Insurance Regulation

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License Qualifications

- 18 years old - File an app with director - Pay $100 license fee - Pass exam for license - Have not committed act to not get license

Agent license

-complete 20 hours of prelicensing education -valid for 180 days from completion of the course

call hours

8 am to 9 pm

Fair Credit Reporting Act

A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential, accurate, relevant and properly used.

Statute

A formal written law enacted by legislature: insurance statutes can be found in the state insurance code

antifraud program

A written plan of procedures they will follow when instances of fraud or suspected fraud are brought to the insurers attention

Fair Credit Reporting Act

Act that protects privacy of background information and ensures that information supplied is accurate.

False advertising

Advertisements cannot include any untrue, deceptive, or misleading statements that apply to the business of insurance or anyone who conducts it.

Rebating

Any inducement offered in the sale of insurance products that is not specified in the policy.

Unlawful Insurance Fraud

Any person engaged in the business of insurance to willfully, with the intent to deceive, make any oral or written statement that contains either false statements or omissions of material fact.

section 1034

Civil Penalties for violations of section 1033, this section states the attorney general may bring a civil action in the US district court for $50,000 for each violation

Moral turpitude

Conduct that is contrary to community standards of justice, honesty or good morals

NAIC

Determines an applicants licensure and standing status in another state

Do Not Call Registry

FTC and FCC solicitation calls cannot be made by telemarketers

Unfair Claims Settlement Practices

Failing to approve or deny coverage of a claim within a reasonable period after a proof-of-loss statement has been completed,

Exempt from CE

Granted inactive status hold only a limited lines license hold only a title insurance license 12 CE hod only a resident surety bail bond license 7 CE

Continuing Education

Has to complete 24 hours of CE 3 hours of ethics

Resident insurance license to a business entity

If the superintendent finds the applicant has met the following requirements -domiciled in Ohio or maintains principal place of business in this state -has designated a licensed insurance agent who will be responsible for the entity's compliance -Has not committed an act that is grounds for denial

Insurance Regulatory Information System (IRIS)

Introduced by the National Association of Insurance Commissioners in 1974 to identify insurance companies that might require further regulatory review.

Misrepresentation

It is illegal to issue, publish, or circulate any illustration or sales material that is false, misleading, or deceptive as to policy benefits or terms, or payment of dividends

Change in address

Licensed agents must notify the superintendent within 30 days

Non-Resident Agent

Licensed as a resident producer in another state, may apply for a nonresident producer license Must be -in good standing -same lines of authority -submitted the request for licensure by the Superintendent -Has not committed an act for denial -good reputation and character -has submitted all documents

Exempt

Not subject to a obligation

Examination of books and records

Once every 3 years and can be deferred to not exceed 5 years Examination expenses must be paid by the insurer

Non-Resident License

Renewed biannually by the last day of the licensees birth month

Investigative Consumer Report

Similar to consumer reports in that they also provide information on the consumer's character, reputation, and habits.

Temporary license

Superintendent may issue a temporary license for a maximum period of 180 days -does not require an examination -in case of death or disability of a licensed agent, the surviving spouse a court appointed personal representative or a member of a business entity -licensed agents entering active us military service -to any other person when the public interest would be best served

The head of the Ohio Dept of Insur

Superintendent, who is the CEO and director of the department of insurance Appointed by the governor (4years)

Appointment

The authority given by an insurer to an agent to transact insurance or adjust claims on the insurers behalf

superintendent

The head of the state department of insurance

consumer reports

Written and /or oral statements regarding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources.

Reciprocity

a mutual interchange of rights and privileges

fraudulent insurance act

an act committed by a person who knowingly and with intent to defraud

inducement

an offer that attempts to influence the other party

Surrender of license

any time as long as the agent is not under investigation by Superintendent

issuance of insurance

application must be submitted within 7 days after agent accepts preimium

agents

cannot charge fees unless the policy issued is a no commission bais the fee has to be disclosed not a percentage of premium agent does not discriminate with the fee

Disclosure Authorization Form

companyy can contain or release information

National call registry

created to control telemarketers

consent agreement

does not admit or deny the charges but agrees to pay a single penalty amount

Statutory

enacted or regulated by a statute

maintain claim data

for at least 3 years

Certificate of authority

from the department of insurance and indicates the Superintendent of insurance has examined the business and found it to be financially stable in accordance with insurance code

cease and desist order

hearing within 15 days

Considered insolvent

if for a period of 3 years the insurer is unable to pay its obligations when due

License Cancellation

if want to apply for a new license must go through steps of a new agent

Surplus lines insurance

insurance that is not available from admitted insurers

Twisting

is a misrepresentation, or incomplete or fraudulent comparison of insurance policies that persuades an insured/owner to his or her detriment to cancel, lapse switch policies with another insurer

Insurance agent

is any person who, in order to sell, solicit, or negotiate insurance is required to be licensed under the laws of this state, including limited lines insurance agents and surplus line brokers. Licensed in accordance to state law

Superintendent

issues cease and desist order

Licensing

life - coverage on human lives

Insurance fraud

misdemeanor on the first degree

Non resident business

must apply for renewal biennially on a date established by the Superintendent

insurance applicants

must be notified in writing whenever insurers request investigative consumer reports

Duty to report convictions

must notify superintendent within 30 days after the final disposition of the matter

Agent

must report administrative actions within 30 days

Felony in the fourth degree

no one should knowingly obtain info about an individual from an insurance institution or agent under false pretenses

Discrimination

of rates, policy benefits for persons within the same class or with the same life expectancy

defamation

one that makes oral or written statements intended to injure another producer or insurer

Dividends

paid to policyholders of a mutual insurer are not considered to be a rebate because they may get paid out

Willful noncompliance

penalty up to 2500

License Renewal

renew biennially on or before the last day of the agents birth month

Restitution

restoration to the original condition or repayment

cease and desist order

ruling requiring a company to stop an unfair business practice that reduces or limits competition max penalty 10,000

Cyber Security

submitted to superintendent of insurance by feb 15 that they are in compliance

Felony or misdemeanor

superintendent may suspend, revoke or refuse to issue or renew license if an agent has been convicted or pleaded guilty or no content to a felony or a misdemeanor that involves miuse or theft of money or property, forgery, fraud, dishonest acts or moral turpitude

suspension

termination of all authority to hold a license for a specific amount of time

Revocation

the permanent loss of membership, certification, or licensure.

Insurance Regulation

the rules of the insurance market, as established by law, administered by public officials, and interpreted by the courts, all for the purpose of promoting and protecting the public interest

unfair trade practices

trading practices that derive a gain at the expense of competition

insolvent

unable to meet financial obligations

1033 Waiver

written consent from a Commissioner for an individual convicted of a crime involving dishonesty to work in the business of insurance


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