NC Statutes

Insurance Information and Privacy Protection Act

Establish standards for collection use, and disclosure of information, maintain a balance between the need for info by those conducting the business of ins and public's need for fairness in insurance info practices, regulatory mechanism to enable natural persons to ascertain what info is being or has been collected, limit the disclosure of info collected, enable insurance applicants and policyholders to obtain the reasons for any adverse underwriting decisions

Safe Driver Incentive Plan (SDIP)

Established to differentiate between safe drivers and those with records of at fault accidents and major or minor moving traffic violation convictions

Illegal

Discrimination in rates, premiums, or policy benefits for persons within the same class or with the same life expectancy

North Carolina Rate Bureau

Duty of every insurer that writes workers compensation insurance and risk that has been certified as "difficult to place" by any fire and casualty agent

$1,000-$5,000

Violation of a company transacting insurance while not authorized to do business within this state penalty amount

uniform application

the current version of the NAIC Uniform Application for resident and nonresident agent licensing

All insurers must be members

Who are the members of the Post Assessment Insurance Guarantee Association

temporary license

the Commissioner may issue a temporary insurance agent license for a max period of 180 days w/o requiring an examination if the Commissioner deems that the temporary license is necessary for the servicing of an insurance business

terminate

the cancellation of the relationship between an insurance agent and the insurer or the termination of an agent's authority to transact insurance

Property

direct or inconsequential loss or damage to property of any kind

commissions/fees can be paid in these circumstances

to a business entity by a person involved, an agent in connection w/ renewals of insurance, or in connection w/ the indirect receipt of commissions where a license is not required

Sell

to exchange a contact of insurance by any means, for money or its equivalent, on behalf of an insurance company

coercion

to require, as a condition to a loan, that the applicant purchase insurance from a specific insurer

Hearing

10 days prior notification, if commissioner suspects its agent has committed a violation or is engaged in an unfair trad practice

Represents the Insured

A broker represents

Represents the Insurer

An agent represents

Judicial Review

Any order or decision of the Commissioner is subject to

Accounts of Post-Assessment Insurance Guarantee Assocation

Automobile insurance, Workers Compensation, all other insurance to which the Article applies

No

Can insurer or reps knowingly issue any policy of insurance in this state that does not conform to the rates, rating plans, classifications, schedules, rules, and standards made and filed by the Bureau?

False Adverstising

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

North Carolina Rate Bureau

Created to provide services and programs to the insurance industry in NC for automobile, property, and workers comp

Brokers License

File a bond for at least $15,000, not terminated within at least 30 days notice

50 days

How many days after the date of filing will the Commissioner give written notice to the Bureau specifying in what respect and what extent the Commissioner contends the filing fails to comply with the requirements

15 days

How many days does a written proof of loss after a notice of the loss be sent in?

at least 15 days in advance

How many days when an insurer changes the coverage other than at the request of the insured or changes the premium rate, give the insured written notice of such change

Between $100-$1,000

How much is the monetary penalty handed down from the commissioner in the even of suspension or revocation

Annually

How often must records of convictions for moving traffic violations to be considered be obtained under SDIP?

Company must pay any penalties and the expense of the investigation

If the commissioner finds that any complaint against a company is justified

An insurer may deviate from the rates promulgated by the Bueau

If the insurer has filed the proposed deviation with the Bureau and Commissioner, based on sound actuarial principles, and approved by Commissioner

Misrepresentation

Illegal act to issue, publish, or circulate any illustration or sales material that is false, misleading, or deceptive as to policy benefits or terms, payment of dividends, etc.

any period of 12 consecutive months

In case of a policyholder, notice required must be provided at lease once in

30 days

Insurance instutition or agent discloses personal info about an applicant/policyholder, must provide notice to them withing how many days

Uniform Unauthorized Insurers Act

No person, corp, assoc. may: act as an agent for any unauthorized insurer, negotiate for or place insurance coverage for another with an unauthorized insurer, aid an unauthorized insurer in effecting insurance or in transacting insurance business in this state, make, negotiate for or place, or aid in negotiating or place any ins contract in this state for an applicant for insurance covering any property or risk

North Carolina Rate Bureau

Must maintain and furnish to the Commissioner on an annual basis the statistics on earning derived by member companies from the investment of unearned premium, loss, and loss expense reserves on nonfleet private passenger motor vehicle insurance policies written in NC

home state

NC and any state of the US which an insurance agent maintains his/her principal place of residence or business and is licensed as an insurance agent

10 days

Notifying the commissioner for change of address, email address, or criminal conviction

Cease and desist order

Occurs after hearing (can be before), if the commissioner determines that a person has violated n insurance statute or regulation

Class I Felony, subject to $2,000-$10,000

Penalty for false financial statements

Notices not required

Policyholder whose last known address is deemed invalid; policy is lapsed, expired, or inactive and has not communicated with the policyholder for a period of 12 consecutive months

Acts of Pretext Interviews

Pretends to be someone else, pretends to represent a person he/she not representing, misrepresents the true purpose of the interview, refuses to identify him or herself upon request

Restricted License

Renewed annually, a foreign military sales agent representing a life insurance company in NC, provided the agent represents the insurance company only in a foreign country or territory and either on a US military installation/personnel

period of 3 years

Surcharges applied to premium under SDIP

License will be automatically suspended

When a person is convicted of a criminal violation of the General Statute

Assumed Name

When an insurance producer conducts business under any name other than the producer's legal name, he or she must notify the commissioner before using

business entity

a corp, association, partnership, limited liability, company, limited liability partnership, or other legal entity. NOT a sole proprietorship

license

a document issued by the commissioner authorization a person to act as an insurance agent for the kinds of insurance specified in the document

embezzlement

a felony if any insurance agent, broker, or administrator, embezzles or fraudulently uses or withholds any money received as a result of acting as an agent/broker/admin (felony). if more than $100k (class C felony) if less than $100k (class H felony)

broker

a licensed agent who procures insurance for a party other than himself thru a duly authorized agent of an insurer that is licensed to do business in NC but for which the broker is not authorized to act as agent (represents the insured or beneficiary)

limited lines agent

a person authorized by the Commissioner to sell, solicit, or negotiate limited lines insurnace

agent

a person licensed to solicit/negotiate a policy of insurance

Producer

a person required to be licensed o sell, solicit, or negotiate insurance (agent, broker, limited rep)

insurance producer

a person required to be licensed to sell, solicit, or negotiate insurance

Class H Felony

a person w/ the intent to injure, defraud, or deceive an insurer, presents a statement as part of a claim for payment knowing it contains misleading/false info concerning the claim is guilty of a

Resident

a person who lives in NC or any county outside this state that borders NC

only at the time the final policy of title insurance is issued

a title insurance company must give notice of its insurance information practices

negotiate

act of conferring directly w/, or offering advice directly to, a purchaser of a particular contract of insurance concerning any of the substantive benefits, terms, or conditions of the contract, only if the person engaged in that act either sells insurance or obtains insurance from insurers or purchasers

commingling

all account records maintained by agents, brokers, and limited reps must be kept separation from any other biz records (no commingling is allowed) and demonstrate at all times that collected funds due to insurers and return premiums due to policyholders are available at all times

contract of insurance

an agreement by which the insurer is bound to pay money or its ewuivalent or to do some act of value to the insured upon, and as an indemniy or reimbursement for the dstruction, loss, or injury in which other party has interest

Prepare or request an investigative consumer report about an individual in connect with an insurance transaction

an application for insurance, policy renewal, policy reinstatement, or a change in insurance benefits

adjuster

an individual who investigates/reports claims arising under insurance contracts

nonresident producer

an individual who is domiciled and licensed as a resident producer in a state other than NC. they will grant the same rights and privileges afforded a resident licensee and, subsequently, is subject to the same revocation, suspension and formal proceedings

Rebating

any inducement offered to the insured in the sale of insurance products that is not specified in the policy

rebating

any inducement offered to the insured in the sale of insurance products that is not specified in the policy

agents liability

any person representing an insurer is personally liable on all contracts of insurance unlawfully made by or through him for any company not authorized to do biz in the state

false statements in applications for insurance

any person who knowingly of willfully makes any false or fraudulent statement or representation in an application for insurance or to obtain a fee/commission/money (class 1 misdemeanor)

false pretenses and cheats

any person who knowingly, by means of any kind of false pretense, obtains or attempts to obtain from any person any money, goods, property, services, or other thing of value with the intent to cheat or defraud any person

Class 1 midemeanor

any person who pretends to be licensed and engages in any form of insurance is guilty of?

Class 1 Misdemeanor

any person who unlawfully solicits, negotiates for, collects a premium for a contract of insurance, or transacts of any unlawful insurance with an insurance company not licensed to do insurance business in NC

Policy renewal notice

at the time of policy renewal date; personal info is collected, notice meeting the requirements has been given within the previous 24 months

Application for Insurance notice

at the time of the delivery and at the time of the collection of personal info

Solicit

attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company

solicit

attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company. NOT a referral to a licensed insurance agent or broker that doesn't include a discussion of specific insurance policy terms & conditions

acting w/o a license

class 1 misdemeanor

agents signing certain blank policies

class 3 misdemeanor - agent/rep who sign any blank contract or policy of insurance. fine of $1k-$5k. one exception - transportation ticket policies of accident insurance and baggage insurance policies can be countersigned when blank thru coin-operated machines

Pretext Interviews

conducted in an attempt to obtain info about a natural person

Casualty

coverage of legal liability, including death, injury or disability, or damage to real and personal property

Commissioner

elected to office by the people, 4 year term, appoints to attorney general

sell

exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company. it does NOT mean a referral to an agent or broker that does not include a discussion of specific insurance

2 years

how many years can a suit be filed where an insurance institution or agent fails to comply with regulations regarding consumer information privacy and consumer rights

bond

in order to receive a broker's license, the applicant must file a BLANK w/ the commissioner for at least $15k

Nonresident Producer

individual who is domiciled and licensed as a resident producer in a state other than NC

unfair discrimination

insurers cant base any standard or rating plan for private passenger automobiles or motorcycles upon the age or sex of the persons insured

unfair discrimination

insurers cant refuse to insure or continue to insure, limit the amount, extent, or kind of coverage available to an individual based off blindness, deafness, race, color, national origin, or ethnic origin

False financial statements

intended to deceive public officials or the general public about the financial condition of an insurer

mirepresentation

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, the payments of dividends, etc. including oral statements

false advertisting

it is prohibited to advertise or circulate any materials that are untrue, deceptive, or misleading

duly licensed agents

may accept any commission, fee, or other valuable consideration for the sale, solicitation, or negotiation of insurnace

renewal or other deferred commissions

may be paid to a person for selling, soliciting, or negotiating insurance if the person was required to be licensed at the time of the sale, solicitation, or negotiation and was so licensed at that time

twisting

misrep, or incomplete comparison of insurance policies that persuades an insured/owner, to his/her detriment, to cancel, lapse, switch policies, or take out a policy with another insurer. this is prohibited

Twisting

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

examples of false advertising

misrepresenting terms, benefits, conditions, or advantages on insurance policies, any dividends to be received or paid out, financial condition of any person or the insurance company, or true purpose of an assignment or loan against a policy

defamation

occurs when an oral or written statement is made that is intended to injure a person engaged in the insurance business

Defamation

oral/written statement is made that is intended to injure a person engaged in the insurance business, statements that are maliciously cirtical

Post-Assessment Insurance Guaranty Association (Guaranty Fund)

provide a mechanism for covered claims when an insurance company becomes insolvent

accident and health insurance

provides coverage to renters and other vehicle occupants for accidental death or dismemberment and for medical expenses resulting from an accident that occurs during the rental period

personal effects insurance

provides coverage to renters and other vehicle occupants for the loss of, or damage to, personal effects that occurs during the rental period

excess liability insurance

provides coverage to the rental car company or franchise and renters and other authorized drivers of rental vehicles

examples of rebates

rebates of premiums payable on the policy; special favors/services; advantages in dividends/benefits; stocks, bonds, securities, and their dividends or profits.

Coercion

requires, as a condition to a loan, that the applicant purchase insurance from a specific insurer

false financial statements

those that are intended to deceive public officials or the general public about the financial condition of an insurer