NC Regulations For Health

Insurance institution can prepare or request an investigative consumer report about an individual in connection with an insurance transaction involving the following

-An application for insurance -A policy renewal -A policy reinstatement -A change in insurance benefits

The purpose of Insurance Information and Privacy Act is to do the following

-Establish standards for the collection, use, and disclosure of information gathered in connection with Insurance transactions by Insurance institutions, agents,or insurance support organizations -Maintain a balance between the need for information by those conducting the business of insurance and the public's need to minimize intrusiveness -Establish a regulatory mechanism to enable natural person to ascertain what information is being or has been collected about them in connection with Insurance transactions and to have access to such information for the purpose of verifying or disputing its accuracy -limit the disclosure of information collected in connection with the insurance transaction -Enable Insurance applicants and policyholders to obtain the reasons for any adverse underwriting decision

A person who is not a resident of this state may receive a nonresident Producer license if he/she meets the following qualifications

-Has submitted or transmitted to the commissioner a copy of the application for licensure that the person submitted to that person's home state, or in lieu of the same, a completed Uniform Application or Uniform Business Entity Application -Lives in a home state awards insurance Producer licenses to resident of this state on the same basis (reciprocity).

A person who is not a resident of this state may receive a nonresident Producer license if he/she meets the following qualifications

-Has submitted the request for licensure in the form prescribed by the commissioner and has paid the applicable fees -Is currently licensed as a resident and is in good standing in his or her home state

Pretext Interview are interviews conducted in an attempt to obtain information about a natural person, performs one or more of the following acts, during which a person does any of the following

-Pretends to be someone else -pretends to represent a person he or she is not in fact representing -Misrepresents the true purpose of the interview -Refuses to identify him or herself upon request

The North Carolina Life and Health Insurance Guaranty Association is composed of all insurers who lawfully do business in the state. It assesses members according to the lines of business it transacts and maintains 2 separate accounts

1. The life insurance and annuities account 2. The health insurance account

Cease and desist order from pertaining to consumer information privacy will result in a fine of

10,000 per violation

Cease and desist order from unfair trade practices may be subject a fine from

1000-5000 for each violation

A bond cannot be terminated unless at least

30 days prior written notice is given by the surety to the licensee and the commissioner. If a broker's license is terminated, the commissioner must notify the surety within 10 days.

Immunity

A person cannot be charged with defamation, invasion of privacy, or negligence as a result of disclosing personal or privileged information or for furnishing personal or privileged information to an insurance institution, agent, or insurance support organization. No immunity is provided, however, for furnishing false information with malice or willful intent to injure any person

Within 30 days

After the agent has received the original or additional notification, the agent may file written comments concerning the substance of the notification with the commissioner. The agent must, by the same means, simultaneously send a copy of the comments to the reporting insurer, and the comments will become part of the commissioner's file and accompany every copy of a report distributed or disclosed for any reason about the agent.

A requirement to obtain a bond license is

An applicant must hold a valid agent's license and throughout the duration of the broker's license. A broker's license will be issued to cover only those kinds of insurance authorized by the agent's license. Suspension or revocation of the agent's license will cause immediate revocation of the broker's license

Adjuster

Any individual, who, for salary, fee, or commission, investigated or reports to his principal relative to claims arising under insurance contracts other than life and annuity. An attorney at law who adjusts insurance losses from time to time incidental to the practice of his profession or an adjuster of marine losses is NOT deemed to be an adjuster

Once a license is suspended, revoked, non renewed or surrendered, the commissioner will notify the

Central office of NAIC

Any person who pretends to be licensed and engages in any form of insurance transaction may be deemed guilty of a

Class 1 misdemeanor

A nonresident Producer

Is an individual who is domiciled and licensed as a resident producer in a state other than N.C

Limited Lines Agent

Means a person authorized by the commissioner to sell, solicit, or negotiate limited lines of Insurance.

Insurance Producer or Producer

Means a person required to be licensed to sell, solicit, or negotiate insurance. Insurance Producer or Producer includes agent, broker, and limited representative.

Terminate

Means the cancellation of the relationship between an insurance agent and the insurer or the termination of an agents authority to transact insurance

Uniform Application

Means the current version of the NAIC Uniform application for resident and nonresident agent licensing.

Within 3 business days

The commissioner must be notified in the event of any bankruptcy, insolvency, or receivership proceedings affecting the persons licensed.

Retaliatory Provision

There can be no requirement that a licensed resident agent or broker must counter sign, solicit, transact, take accept, deliver record, or process in any manner an application, policy, contract, or any other form of insurance on behalf of a nonresident agent or broker or an authorized insurer or share in the payment of commissions related to such business.

Additional information that would have been reportable to the commissioner had the insurer known it existed

Within 15 days after making the notification required, the insurer must mail a copy of the notification to the agent at the agent's last known address by certified mail, return receipt requested, postage prepaid, or by overnight delivery using a nationally recognized carrier