General Wisconsin Insurance Laws

Consumer report

A written and/or oral information regarding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources.

Libel

A written or printed untrue statement that damages a person's repuation

estoppel

ABC insurance company receives an incomplete application and issues the policy anyway. Six months later ABC realizes the missing information. What term is used that prevents ABC from forcing the policyowner to answer further questions?

Fair Credit Reporting Act

Act that protects privacy of background information and ensures that information supplied is accurate.

fines and/or 10 years jail

Anyone engaged in the business whose activities affect interstate commerce, and who knowingly makes false material statements may be face what?

Appointment: 15 days

Before an intermediary transacts business, they must submit an application on on or before the date of appointment. The appointment is effective how many days prior to the date the appointment is entered into the system?

Reinvestigate

Carl's application for a life policy was rejected because of information disclosed in an inspection report. Carl reviewed the consumer reporting agency's file and found they had incorrect information concerning his personal life. Carl can legally require the reporting agency to ?

Rebating

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

Right to file complaint

Every insurer must provide such notice to its policyholders when the policy is issued

Accessible to the public

Every producer must maintain a place of business in this state

Not imprisonment

Failing to report to the de

Without receiving written consent from an insurance regulatory authority

Federal law makes it illegal for any individual convicted of a crime involving dishonesty or breach of trust to work in the business of insurance affecting interstate commerce

Implied authority

Not stated in an agent's contract but is required for the agent to conduct business

Elements of insurable risks

due to chance, definite and measurable, statistically predictable, not catastrophic, randomly selected and large loss exposure

churning

replacing insurance policies for the sole purpose of making commissions.

Legal duty owed, breach of legal duty, proximate cause, damages

4 elements of negligence

Readability rule

A minimum score of 40 on the Flesch reading ease test or equivalent. Note, however, that the minimum score for Medicare supplement policies is 50; Except for specification pages, schedules, and tables, the policy must be printed in 10-point type; The policy must be appropriately divided, captioned and presented in a meaningful sequence; overall appearance must be understandable; A table of contents or index may be required; Exclusions must be clearly explained; Definitions are required where appropriate; and Cross-referencing must be used at a minimum.

Firm

A person that markets insurance but does not include an insurer.

25

An agent is presumed to have exceeded the occasional exchange of business if the agent places more than how many insurance risks per calendar year with all insurers?

Principal

Another name for the insurer

Annually

Chapter: General Wisconsin Insurance Laws Question 1 of 20 How often must insurers provide a current copy of the privacy policy and practices to each customer? Monthly Quarterly Semi-annually Annually

false advertising

Circulating deceptive sales material to the public is what type of Unfair Trade Practice?

10 days

Cost of examinations are due how many days after the examinee has been served with a detailed account of all the costs on the charge-back basis

competence and trustworthiness

Criminal record and convictions; Accuracy of information given on the application; Regulatory actions; Violation of orders of any state insurance Commissioner; Misrepresentation or fraud in the application process or insurance practice; Owing delinquent income tax or child support; or Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial irresponsibility in the conduct of business.

5 days

If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?

$5,000

If a person does not comply with an order issued within 2 weeks after the Commissioner has given notice, the Commissioner may issue a forfeiture of up to how much for each day that the violation continues?

Termination: 30 days

If the insurer obtains knowledge that the terminated intermediary was involved in any insurance violations, the insurer must submit completed explanations and documentation in writing within how many days?

Licensed for the same line

In Wisconsin, producers are permitted to share or split commissions if they are

wording of the policy

In insurance policies, contract ambiguities are automatically ruled in the favor of the insured. What privilege does the insurer has in order to balance this?

Rebating

Inducement offered in form of premiums on the policy, special favors or services, advantages in the dividends or other benefits; and stocks, bonds, securities, and their dividends or profits

Reasonable Expectations

It is not always practical or necessary to state every direct and indirect provision or coverage offered by an insurance policy. If an agent implies through advertising, sales literature or statements that these provisions exist, an insured could reasonably expect coverage.

reduction

Lessen the possibility of a loss by installing deadbolt locks

Exempt from continuing education

Limited lines license (credit, crop, title, travel, legal expense) Nonresident agent license if the resident state grants exemptions to WI residents

1% net premiums earned

Maximum annual billing for an insurer

$200,000

Maximum limit of coverage that may be provided on any DWELLING at one location under a fire policy issued by the WIP

Twisting

Misrepresentation that persuades an insured/owner, to his or her detriment, to cancel, lapse, or switch policies from one to another.

30 days

Oral contracts are valid for how long?

50

Rule of readability

Controlled business

Selling a policy on themselves, their family, their coworkers is what?

$0

The Commissioner obtains a restraining order against a person who has violated an insurance law. The person continues the violation for 10 days. The person will have to pay a fine of

Express

The authority a principal intends to grant to an agent by means of the agent's contract. It is the authority written in the contract

Reciprocal Insurance Exchange

The chief administrator of the insurer is called an "attorney-in-fact"

Utmost good faith

The insurer must be able to rely on the statements in the application, and the insured must be able to rely on the insurer to pay valid claims. In the forming of an insurance contract, this is referred to as

5 and 25

Unless proven otherwise, an agent is presumed to have exceeded the occasional exchange of business if he/she places more than ? insurance risks per calendar year with a single insurer with which he/she is not listed as an agent, or exchanges more than ?insurance risks per calendar year with all insurers.

10 consecutive days

What constitutes promptness?

Collusion

When an agent and policyholder or insured act together to deceive or defraud the insurer. The sections on specific knowledge do not apply in this case nor if the policyholder or insured knew that the agent was acting beyond the scope of their authority.

Rebating

When producers give or promise anything of value that is not specified in the policy.

Termination: 30 days

When the appointment of an agent is terminated, the insurer must notify the COMMISSIONER with appropriate forms and documents prior to or within 30 days of the termination date?

15 days

When the appointment of an individual agent is terminated, the insurer must notify the intermediary in writing, prior to or within how many days of filing the termination notice?

3 days

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?

warrenty

a statement made in an insurance application by the insured that is the absolute truth

5

maximum number of insurance risks an agent can place with a single insurer in one calendar year if the agent is not listed with that insurer

misrepresentation

misleading statements with the intent to defraud another

twisting

misrepresentation, or incomplete or fraudulent comparison of insurance policies that persuades an insured/owner, to his or her detriment, to cancel, lapse, or switch policies from one to another

Indemnity provision

restores an insured person to the same financial state as before the loss

Express, implied, apparent

three types of agent authority

Misrepresentation

An agent who includes a statement or omits a statement which, when taken in context of the whole presentation, may tend to mislead or deceive the persons addressed has committed what?

$15,000

The Wisconsin Insurance Plan's maximum limit of coverage against loss by BURGLARY or theft on any eligible property, other than a dwelling is how much?

Examinee

The reasonable costs of examinations must be paid by who?

The customer's associates, friends, and neighbors provide the report's data

Unique characteristic of investigative consumer reports

False advertising

the illegal practice of advertising or circulating materials that are untrue, deceptive, or misleading.

Competent parties

this requires that both parties be of legal age, mentally competent to understand the contract, and not under the influence of drugs

60 days

An insurance policy is considered a "new policy" if it has been in effect for what maximum time period?

12 months

An intermediary has just placed insurance on himself. He can receive compensation for this transaction only if he has placed insurance on other individuals with the same insurer within the last

Controlled Business

Any coverage written on a producer's own life, health or property, and/or that of the producer's immediate family or business associates. A licensee is not allowed to collect commissions on controlled business above the state-specified limit.

Reinsurance mangager

Any person who has authority to bind, or manages all or part of the assumed reinsurance business of a reinsurer and acts as an agent for the reinsurer

fines and/or 5 years jail

Anyone convicted of a felony involving DISHONESTY or BREACH OF TRUST, who also engages in the business of insurance will face what?

1%

Maximum annual billing for an insurer

$2500

Maximum penalty for habitual WILLFUL noncompliance with the Fair Credit Reporting Act

$1,000

Maximum penalty for habitual willful noncompliance with the Fair Credit Reporting Act

Termination: 15 days

The insurer must notify the intermediary in writing, prior to or within how many days of filing the termination notice that they are no longer listed as a company rep?

5 years

The notice reporting the insurer's know deficiencies must remain open and available for inspection for how long?