Chapter 8 State Insurance Laws

To qualify for a certificate of authority, an insurer must comply with the provisions of the law as a domestic insurer as one of the following:

-Lloyd's association; or -Reciprocal insurer -Incorporated stock or mutual insurer -Fraternal benefit society -Nonprofit hospital or medical service corporation

An insurance transaction includes

-Solicitation and inducement -Preliminary negotiations -Effectuation of an insurance contract -Transaction of matters that result from the effectuation of the contract

What do the legal counsel do?

-examine witnesses -present evidence -have commissioner issue subpoenas to compel attendance of witnesses and production of evidence.

Cease and desist order, the Commissioner has the authority to

-Place the violator on probation for up to 1 year for each act in violation -penalty of up to $2,000 for each act -or violation, or up to $5,000 per violation if the person knew or reasonably should have known he/she was in violation

Certificate Authority

No person may act as an insurer or transact insurance in Georgia unless a ___has been granted by the Commissioner.

The following classes of insurance may be transacted

-Life, accident, and sickness -Property, marine, -transportation -Casualty -Surety -Title -Health Maintenance Organization

inducement

An action aimed at persuading

What does the commissioner order state ?

Every order must state : -the effective date -the purpose -grounds on which it is based -provision of the law in which the action is being taken

60 days

If the Commissioner finds accounts and records to be inadequate or incorrectly kept or posted, the person being examined will have ____upon notification to correct the accounting.

emergency order will be issued, effective immediately

If the act, practice, or transaction occurring constitutes imminent peril to the public health, safety, or welfare, an ____

The Commissioner must have rules or regulations approved by who?

The Attorney General and on public file for at least 10 days before a rule/regulation becomes effective.

90

The Commissioner has ___days to approve or disapprove an application

90

The Commissioner has days to approve or disapprove an application.

Examination Expenses

The insurer or other person so examined will pay all costs of the examination, including actual travel and living expenses.

a notice of opportunity ,10

The order will include ___for a hearing, which must be requested within ___days of receipt of the order.

subpoena

a court order requiring appearance and/or testimony

The hearing must be held at

a place designated by the Commissioner and be open to the public.

10

the Commissioner must give at least the Commissioner must give at least ___days' advance notice of the time and place of a hearing stating the matters to be considered.

$1.5 million

To qualify for an original certificate of authority to transact one or more classes of insurance, a domestic insurer must possess and maintain a minimum of ___in capital stock or in surplus.

June 30

Certificates of authority expire at Midnight on__ of the year following date of issuance or renewal.

What must the representatives of the person being examined do?

facilitate such examination and aid the examiners

To apply for a certificate of authority, an insurer must

file an application showing its name, home office location or principal office in the United States

Any party to the hearing may appear

in person

Subpoenas will be served

in the same manner as if issued by a superior court.

Cease and Desist Order

it appears that a person has engaged in, is engaging in, or is about to engage in a prohibited act, the Commissioner may issue a ____

Any party must be represented by ?

legal counsel, who may be present to hear and inspect all evidence

Any order of the Commissioner issued to multiple recipients

may be served by sending it by electronic mail.

The Commissioner will give notice to the persons directly affected by the hearing if unknown..

notice may be published in a newspaper of general circulation at least 10 days prior to the hearing.

If the Commissioner has reason to believe a person has violated a provision that is considered a criminal act then

notice will be sent to the prosecuting attorney in whose jurisdiction the violation may have occurred.

when are orders and notices effective from the commissioner?

only when they are in writing and signed by the Commissioner's authority.

What is the purpose of the Georgia's department?

promote efficiency in operation and service to the public.

Failure to obey a subpoena that has been issued and served to a person required to appear will result in an order by a superior court

requiring the individual to comply with the subpoena and to testify.

Depositions

testimony taken down in writing

what happens if the examinee fails to make corrections on account?

the Commissioner may employ experts to rewrite, post, or balance such records at the expense of such examinee.

Notice to show cause states?

the proposed action to be taken unless such person can show cause as to why the action should not be taken.

Investigations /notice of hearings

Commissioner may initiate any proceeding or actions as provided by law

Report of examination

Commissioner may make a full written report of the examination including only facts obtained from documents examined and sworn testimony of witnesses.

Access of Commissioner to Records

Every person being examined must produce and make freely accessible all records, accounts, documents and files relevant to the examination.

how often must a domestic insurer be examined?

at least once every 5 years.

What does the report of examination serve as ?

certified by the Commissioner or examiner and will be admissible as evidence in any proceeding brought by the Commissioner against the person examined.

Willfully testifying falsely under oath regarding information that is material to an examination, investigation, or hearing is classified as

committing an offense of false swearing

The Commissioner, or a person authorized by the Commissioner may do what ?

conduct an examination of any insurer authorized to do business in this state as often as necessary -may also examine each insurer or rating organization applying for authority to do business in this state.

What is the role of the Commissioner ?

enforces and executes the duties imposed by the Insurance Code. -may make reasonable rules and regulations necessary for the administration and enforcement of the Insurance Code.

The commissioner has the power to do what and why?

examine and investigate into the affairs of every person engaged in the insurance business in Georgia Why? -to determine whether the person has been or is engaged in any unfair method of competition, or in any unfair or deceptive act or practice prohibited by insurance laws and regulations.

Penalty After a Hearing

A fine of up to $10,000 per violation -Suspension or revocation of the person's license if the person knew he/she was in violation -Such other relief as is reasonable and appropriate

The chief officer of Georgia's Department of Insurance is?

the Insurance Commissioner, who is elected to office for a term of 4 years.

An order or notice may be served by

-delivery in person -by mail -addressed at the principal place of business or last address of record

30

The Commissioner must issue a final order within __ days after a hearing is concluded.

The Commissioner must provide what for the proceeding?

provide a copy of the proposed examination report to the insurer examined at least 20 days before the report is filed.

The order and notice will be delivered by

registered or certified mail or overnight mail with a return receipt.

Failure to obey and answer a subpoena, results in

the individual being guilty of a misdemeanor.

30

The Commissioner will hold a hearing if required by a provision of the law or a written demand made by an aggrieved person. Any demand for a hearing must be held within __ days after receipt of such demand.

examination of other persons

as often as necessary: -the accounts -records of any insurance agent -solicitor broker -general agent -adjuster -insurer -representative.

What does the Commissioner has the authority to during investigations?

-take depositions -subpoena -witnesses -administer oaths -examine any individual under oath - compel the production of records, books, papers, and other documents.