Ch. 15 - State Laws, NC Life & Health State Laws pt. 21-39

gratuity; remuneration; repair services

When an insurer, agent, or adjuster recommends an auto repair service, they may not receive ___ or ___, but discounts agreed to by ___ ___ are allowed.

lapsed; expired; inactive; privacy; promotional; 12

the insurer or agent is not responsible to provide these notices to Any policyholder whose policy is ___, ___, or ___ with no communication from the insurer, other than annual ___ notices and ___ materials, for at least ___ months

30

A license applicant may request a review by the Commissioner within ___ days after receiving notice that the license application has been denied.

charge; demand; receive; filing

An insurer, agent, or broker must not Knowingly ___, ___, or ___ a premium for any policy of insurance except in accordance with the applicable ___ approved by the Commissioner

commission; service fee; brokerage

A person may not accept a ___, ___ ___, ___, or other valuable consideration for selling, soliciting, or negotiating insurance if that person is required to be licensed but is not.

Pretends to be someone they are not Pretends to represent a person they are not representing Misrepresents the true purpose of the interview Refuses to disclose their identity upon request

A pretext interview is an interview whereby a person, in an attempt to obtain information about a natural person, performs one or more of what four acts?

An officer, director, or employee of an insurer who does not receive commission on insurance policies written in this state when their duties Are executive, administrative, managerial, or clerical, Relate to underwriting, loss control, inspection, or processing a claim, Are limited to a special agent or agency supervisor providing technical assistance; A person who performs administrative services related to group insurance policies; Employees of an insurer who are engaged in rating risks or supervising producer training; A person whose activities are limited to advertising without intent to solicit insurance; A nonresident who transacts insurance for commercial property and casualty risks to an insured with risks in multiple states, as long as the nonresident is properly licensed in the state where the insured maintains its principal place of business; A salaried employee who advises their employer on the employer's insurance interests

A producer license is not required for what 6 individuals who do not participate in the sale, solicitation, or negotiation of insurance?

before; policy delivery

A separate privacy disclosure notice must also be delivered no later than either ___ the initial disclosure to an entity using the information for marketing purposes or the time of ___ ___

A 180 days

A temporary license may be issued to an individual for up to how long? A 180 days B 365 days C 30 days D 90 days

charge; receive; premium; contract; consents

An insurer, agent, or broker must not knowingly ___ or ___ from an applicant any money or other consideration in addition to the ___ in return for the processing of ___ or other forms, or for the rendering of services associated with a ___ of insurance, unless the applicant ___ in writing before any services are rendered

appointment

An agent is considered to have one ___ for each kind of insurance they are licensed for in North Carolina.

30; order; consent; legal

An agent must report any adverse administrative action taken against them in another state, or by another governmental unit in this state, within ___ days after the final disposition. The report must include a copy of the ___, ___ order, and any other relevant ___ documents.

adjuster; compensation; denied

An agent or limited representative may occasionally act as an ___ without being licensed when requested by an insurer, but they may not act as an adjuster if the agent's ___ is determined by the adjustment of losses. This law decreases the probability of reasonable claims being ___

Class 3 misdemeanor; 1,000; 5,000

An agent or limited representative who signs a blank contract or insurance policy is guilty of a ___ ___ ___, punishable by a $___-$___ fine upon conviction.

30

An applicant who disagrees with the outcome of the review may request a hearing within ___ days.

licensed; authorized; cancelled; fee

An appointment continues in effect as long as the appointed agent is properly ___ and the appointing insurer is ___ to transact business in this state, unless the appointment is ___. The insurer must submit an appointment ___

appointment

An individual who holds a valid insurance agent's license may not solicit, negotiate, or otherwise act as an agent for an insurer without an insurer___

commission; service fee; producer

An insurance company or producer may not pay a ___, ___ ___, or other valuable consideration to a person other than a licensed insurance ___ for selling, soliciting, or negotiating insurance.

assumed name

An insurance producer doing business under any name other than the producer's legal name must notify the Commissioner before using the ___ ___

value; claimants

An insurance professional may not accept anything of ___ from a service provider for recommending the provider to ___

salvage

An insurance professional may not buy ___ from a claimant

settlement

An insurance professional may not delay ___ of a property damage claim because of the claimant's choice of auto repair shop

legal counsel

An insurance professional may not discourage a claimant from seeking ___ ___

choose

An insurance professional may not recommend an auto repair service without stating that the claimant gets to ___ the shop

agent; 15

An insurer authorized to do insurance business in this state may appoint any properly licensed individual as its ___. To do so, the insurer must file a notice of appointment within ___ days after the date the first insurance application is submitted.

30

An insurer or agent must notify a person at least ___ days before disclosing private information.

failing; malice; fined; suspended; revoked

An insurer or producer ___ to report a termination, or reporting a termination with ___, may, after a notice and hearing, be ___ or have a license ___ or ___

30

An insurer that terminates a producer's appointment must notify the Commissioner within ___ days after the termination's effective date.

pay; allow; give; accept; rebate; discount; abatement; credit; reduction

An insurer, agent, or broker must not Directly or indirectly ___, ___, ___, or ___ as an inducement to buy insurance any ___, ___, ___, ___, or ___ of the premium named in an insurance policy

pay; allow; give; accept; favor; advantage

An insurer, agent, or broker must not Directly or indirectly ___, ___, ___, or ___ as an inducement to buy insurance any special ___ or ___ in the dividends or other benefits

pay; allow; give; accept; consideration; inducement

An insurer, agent, or broker must not Directly or indirectly ___, ___, ___, or ___ as an inducement to buy insurance any valuable ___ or ___ not specified in the policy

losses; claims; class 1 misdemeanor; class h felony

Any person who solicits, negotiates, or sells insurance for an unauthorized insurer is strictly liable for any ___ or unpaid ___ if an unauthorized insurer fails to pay any claim in part or in full. The person making the sale will be guilty of a ___ ___ ___ if they do not know the insurer is unauthorized and a ___ ___ ___ if they knew or should have known the insurer was not authorized.

policy delivery; received

Applicants for insurance must be given notices of the insurer's information practices at the time of ___ ___ if the information is provided by the applicant or public records, or when the information is ___ if provided by someone other than the applicant or public records.

application; fee; certificate; The applicant is of good character; The applicant is employed by the signer; The applicant will be supervised by a licensed adjuster; The employer will be responsible for the acts of the applicant during the learning period

Applicants must file with the Commissioner an ___ for an adjuster's license, advance payment of the examination ___, and a ___ signed by the applicant's employer certifying what four things?

termination

At the Commissioner's request, insurers must provide additional information, documents, or records about the ___

learner's permit; 90

Before an adjuster obtains a license, the Commissioner will issue a ___ ___, authorizing the applicant to act as an adjuster for ___ days prior to being fully licensed

April 1

Business entities are also responsible for paying renewal fees for each appointed agent per line of insurance prior to ___ of each year

March 31

Business entity licenses expire on ___ of each year unless the renewal fee is paid.

adverse underwriting

The purpose of the Insurance Information and Privacy Protection Act is to enable insurance applicants and policyholders to obtain reasons for ___ ___ decisions

indirect receipt

Commissions, fees, or other valuable consideration for the sale of insurance may be assigned or directed to be paid in connection with the ___ ___ of commissions in circumstances in which a license is not required

producer; renewals; deferred commissions

Commissions, fees, or other valuable consideration for the sale of insurance may be assigned or directed to be paid to a ___ in connection with ___ of insurance business originally sold by or through the licensed person or for other ___ ___

owner; shareholder; member; partner; director; employee; agent

Commissions, fees, or other valuable consideration for the sale of insurance may be assigned or directed to be paid to a business entity by an ___, ___, ___, ___,. ___, ___, or ___ of that business entity

standards; transactions

The purpose of the Insurance Information and Privacy Protection Act is to establish ___ for the collection, use, and disclosure of information gathered in connection with insurance ___

regulatory; accuracy

The purpose of the Insurance Information and Privacy Protection Act is to establish a ___ mechanism to enable the public to know what information is being collected and allow them to verify or dispute its ___

disclosure

The purpose of the Insurance Information and Privacy Protection Act is to limit the ___ of collected information

information; fairness; intrusiveness

The purpose of the Insurance Information and Privacy Protection Act is to maintain a balance between the insurer's need for ___ and the public's need for ___ and minimal ___ in insurance information practices

insurance transactions

These regulations apply to insurers and agents who engage in insurance transactions or collect, receive, or maintain information connected to ___ ___ with North Carolina residents.

permitted

Disclosing information given by a consumer reporting agency to a person other than an insurer or agent is also ___

Specify the date Specify the types of persons authorized to disclose information about the individual Specify the nature of the information to be disclosed Name the insurance institution or agent and identify to whom the individual is authorizing information to be disclosed Specify the purpose for which the information is being collected Specify the length of time the authorization remains valid (30 months for information involving life and health insurance)

Disclosure authorization forms must comply with the state law by meeting what 6 requirements?

affiliates; third parties; personal

The separate privacy disclosure notice should provide information about the insurer's policies with disclosing nonpublic personal information to ___ or nonaffiliated ___ ___, and their policies to protect the nonpublic ___ information of consumers.

To willfully make a false statement on an insurance application for the purpose of obtaining any fees or commissions from a company engaged in the business of insurance For an agent, broker, or limited representative to knowingly receive premium payment through fraudulent representations For any unlicensed person to act as or pretend to be a licensee by collecting premiums or soliciting, investigating, or examining risks (Anyone not duly licensed who acts as a licensee will be liable for all the duties, requirements, liabilities, and penalties to which that licensee is subject) To act as an adjuster or aid in the adjustment of claims for an unauthorized insurer

Four Class 1 misdemeanors

B 30 days

How much time does an insurer have to notify the Commissioner after an agent's appointment is terminated? A 15 days B 30 days C The insurer is not required to notify the Commissioner D 60 days

30; complaint; court order; convicted; 10

If an agent is prosecuted for a crime other than misdemeanor auto violations in any jurisdiction, they must report it to the Commissioner within ___ days after the initial pretrial hearing date. The report must include a copy of the initial ___, any ___ ___ issued, and any other relevant documents. If the licensee is subsequently ___ of the crime, they must report it to the Commissioner within ___ days after the date of conviction.

30; inform; permit; copy; entities; 2; correction

If an individual requests access to their recorded personal information, the insurer or agent has ___ days to ___ the client of the information, ___ them to see the information or obtain a ___, disclose what ___ received the information within the previous ___ years, and provide the procedure through which a ___ may be requested.

refuse; written; grounds

If the Commissioner finds that the applicant has not fully met the requirements for licensing, the Commissioner will ___ to issue the license and send ___ notification to the applicant and the appointing insurer of the denial, stating the ___ for the denial.

appointment; NAIC

If the Commissioner suspends, revokes, or refuses to grant a license, any ___ of the applicant is also revoked. The Commissioner will notify every appointing insurer and the central office of the ___

writing; correction; 2; 7

If the insurer complies, it must notify the client in ___ and furnish the ___ to any person designated by the client who may have received the information within the previous ___ years as well as any insurance-support organization that provided the information or received the information within the previous ___ years.

immune; liability; confidential

In the absence of malice, any person, insurer, or organization providing information or statements about the termination of a producer's appointment will be ___ from civil ___, and the information will be ___

policy reinstatement; change

In the case of a policy reinstatement or change in insurance benefits, a notice must be provided no later than the time a request for a ___ ___ or ___ in insurance benefits is received by the insurance institution.

renewal date

In the case of a policy renewal, a notice must be provided no later than the policy ___ ___

written authorization; decisions; eligibility; criminal

Insurers, agents, agency support personnel, and corporations may not disclose any personal information about an individual in connection with an insurance transaction without having the individual's ___ ___ before the disclosure occurs. However, this information may be used without authorization when making legitimate business ___, determining ___ for benefits, or preventing ___ activity (such as fraud, misrepresentation, or concealment)

information; sources; techniques

The notice of insurance information practices must be in writing and must state the types of ___ that may be collected and the ___ and ___ used

applicant

The notice of insurance information practices must be in writing and must state whether personal information may be collected from someone other than the ___

may not; license revocation

Licensed adjusters may/may not engage in the practice of law, and doing so is cause for ___ ___

agents; brokers

Licensees may not advertise or represent themselves as licensed insurance ___ or ___

April 1; staggered

Licenses for brokers, limited representatives, adjusters, and motor vehicle damage appraisers are renewed on ___ of each year, unless the Commissioner establishes ___ license renewal dates to apportion renewals throughout the calendar year.

cause; suspension; probation; revocation; nonrenewal

The notice of termination of appointment must state the ___ for termination if the cause is also ground for license ___, ___, ___, or ___

renewal; permissible

The payment of ___ or other deferred commissions to a person who held a license at the time of the original sale is ___.

renewal; 24

Notice of insurance information practices is not required with a policy ___ if personal information is collected only from the policyholder or from public records or if a privacy information notice meeting the requirements has been provided within the previous ___ months.

30; disclosure

Rental Car Insurance may be written only if the rental period does not exceed ___ consecutive days and the terms of the coverage meet certain ___ requirements.

surrendered; lapsed

The Commissioner may enforce penalties or take action against a person who is under investigation or has been charged with a violation even if the person's license has been ___ or ___

Excess liability insurance to cover the rental car company, its franchisee, and its renters in excess of the standard liability limits provided by the company in its rental agreement for liability arising from the negligent operation of the rental vehicle; Accident and health insurance that covers renters and occupants for accidental death and dismemberment and medical expenses resulting from an accident; Personal effects insurance to cover loss of or damage to a renter's personal effects; Any other coverage approved by the Commissioner

The Commissioner may issue to a rental car company or its franchisee a limited license to write what four things?

emergency; motor vehicle damage appraisers; 30

The Commissioner may permit an experienced adjuster licensed in another state to act as an adjuster in this state without a license if ___ adjustment work is necessary, for a period of time determined by the Commissioner. The same permission may be given to experienced ___ ___ ___ ___ doing emergency appraisal work, limited to a ___-day period.

D Reporting a crime from another jurisdiction to the Commissioner

The Commissioner may revoke an agent's license for all of the following reasons, except: A Making a material misstatement on a licensing application B Mishandling funds received while transaction insurance business C Failing to pay court-ordered child support D Reporting a crime from another jurisdiction to the Commissioner

Providing materially incorrect, misleading, incomplete, or false information on a licensing application; Violating any state's insurance law or order of the Commissioner; Obtaining or attempting to obtain a license through misrepresentation or fraud; Improperly withholding, misappropriating, or converting monies received while transacting insurance business; Intentionally misrepresenting the terms of an insurance policy or application; Being convicted of a felony or a misdemeanor involving dishonesty, breach of trust, or moral turpitude, or committing any insurance unfair trade practice; Using dishonest or fraudulent practices or demonstrating incompetence, untrustworthiness, or financial irresponsibility in the conduct of business; Having an insurance producer license denied, suspended, or revoked in another state; Forging another's name on an insurance application or document related to an insurance transaction; Willfully failing to notify the Commissioner of insolvency, bankruptcy, or receivership proceedings being taken against a licensee within 3 business days after the proceedings begin; Knowingly accepting insurance business from an individual not licensed to broker that kind of business; Soliciting, negotiating, or selling insurance for an unauthorized insurer, even if the licensee did not know the insurer was not authorized; Failing to comply with a court order to pay child support; Failing to pay state income tax; Cheating on a prelicensing or continuing education exam; Willfully overinsuring property

The Commissioner may suspend, place on probation, revoke, or refuse to renew a license for any one or more of what 16 reasons?

3; 40

The Commissioner must notify a nonresident licensee within ___ business days of receiving legal process against the licensee. The licensee must be given at least ___ days to respond.

75

The annual fees required, per license, when a license is issued, renewed, or cancelled are $___ for adjusters other than crop/hail adjusters

100

The annual fees required, per license, when a license is issued, renewed, or cancelled are $___ for business entities

10

The annual fees required, per license, when a license is issued, renewed, or cancelled are $___ for individual agents

50

The annual fees required, per license, when a license is issued, renewed, or cancelled are $___ for resident and nonresident brokers

20

The annual fees required, per license, when a license is issued, renewed, or cancelled are: $___ for oversees military sales agents, limited representatives, and crop/hail adjusters

30; producer

The producer has ___ days after receiving the termination notice to file written comments with the Commissioner and insurer. These comments will be included with any report distributed or disclosed about the ___ as permitted by law.

15

The insurer must give the producer a copy of the termination notice within ___ days after notifying the Commissioner of the termination.

invalid

The insurer or agent is not responsible to provide these notices to any applicant or policyholder whose last known address is deemed ___ by postal authorities

training program; disclosure; is not; renters

The licensee must conduct a Commissioner-approved ___ ___, informing trainees of the kinds of insurance being offered, a ___ to prospective renters that the insurance is/is not required to rent the vehicle, and a disclosure to prospective ___ that they may already have insurance policies that provide the same coverage.

privacy rights; access; correction

The notice of insurance information practices must be in writing and must state A description of the individual's ___ ___, including right of ___ and ___, and how they may be exercised

retained; persons

The notice of insurance information practices must be in writing and must state That information obtained from an insurance-support organization may be ___ by the organization and disclosed to other ___

disclosures; frequency

The notice of insurance information practices must be in writing and must state the types of ___ required, which ones require prior authorization, and the ___ they must be provided

commissions; distributing; deposits

These rules do not prohibit the payment of ___ or other compensation to duly licensed agents, brokers, and limited representatives. They also do not prevent a participating insurer from ___ to its policyholders dividends, savings, or the unused portion of premiums and premium ___.

annually

This privacy disclosure notice must be provided ___ during the continuation of the policy.

trustworthy; competent

To apply for the limited license, the applicant must file with the Commissioner a written application signed by an officer of the applicant and a certificate by the insurer stating that the applicant is ___ and ___

Upon application for a license by any person who is not licensed but is legally required to secure a license; If additional licensing for another kind of insurance is requested; Upon application for a supplemental license to sell Medicare Supplement or LTC policies

What 3 circumstances require an additional $50 fee?

credited; appointment

When a temporary license is issued, the fee is the same rate as for a permanent license of the same type, and it may be ___ against the fee required for an ___ by the sponsoring company.

occupation

When dealing with the public, all insurance professionals must identify themselves and their ___

National Producer Number; website; licensure

When dealing with the public, all insurance professionals must on request, provide their ___ ___ ___ and Department's ___ and phone number for verification of ___ status

A medical institution to verify insurance coverage or inform the individual of a medical problem of which they may not be aware A person making an inquiry when providing funeral services to the deceased insured Insurance regulatory authority Law enforcement or other governmental authority In response to a judicial or administrative order Actuarial or research studies, or for marketing statistics, when the name is not disclosed An insurer's or agency's sale, merger, or consolidation Any audit in connection with an insurer's or agent's product or service A group policyholder for reporting claims experience A lien holder, mortgagee, or similar who has a proven legal interest in the insurance benefits A government authority in determining eligibility for benefits, such as Medicaid Anyone else, if required by law

When necessary, limited information may be provided to what 12 entities?

B 24

When renewing a policy issued in North Carolina, a privacy information notice does not need to be provided to the insured if a notice meeting the requirements was provided within the previous ______ months. A 36 B 12 C 24 D 6

B An agency clerk who maintains records for agents

Which of the following individuals does not require an insurance agent's license in North Carolina? A An individual licensed in Virginia wishing to sell insurance in Winston-Salem B An agency clerk who maintains records for agents C An individual wishing to represent purchasers of insurance D An individual who has earned the Chartered Life Underwriter (CLU) designation

Comply with the client's request Notify the client of its refusal to make such corrections, the reason for the refusal, and the individual's right to file a formal statement with the insurance institution

Within 30 days after an insurer receives a written request from a client to correct, amend, or delete personal information about the client, the insurer must do one of what two things?

may not; funds; credit

insurers and agents writing credit life and credit accident and health insurance may/may not allow an agent to retain any portion of funds received for the payment of ___ incurred under ___ policies.