Utah Insurance regulations

License requirements

-!8 years or older -Satisfies education needed -Pays applicable fees -Has not commited an act that is grounds for denial, suspension, revocation. -Is deemed competent and trustworthy

If the insurer does not provide rate filing information within 45 days of the commisioners mailed notice, the rating filing will be:

-Considered incomplete and unfiled -Returned to the insurer as not filed and unavailable for use. -If the rate filing is returned to an insurer, they may not use the rate filing for any policy issued or renewed on or after 60 days of the filing's return. -Insurers may applied to use a higher rate than usually applies to a specific risk. If the rate is filed, but not disapproved within 10 days, the highjer rate may be applied.

Nonresidents may be licensed as a nonresident producer without taking a written examination if that person:

-Is licensed as a resident producer in his or her home state at the time of the application -Applied to the commissioner for a nonresident producer license -Submitted the application for licensure to the applicant's home state, as well as a completed uniform application and the fees -Has a license in good standing in home state and the home state licenses Utah nonresidents as Utah licenses that state's nonresidents (reciprocity)

If license lapses due to military service or long-term medical disability:

-Licensee may request reinstatement no later than 1 year after the day it lapsed -The licensee may also request a waiver of any fees imposed for failing to comply with renewal procedures, exams

The following are Unfair claims settlement practices if committed openly and in conscious disregard of rules and regulations, or if committed with such frequency as to indicate a general business practice:

-Misrepresenting pertinent facts or insurance policy provisions relating to coverages -Failing to acknowledge and act reasonably promptly upon communications with respect to claims -Failing to adopt and implement reasonable standards for the prompt investigation of claims -Refusing to pay claim without conducting reasonable investigation based upon all available information -Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed -Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonable clear -Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds -Attempting to settle a claim for less than the amount to which a reasonable person would have believed that such person was entitled by reference to written or printed advertising material accompanying or made part of an application -Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made. -Making known to insureds or claimants a policy of appealing from arbitration awards in favor of the insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration -Delaying the investigation or payment of claims by requiring an insured, claimant or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information. -Failing to promptly settle claims, where liability has become reasonably clear, under one portion of the insurance policy

A license will lapse if the licensee FAILS to do any of the following:

-Pays fees when due -Complete CE requirements before submitting the license renewal application -Submit a completed renewal application as required -Submit additional documentation required to complete the licensing process as related to a specific license type -maintain an active license in his or her resident state if the licensee has a nonresident license.

Commissioner's duty and powers

-the chief officer of the Department of Insurance. -Appointed by the governor with the consent of the senate. -Governor will take place if commissioner is vacant or unable to perform -Regulate the internal affairs of DOI -Enforce the state insurance laws, and make reasonable rules nad regulations to help carry out provisions of the insurance code -Control and supervise all insurance business transacted inthis state -Issues licenses and certificates of authority, as well as suspend, revoke, or deny licensing -Conduct examinations and investigations of insurers -Issue orders and notices regarding insurance matters -Review and approve policy and contract forms, and insurance rates -DOES NOT SET PREMIUM RATES OR ESTABLISH FINES AND PENALTIES

Reinstatement

A license that has lapsed or was voluntarily surrendered may be reinstated within 1 year of the day on which it became in inactive.

Nonresident

A person who is not a legal resident of Utah

Producer

A representative of at least one insurance company. Must maintain at least one current appointment from an insurer and have complied with any applicable continuing education requirements.

Renewal

An insurance license but be renewed every two years with the property forms, fees, and continuing education.

Producer appointment

An insurance producer cannot act as an agent of an insurer unless the producer becomes appointed by that insurer. An insurance producer who is not acting as an agent of an insurer is not recquired to become appointed. To appoint producers as its agent, the appointing insurer must electronically file a notice of appointment that identifies the effective date of appointment within 15 days of the appointment.

Solvent

An insurer is solvent if it has the assets and is ABLE to meet its financial obligations.

Termination of appointment

An insurer or authorized representative of the insurer that terminates the appointment, employment, contract or other insurance business relationship with a producer for any reason must electronically submit the termination to the DOI within 30 days of the identified date of termination.

Assumed name

Any licensee doing business under a name other than their legal name must notify the commissioner before using the assumed name in this state.

Continuing education requirements

Are established to maintain and improve insurance skills of producers. All producers, brokers, and adjusters must complete a minimum of 24 hours of CE every 2 years prior to license renewal as follows: -At least 3 hours of the total 24 hours must be in ethics training - The licensee must complete at least of the 12 hours through classroom courses. -The hours not completed through classroom hours may be obtained through home study, video recording, experience credit, or another approved method -The licensee may obtain CE hours at any time during the 2 year period 0Credit from one period does nor carry over to the next.

Change of address or telephone number

Every producer or broker licensed in Utah must notify the commissioner in writing, within 30 days of any change in his or her residence address, business address or telephone number.

Insolvent

If at any time an insurer becomes UNABLE to meet financial obligations.

Reporting actions

Licensed producers and applicants for producers license must report to the commissioner any administrative action taken against the person in another jurisdiction or by another regulatory agency in this state, and any criminal prosecution of the producer in any jurisdiction. The report must be filed at the time the person applies for an individual or agency license, or within 30 days of the action or prosecution. Must include a copy of the complaint or other documents.

Licensees

May not act as consultants, producers, or brokers unless they have complied with the disclosure of conflict of interest provision. This means: -Before performing consultant services they must disclose to the client their interests and relation to the insurer. -The consultant's fee is agreed upon in writing before performing the consulting services -Any report resulting from consulting services contains a copy of the disclosure mentioned above.

Policy forms

The commissioner may prohibit the use of certain forms. IF so, the form must be discontinued within 15 days. After a form is no longer in use, insurers must maintain a record of its use for 5 years from the last day the form was used, or from the last day that any policy issued using that form is in effect.

Purpose of licensing

To ensure that a producer meets educational and ethical standards required to fulfill producer's responsibilities to the insurer and the public.

Examination of records

To ensure that the companies remain solvent and conduct business in compliance with laws and regulations pertaining to policy forms, licensing rates, claims, and market conduct. Commissioner may examine any authorized insurer at any time, but must examine domestic and foreign insurers at least once every 5 years. The records must be available for the commissioner to inspect during all business hours for at least the current calendar plus 3 years.

Adjuster (directing the investigation, negotiation, or settlement of a claim)

engage in insurance adjusting on behalf of the insurer, policyholder, or a claimant.

Consultant

offers advice to the public about the benefits, advantaged and disadvantages of insurance policies for a fee. (must have 3-4 years of previous experience)

Rate regulation

to promote the public welfare by regulating insurance rates in order to assure that they are not excessive, inadequate, or unfairly discriminatory, and to authorize and regulate cooperative action among insurers in rate making. The Utah insurance code requires insurers to file their premium rates with the commissioner. All rate filings are subject to a 30-day waiting period before they become effective.