reglab/housing_qa huggingface dataset:
MD. Insurance Code Ann. §  12-204 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-204 - Hearings on Minimum Benefits or Coverage

    (a)    The Commissioner may hold hearings to determine if accident, disability, and health insurance policies meet the requirements of § 12-205 of this subtitle, so that fraud and the issuance of insurance policies economically unsound to insureds may be prevented and to ensure that a minimum amount of benefits or coverage is made available to the policy or certificate holders.    (b)    After evaluating the results of a hearing, the Commissioner shall, in compliance with § 12-205 of this subtitle, adopt reasonable regulations establishing minimum benefits or coverages necessary to meet the needs of insureds.
MD. Insurance Code Ann. §  12-205 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-205 - Disapproval of Forms

    (a)    (1)    The Commissioner shall disapprove a form or withdraw the previous approval of a form filed under § 12–203 of this subtitle if the form does not meet the requirements of subsection (b) of this section.        (2)    The order of disapproval or withdrawal of approval shall inform the insurer of:            (i)    a statutory or regulatory basis for the disapproval or withdrawal of approval; and            (ii)    an explanation of the application of the statutory or regulatory basis for the disapproval or withdrawal of approval.    (b)    A form may not:        (1)    in any respect violate or fail to comply with this article;        (2)    contain or incorporate by reference, if the incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions that deceptively affect the risk purported to be assumed in the general coverage of the contract;        (3)    have a title, heading, or other indication of its provisions that is likely to mislead the policyholder or certificate holder;        (4)    contain an inequitable provision of insurance without substantial benefit to the policyholder;        (5)    be printed or otherwise reproduced so as to make a provision of the form substantially illegible;        (6)    provide benefits in a health insurance policy that are unreasonable in relation to the premium charged;        (7)    contain, irrespective of the premium charged, a benefit that is not sufficient to be of real economic value to the insured;        (8)    fail to provide minimum benefits or coverages that the Commissioner considers necessary to meet the minimum needs of the insured; or        (9)    in a health insurance application form or a nonprofit health service plan application form, contain inquiries about:            (i)    a preexisting condition, illness, or disease for which the applicant has not received medical care or advice from a licensed health care provider:                1.    during the 7 years immediately before the date of application; or                2.    for an application for an individual health benefit plan that is subject to § 15–508.1 of this article, during the 5 years immediately before the date of application; or            (ii)    medical screening, testing, monitoring, or any other similar medical procedure that the Commissioner specifies and that the applicant received:                1.    more than 7 years before the date of application; or                2.    for an application for an individual health benefit plan that is subject to § 15–508.1 of this article, more than 5 years before the date of application.
MD. Insurance Code Ann. §  12-206 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-206 - Applications for Life or Health Insurance or Annuities

    (a)    (1)    This subsection does not apply to industrial life insurance policies.        (2)    Unless a complete copy of the application for the issuance of a life insurance or health insurance policy or annuity contract is attached to or otherwise made a part of the policy or contract when issued, the application is not admissible in evidence in a proceeding relating to the policy or contract.    (b)    (1)    If an insured, beneficiary, or assignee of a reinstated or renewed life insurance or health insurance policy that is delivered in the State makes a written request to the insurer for a copy of any application for reinstatement or renewal, the insurer shall deliver or mail the copy within 30 days after the request is received at the insurer’s home office or branch office.        (2)    If a requested copy is not delivered or mailed, the insurer may not introduce the application in evidence in any proceeding based on or involving the policy, its reinstatement, or its renewal.        (3)    If the request is from a beneficiary, the time for the insurer to provide a copy does not begin to run until after the insurer receives evidence that satisfies the insurer of the beneficiary’s vested interest in the policy or contract.    (c)    (1)    Except as provided in paragraph (2) of this subsection, an alteration of a written application for a life insurance or health insurance policy or annuity contract may not be made by a person other than the applicant without the applicant’s written consent.        (2)    An insurer may make an insertion for administrative purposes only in a way that indicates clearly that the insertion is not to be ascribed to the applicant.
MD. Insurance Code Ann. §  12-207 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-207 - Statements in Applications for Life or Health Insurance or Annuities

    (a)    Each statement by or on behalf of the insured or annuitant in an application for the issuance, renewal, or reinstatement of a life insurance or health insurance policy or annuity contract is considered to be a representation and not a warranty.    (b)    A misrepresentation, omission, concealment of facts, or incorrect statement does not prevent a recovery under the policy or contract unless:        (1)    the misrepresentation, omission, concealment, or statement is fraudulent or material to the acceptance of the risk or to the hazard that the insurer assumes; or        (2)    if the correct facts had been made known to the insurer, as required by the application for the policy or contract or otherwise, the insurer in good faith would not have:            (i)    issued, reinstated, or renewed the policy or contract;            (ii)    issued the policy or contract in as large an amount or at the same premium or rate; or            (iii)    provided coverage with respect to the hazard resulting in the loss.
MD. Insurance Code Ann. §  12-208 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-208 - Discharge on Payment

    (a)    Whenever the proceeds of or payments under a life insurance or health insurance policy or annuity contract become payable in accordance with the policy or contract or in accordance with the exercise of any right or privilege under the policy or contract, and the insurer makes payment in accordance with the policy or contract or in accordance with a written assignment of the policy or contract, the person then designated in the policy or contract or by the assignment as being entitled to the proceeds or payments is entitled to receive the proceeds or payments and to give a full release.    (b)    Payment shall discharge the insurer fully from all claims under the policy or contract unless, before payment is made, the insurer has received at its home office notice written by or on behalf of another person that the other person claims to be entitled to the payment or to some interest in the policy or contract.
MD. Insurance Code Ann. §  12-209 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-209 - Prohibited Provisions in Policy or Contract

    A life insurance or health insurance policy or annuity contract may not be delivered or issued for delivery in the State if the policy or contract:         (1)    states that the policy or contract is to be construed according to the laws of another state or country;        (2)    states that the rights and obligations of the insured or of a person with a claim under the policy or contract are to be governed by laws other than the laws of this State;        (3)    provides a period shorter than 3 years within which an action may be brought on the policy or contract;        (4)    deprives the courts of the State of the jurisdiction of any action against the insurer;        (5)    provides that the insurance producer who solicits the insurance or annuity is the agent of the insured; or        (6)    makes the acts or representations of the insurance producer who solicits the insurance or annuity binding on the insured.
MD. Insurance Code Ann. §  12-210 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-210 - Extension of Grace Period on Life, Accident, or Health Insurance Policy

    (a)    On advance written notice to an insurer, the Commissioner may extend by a maximum of 60 days the grace period for making premium payments on life insurance, accident, and health insurance policies if:        (1)    an emergency situation exists that would delay or prevent the prompt and orderly payment of the premiums due by all or a substantial number of the insureds of the insurer; and        (2)    the emergency is not the fault of the insureds.    (b)    For purposes of this section, an emergency situation includes a fire, earthquake, flood, postal strike, insurance producer strike, or other situation that is not under the control of insureds.
MD. Insurance Code Ann. §  12-211 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 2 - Life and Health Insurance and Annuities|Section 12-211 - Prohibited Provision in Disability Policies

    (a)    In this section, “carrier” means:        (1)    an insurer; or        (2)    a nonprofit health service plan.    (b)    A disability insurance policy may not be sold, delivered, or issued for delivery in the State by a carrier if the policy contains a clause that purports to reserve sole discretion to the carrier to interpret the terms of the policy or to provide standards of interpretation or review that are inconsistent with the laws of the State.
MD. Insurance Code Ann. §  12-301 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 3 - Property and Motor Vehicle Liability Insurance|Section 12-301 - Insurable Interest in Property Required

    (a)    In this section, “insurable interest” means an actual, lawful, and substantial economic interest in the safety or preservation of the subject of the insurance against loss, destruction, or pecuniary damage or impairment to the property.    (b)    A contract of property insurance or a contract of insurance of an interest in or arising from property is enforceable only for the benefit of a person with an insurable interest in the property at the time of the loss.    (c)    An insurable interest in property is measured by the extent of possible harm to the insured from loss, injury, or impairment of the property.    (d)    (1)    This subsection applies only to an automobile insurance policy that is procured by an independent insurance producer.        (2)    Upon renewal of an existing automobile insurance policy, if the insured or a person holding an insurable interest in the subject of the policy requests proof of insurance, an authorized insurer shall provide:            (i)    a copy of the automobile insurance policy declarations; or            (ii)    written proof of the automobile insurance that consists of:                1.    the name and address of the insured and insurer;                2.    a description of the vehicle, including the vehicle identification number, that is the subject of the insurance policy;                3.    a description and the amount, if applicable, of the insurance coverage including applicable deductibles;                4.    the inception and expiration dates of coverage;                5.    the name and address of the person with an insurable interest; and                6.    the premium for the applicable coverage.    (e)    An insurer may require written authorization from the insured before providing proof of insurance under this section to a person other than a financial institution.
MD. Insurance Code Ann. §  12-302 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 3 - Property and Motor Vehicle Liability Insurance|Section 12-302 - Guardian Authorized to Insure Minor's Property

    (a)    A guardian of a minor may insure for the minor property that the minor owns.    (b)    A property insurance contract issued to a guardian under subsection (a) of this section has the same effect as if the minor were an adult and had made the property insurance contract.
MD. Insurance Code Ann. §  12-303 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 3 - Property and Motor Vehicle Liability Insurance|Section 12-303 - Effect of Death of Insured

    A change of interest on the death of the insured does not void property insurance and the property insurance passes to the person taking the interest in the property.
MD. Insurance Code Ann. §  12-304 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 3 - Property and Motor Vehicle Liability Insurance|Section 12-304 - Certificate on Property of Borrower

    (a)    If an insurer issues and delivers a policy to a lender on property of a borrower that has been pledged, mortgaged, or is subject to a conditional contract of sale, the insurer must issue a certificate to the borrower or owner of the property in accordance with subsection (b) of this section.    (b)    The certificate issued under this section shall set forth:        (1)    the coverages provided in the policy;        (2)    the amount of premium charged for the policy;        (3)    the date the policy takes effect; and        (4)    the date the policy expires.
MD. Insurance Code Ann. §  12-305 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 3 - Property and Motor Vehicle Liability Insurance|Section 12-305 - Motor Vehicle Liability Insurance -- Mandatory Settlement of Property Damage Claim

    (a)    A claim for damage to property resulting from a motor vehicle accident may not be denied or payment of the claim delayed because the claimant, or another person, has a claim pending for bodily injury that may have arisen from the same or another accident.    (b)    The amount payable for a claim for damage to property is due and owing immediately and shall be paid promptly by an insurer or by a self-insurer that is approved under § 17-103(a) of the Transportation Article if:        (1)    the insurer or self-insurer has provided the coverage for the liable party; and        (2)    there is no significant dispute about:            (i)    the liability for the payment of the full property damages; or            (ii)    the monetary amount of those damages, including:                1.    if claimed, an amount for the loss of the use of the motor vehicle; and                2.    the cost of obtaining an estimate of repairs.
MD. Insurance Code Ann. §  12-306 (2021)
2021 Maryland Statutes|Insurance|Title 12 - Policy Forms and Provisions|Subtitle 3 - Property and Motor Vehicle Liability Insurance|Section 12-306 - Motor Vehicle Liability Insurance -- Effect of Settlement of Property Damage Claim

    A settlement made by an insurer or a self-insurer approved under § 17-103(a) of the Transportation Article under a motor vehicle liability insurance policy of a claim arising from an accident or other event for damage to or destruction of property owned by another person:         (1)    may not be construed as an admission of liability by the insured or recognition of liability by the insurer or self-insurer with respect to another claim arising from the same accident or event; and        (2)    does not preclude a claim for bodily injury or other claims outside the scope of the settlement.
MD. Insurance Code Ann. §  14-202 (2021)
2021 Maryland Statutes|Insurance|Title 14 - Entities That Act as Health Insurers|Subtitle 2 - Preferred Provider Organizations|Section 14-202 - Scope of Subtitle

    (a)    (1)    This subtitle applies to insurers that issue or deliver individual or group health insurance policies in the State.        (2)    The provisions of this subtitle that apply to insurers also apply to nonprofit health service plans that issue or deliver individual or group health insurance policies in the State.    (b)    Except as otherwise provided in § 14-206 of this subtitle, this subtitle does not apply to an employee benefit plan to the extent that the plan is governed by the Employee Retirement Income Security Act of 1974 (ERISA).
MD. Insurance Code Ann. §  14-203 (2021)
2021 Maryland Statutes|Insurance|Title 14 - Entities That Act as Health Insurers|Subtitle 2 - Preferred Provider Organizations|Section 14-203 - Regulations

    The Commissioner may adopt regulations to enforce this subtitle.
MD. Insurance Code Ann. §  14-204 (2021)
2021 Maryland Statutes|Insurance|Title 14 - Entities That Act as Health Insurers|Subtitle 2 - Preferred Provider Organizations|Section 14-204 - Authority of Insurers

    Subject to the approval of the Commissioner, an insurer may:         (1)    offer or administer a health benefit program under which the insurer offers preferred provider insurance policies that limit, through the use of provider service contracts, the numbers and types of providers of health care services eligible for payment as preferred providers; and        (2)    establish terms and conditions that providers must meet to qualify for payment as preferred providers.
MD. Insurance Code Ann. §  14-205 (2021)
2021 Maryland Statutes|Insurance|Title 14 - Entities That Act as Health Insurers|Subtitle 2 - Preferred Provider Organizations|Section 14-205 - Benefits for Health Care Services; Payments to and Rates for Providers

    (a)    If a preferred provider insurance policy offered by an insurer provides benefits for a service that is within the lawful scope of practice of a health care provider licensed under the Health Occupations Article, an insured covered by the preferred provider insurance policy is entitled to receive the benefits for that service either through direct payments to the health care provider or through reimbursement to the insured.    (b)    (1)    A preferred provider insurance policy offered by an insurer under this subtitle shall provide for payment of services rendered by nonpreferred providers as provided in this subsection.        (2)    Unless the insurer demonstrates to the satisfaction of the Commissioner that an alternative level of payment is more appropriate, for each covered service under a preferred provider insurance policy, the difference between the coinsurance percentage applicable to nonpreferred providers and the coinsurance percentage applicable to preferred providers may not be greater than 20 percentage points.        (3)    If the preferred provider insurance policy contains a provision for the insured to pay the balance bill, the provision may not apply to an on–call physician or a hospital–based physician who has accepted an assignment of benefits in accordance with § 14–205.2 of this subtitle.        (4)    The insurer’s allowed amount for a health care service covered under the preferred provider insurance policy provided by nonpreferred providers may not be less than the allowed amount paid to a similarly licensed provider who is a preferred provider for the same health care service in the same geographic region.    (c)    (1)    In this subsection, “unfair discrimination” means an act, method of competition, or practice engaged in by an insurer:            (i)    that is prohibited by Title 27, Subtitle 2 of this article; or            (ii)    that, although not specified in Title 27, Subtitle 2 of this article, the Commissioner believes is unfair or deceptive and that results in the institution of an action by the Commissioner under § 27–104 of this article.        (2)    If the rates for each institutional provider under a preferred provider insurance policy offered by an insurer vary based on individual negotiations, geographic differences, or market conditions and are approved by the Health Services Cost Review Commission, the rates do not constitute unfair discrimination under this article.
MD. Insurance Code Ann. §  14-205.1 (2021)
2021 Maryland Statutes|Insurance|Title 14 - Entities That Act as Health Insurers|Subtitle 2 - Preferred Provider Organizations|Section 14-205.1 - Option to Include Preferred or Nonpreferred Providers

    (a)    The Commissioner may authorize an insurer or nonprofit health service plan to offer a preferred provider insurance policy that conditions the payment of benefits on the use of preferred providers if the insurer or nonprofit health service plan does not restrict payment for covered services provided by nonpreferred providers:        (1)    for emergency services, as defined in § 19–701 of the Health – General Article;        (2)    for an unforeseen illness, injury, or condition requiring immediate care; or        (3)    as required under § 15–830 of this article.    (b)    (1)    If an employer, association, or other private group arrangement offers health benefit plan coverage to employees or individuals only through preferred providers, then the insurer or nonprofit health service plan with which the employer, association, or other private group arrangement is contracting for the coverage shall offer an option to include preferred and nonpreferred providers as an additional benefit for an employee or individual, at the employee’s or individual’s option, to accept or reject.        (2)    The insurer or nonprofit health service plan shall provide to each employer, association, or other private group arrangement a disclosure statement on the group application that an option to include preferred and nonpreferred providers is available for the individual or employee to accept or reject.    (c)    An employer, association, or other private group arrangement may require an employee or individual that accepts the additional coverage for preferred and nonpreferred providers to pay a premium greater than the amount of the premium for the coverage offered for preferred providers only.