Florida Statutes, Rules, and Regulations Common to all Lines

Agency

A business location at which an individual, firm, partnership corporation or other entities engage in any activity that by law may be preform by a licensed agent.

Insurer

Party that provides insurance Coverage, typically though a contract of insurance

Unfair Discrimination

when employment decisions and actions are not job related, objective or merit-based

Department of Financial Cervices General Duties and Powers

- To enforce and carry out the insurance code - Implied authority in the insurance code - may conduct investigations, determine of a person had violated a code, or obtain information to administer a code - can collect, propose, publish or disseminate information regarding duties imposed upon the code - they can employ actuaries. Actuaries shall be members of the Society of Actuaries or the Casualty Actuarial Society - they may have additional powers and duties provided by the laws of the state

Office of Insurance Regulation

- are responsible for all activities of the Financial Services Commission - Specific Duties are: - Rate- making supervision - Policy forms approval - Market Conduct Investigation - Issuing Insurer Certificates of Authority - Assessing Insurer Solvency - Regulating viatical settlements - Regulating premium financing arrangements - Administrative supervision

Office of Insurance Regulation Policy Approval Authority & Rates and Forms

-A basic Insurance policy, annuity contract, application form, any group certificate of insurance, rider, endorsement or renewal certificate may not be delivered in Florida unless the form has been filed in the office and has been approved by the office. - each filing has to be made at least 30 days in advance of any use or delivery - at the expiration of the 30 days it will be approved unless notice from the office is sent of approval or disapproval.

Agent Commissions, Compensations and Charges for Extra Services

-Agents are compensated with commissions that are a certain % of the initial (first year) or (renewal) premiums. - Florida law was amended in 2004 and it states that agents may charge for extra services an alternative commission so long that agent and client make a contract and agent returns any commission to the insurer within 30 days. - Commission Rebates: Agents may not rebate any portion of a commission except: :it is available to all insured's in the same actual class. :the agent and the insurer shall be in accordance for a rebate file :the rebate is displayed in public view :the age, sex, place of residence, nationality, ethnic origin, marital status or occupation is not utilized as a decision.

Authorized and unauthorized companies

-An authorize insurer is one duly authorize by a certificate of authority issued by the office. -An Unauthorized insurer does not have a certificate of authority.

Certificate Authority

A document that authorizes a company to start conducting business and specifies the kinds of insurance a company can transact.It is illegal for an insurance company to transact insurance without the certificate. In Florida no insurer or agent can operate with out a certificate of authority.

Misrepresentation

A false statement or lie that can render the contract void.

Insurance Contract

A promise that if certain events occur the insurance company will pay. The ins co's promises are presented in a legal contract called an insurance policy.

Reinsurance

Acceptance by one or more insurers, called reinsurers, of a portion of the risk underwritten by another insurance who has contracted for the entire coverage

Office of Financial Regulation

Is responsible for all activities of the Financial Services Commission. It regulates all banks, credit unions, other financial institutions, finance companies, and the securities industry. The head of the office is the Head or Commissioner They can investigate wrong doing inside and outside of Florida.

Defamation

Knowingly making, publishing, disseminating or circulating, directly or indirectly any oral or written statement that is false or malaises to any person in order to injure them.

false advertising

Knowingly making, publishing, or circulating false advertisement before the public by TV, radio newspaper, magazine or other publication.

Insurance transaction

Solicitation, negotiations, sale, advising an individual concerning coverage or claims

Stock and mutual companies

Stock- are private organizations, organized and incorporated under state laws for the purpose of making a profit for their stockholders. Mutual- -are organized and incorporated under state laws, but they have no stockholders.

Office of Insurance Regulation General duties and powers

To enforce and carry out the insurance code - Their powers or authority may be implied in the insurance code - may conduct investigations, determine of a person had violated a code, or obtain information to administer a code - can collect, propose, publish or disseminate information regarding duties imposed upon the code - they may have additional powers and duties provided by the laws of the state

Department of Financial Services

a. agent and adjuster licensing and investigations- b. Consumer services- c. Insurance Fraud- d. Receivership- e. Unclaimed property- f. Other powers-

License Requirements

a. education- Applicants must prove that they have completed the required pre-licensing education. 200 hours b. application- Applicant must file a written application signed under oath and signed by the applicant, meet required qualifications and pay all fees. c. background check- An Inquiry or investigation of the applicant's qualifications, character, experience, and background. Included with a set of fingerprints. Sent to the Dept. of Law Enforcement and the Federal Bureau of Investigation. d. examination- Exam must be taken within 30 days of completed education classes. minimum of 70%

Twisting

convincing client to replace policy with a new one

Unfair Claims Practices

include attempting to settle claims on the basis of an application or document that was altered without knowledge of the insured. Denying claims without conducting reasonable investigation.

Domestic company

insurer incorporated under the laws of a home state

Foreign company

insurer incorporated under the laws of another state, district, or territory

Agent

means a general lines agent, life agent, health agent or title agent.

Coercion

to enter an agreement to commit actions of boycott, coercion or intimidation in the business of insurance.

Maintaining a License

- Agents are required to continue their studies in the form of continuing education courses. 24 hours - prompt communication with the insurance company - Record Keeping: A licensee has 30 days to report any change to the department. Failure to do so may result in a $250 fine for the first time. Up to $500 or suspension any time after that.

Fraternals

-Nonprofit insurer that provides life and health insurance to members of a religious or social organization -Nonprofit (does not issue common stock) -Operates solely for the benefits of its members

Agent Responsibilities Fudiciary capacity

-The licensee must keep accounts, books and records for three years. -If an offense is made for :$300 or less- misdemeanor :More than $300 but less than $20,000- felony on the third degree :$20,000 but less than $100,000 - felony on the second degree :$100,000 or more - felony in the first degree

Financial Services Commision

1. Chief Financial Officer 2. Finacial Cervices Commission a. Office Financial Regulation b. Office of Insurance Regulation

Other Unfair Practices

1. False statements and entries-knowingly omitting information 2. Failure to maintain complaint handling procedures- Maintain records of all complaints received. 3. Advertising Gift Permitted- an insurer or agent may give a client for the purpose of advertising a gift for no more than $25.00 4. Life insurance limitations- An insurer may not deny a insurance of an individual just because of his foreign travel experiences. 5. Loan or Extension of Credit- No lender may require as a condition to lending money that a person purchase a policy through a particular insurance, agent or broker

Office of Insurance Regulation Agency Actions

1. organizing and licensing of companies 2. Policing against unauthorized insurance activities regulations of company activities, including policy forms, provisions, and rates. 3. supervising licensing of agents, and control of unfair trade and advertising practices. 4. Rehabilitating and liquidating insurers when necessary

Adjuster

A representative of an insurance company who investigates and acts on the behalf of the company to obtain agreements for the amount of the insurance claim.

Office of Financial Regulation agency actions

After imposing any penalties the office will take into account the appropriate of the penalty with respect to gravity of the violation, persons good faith statement and history of previous violations. The office may serve Cease and desist orders for: - unsafe practices -violation of any laws, any rules of the commission, any order of the office -Breach of any written agreement with the office - Prohibited act or practice to SEC. 655.03322 - or willful failure to provide information or ducuments to the office

Controlled business

An entity that obtains and possesses a license solely for the purpose of writing business on the owner, immediate family, relatives, employer and employees.

Alien company

An insurance company incorporated in a country other than the United States.

Office of Insurance Regulation Market Conduct Examination

For foreign insurers in lieu of making own examination the office may accept a full report of the last recent examinations, certified by the insurance supervisory official of another state. For Alien insurance it is limited to the transactions and affairs in the United States. The office will examine each insurer applying for an initial certificate at least once a year for the first three years.

Office of Financial Regulation General duties and powers

In addition to all the powers conferred by the Florida statutes the office has access to the books and records of all person over whom the office exercise general supervision. The office purpose to promote and exercise the safe and sound conduct of business, as well as to maintain public confidence in the financial institutions.

Insurance Guaranty Fraud

The Florida Life and Health Insurance Association is a non-profit legal entity of which all insurers are members of. It purpose is to protect policy owners, insured's and payees of insurance contracts against the failure of an insurer to perform.

Office of Financial Regulation Investigations

The office may investigate in or outside the state It has the power to administer oaths and affirmations, take testimony and depositions and to subpoenas the required persons

Agent Ethics

all agents and insurers should work together in serving the best interest of the public by. -understanding the laws of insurance - presenting accurately and completely every fact to a clients decision. -being fair with clients and colleagues - always placing the policy owners interests first.

Chief Financial Officer (CFO)

elected official and member of florida cabinet, serves as the head of DOFS. Directly oversees the division of insurance agent and agency services. Regulates insurance in florida.

Churning

excessive buying and selling of securities to generate commissions

Sliding

representing to the applicant that a specific ancillary coverage or product is included applied without additional charge when such charge is required.

Rebating

the practice of giving an individual a premium reduction or some other financial advantage not stated in the policy as an inducement to purchase the policy