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Maryland Insurance Administration MarylandAccident and Health or Sickness Producer Series 20-24 Sample Questions:

1. All of the following are examples of unfair claims settlement practices EXCEPT:

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

2. It is unlawful for a person to provide an advertisement that:

A) Uses a policy title to misrepresent a coverage
B) Makes a comparison of benefits between policies
C) Points out coverage advantages of a policy
D) Refers to the insurer's financial rating

3. An elimination period in a disability income insurance policy is the:

A) Same as the probationary period
B) Time period the policy is in force
C) Time during which benefits are paid under the policy
D) Period between the start of a disability and the beginning of benefits

4. An insured incurs a covered accident and health insurance loss on May 30, which is submitted to the insurer on June 8. If the insured terminated coverage on June 1, the insurer:

A) Can refuse to pay the claim because coverage has been terminated
B) Can refuse to pay the claim under the pre-existing conditions exclusion
C) Must pay the claim within one year of termination of coverage
D) Must pay the claim upon receipt of the proof of loss

5. In HMO coverage, all of the following services must be available 24 hours per day, 7 days per week EXCEPT:

A) Dental care
B) In-patient hospital services
C) Primary care
D) Emergency medical care

Solutions: