the capacity to perform activities of daily living?

  • A. Long-term care insurance
  • B. Long-term disability
  • C. Medicare supplement
  • D. Major medical expense

Answer: A

Explanation:
Long-term care insurance (Insurance Article, § 18-101) triggers benefits based on inability to perform ADLs (e.g., bathing), unlike Medigap, major medical, or disability, which focus on medical or work criteria.
References:Maryland Insurance Article, § 18-101; MIA long-term care rules.


NEW QUESTION # 46
Reasonable and customary charges for health care are based primarily on:

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

Answer: C

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 # 47
If an employer with 200 employees wants to offer health insurance and calls a SHOP Exchange Navigator, what should the navigator do?

  • A. Refer the employer to the Maryland Insurance Administration
  • B. Refer the employer to a licensed insurance producer
  • C. Help the employer sign-up through the SHOP Exchange
  • D. Refer the employer to the copyright where a friend works

Answer: B

Explanation:
SHOP Exchange (Insurance Article, § 31-101) serves employers with 1-50 employees; a 200-employee firm exceeds this, so the navigator should refer them to a producer for large group plans, not assist via SHOP, refer personally, or send to the MIA.
References:Maryland Insurance Article, § 31-101; MIA SHOP Exchange guidelines.


NEW QUESTION # 48
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