Insurance Regulation
License Qualifications
- 18 years old - File an app with director - Pay $100 license fee - Pass exam for license - Have not committed act to not get license
Agent license
-complete 20 hours of prelicensing education -valid for 180 days from completion of the course
call hours
8 am to 9 pm
Fair Credit Reporting Act
A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential, accurate, relevant and properly used.
Statute
A formal written law enacted by legislature: insurance statutes can be found in the state insurance code
antifraud program
A written plan of procedures they will follow when instances of fraud or suspected fraud are brought to the insurers attention
Fair Credit Reporting Act
Act that protects privacy of background information and ensures that information supplied is accurate.
False advertising
Advertisements cannot include any untrue, deceptive, or misleading statements that apply to the business of insurance or anyone who conducts it.
Rebating
Any inducement offered in the sale of insurance products that is not specified in the policy.
Unlawful Insurance Fraud
Any person engaged in the business of insurance to willfully, with the intent to deceive, make any oral or written statement that contains either false statements or omissions of material fact.
section 1034
Civil Penalties for violations of section 1033, this section states the attorney general may bring a civil action in the US district court for $50,000 for each violation
Moral turpitude
Conduct that is contrary to community standards of justice, honesty or good morals
NAIC
Determines an applicants licensure and standing status in another state
Do Not Call Registry
FTC and FCC solicitation calls cannot be made by telemarketers
Unfair Claims Settlement Practices
Failing to approve or deny coverage of a claim within a reasonable period after a proof-of-loss statement has been completed,
Exempt from CE
Granted inactive status hold only a limited lines license hold only a title insurance license 12 CE hod only a resident surety bail bond license 7 CE
Continuing Education
Has to complete 24 hours of CE 3 hours of ethics
Resident insurance license to a business entity
If the superintendent finds the applicant has met the following requirements -domiciled in Ohio or maintains principal place of business in this state -has designated a licensed insurance agent who will be responsible for the entity's compliance -Has not committed an act that is grounds for denial
Insurance Regulatory Information System (IRIS)
Introduced by the National Association of Insurance Commissioners in 1974 to identify insurance companies that might require further regulatory review.
Misrepresentation
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, or payment of dividends
Change in address
Licensed agents must notify the superintendent within 30 days
Non-Resident Agent
Licensed as a resident producer in another state, may apply for a nonresident producer license Must be -in good standing -same lines of authority -submitted the request for licensure by the Superintendent -Has not committed an act for denial -good reputation and character -has submitted all documents
Exempt
Not subject to a obligation
Examination of books and records
Once every 3 years and can be deferred to not exceed 5 years Examination expenses must be paid by the insurer
Non-Resident License
Renewed biannually by the last day of the licensees birth month
Investigative Consumer Report
Similar to consumer reports in that they also provide information on the consumer's character, reputation, and habits.
Temporary license
Superintendent may issue a temporary license for a maximum period of 180 days -does not require an examination -in case of death or disability of a licensed agent, the surviving spouse a court appointed personal representative or a member of a business entity -licensed agents entering active us military service -to any other person when the public interest would be best served
The head of the Ohio Dept of Insur
Superintendent, who is the CEO and director of the department of insurance Appointed by the governor (4years)
Appointment
The authority given by an insurer to an agent to transact insurance or adjust claims on the insurers behalf
superintendent
The head of the state department of insurance
consumer reports
Written and /or oral statements regarding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources.
Reciprocity
a mutual interchange of rights and privileges
fraudulent insurance act
an act committed by a person who knowingly and with intent to defraud
inducement
an offer that attempts to influence the other party
Surrender of license
any time as long as the agent is not under investigation by Superintendent
issuance of insurance
application must be submitted within 7 days after agent accepts preimium
agents
cannot charge fees unless the policy issued is a no commission bais the fee has to be disclosed not a percentage of premium agent does not discriminate with the fee
Disclosure Authorization Form
companyy can contain or release information
National call registry
created to control telemarketers
consent agreement
does not admit or deny the charges but agrees to pay a single penalty amount
Statutory
enacted or regulated by a statute
maintain claim data
for at least 3 years
Certificate of authority
from the department of insurance and indicates the Superintendent of insurance has examined the business and found it to be financially stable in accordance with insurance code
cease and desist order
hearing within 15 days
Considered insolvent
if for a period of 3 years the insurer is unable to pay its obligations when due
License Cancellation
if want to apply for a new license must go through steps of a new agent
Surplus lines insurance
insurance that is not available from admitted insurers
Twisting
is a misrepresentation, or incomplete or fraudulent comparison of insurance policies that persuades an insured/owner to his or her detriment to cancel, lapse switch policies with another insurer
Insurance agent
is any person who, in order to sell, solicit, or negotiate insurance is required to be licensed under the laws of this state, including limited lines insurance agents and surplus line brokers. Licensed in accordance to state law
Superintendent
issues cease and desist order
Licensing
life - coverage on human lives
Insurance fraud
misdemeanor on the first degree
Non resident business
must apply for renewal biennially on a date established by the Superintendent
insurance applicants
must be notified in writing whenever insurers request investigative consumer reports
Duty to report convictions
must notify superintendent within 30 days after the final disposition of the matter
Agent
must report administrative actions within 30 days
Felony in the fourth degree
no one should knowingly obtain info about an individual from an insurance institution or agent under false pretenses
Discrimination
of rates, policy benefits for persons within the same class or with the same life expectancy
defamation
one that makes oral or written statements intended to injure another producer or insurer
Dividends
paid to policyholders of a mutual insurer are not considered to be a rebate because they may get paid out
Willful noncompliance
penalty up to 2500
License Renewal
renew biennially on or before the last day of the agents birth month
Restitution
restoration to the original condition or repayment
cease and desist order
ruling requiring a company to stop an unfair business practice that reduces or limits competition max penalty 10,000
Cyber Security
submitted to superintendent of insurance by feb 15 that they are in compliance
Felony or misdemeanor
superintendent may suspend, revoke or refuse to issue or renew license if an agent has been convicted or pleaded guilty or no content to a felony or a misdemeanor that involves miuse or theft of money or property, forgery, fraud, dishonest acts or moral turpitude
suspension
termination of all authority to hold a license for a specific amount of time
Revocation
the permanent loss of membership, certification, or licensure.
Insurance Regulation
the rules of the insurance market, as established by law, administered by public officials, and interpreted by the courts, all for the purpose of promoting and protecting the public interest
unfair trade practices
trading practices that derive a gain at the expense of competition
insolvent
unable to meet financial obligations
1033 Waiver
written consent from a Commissioner for an individual convicted of a crime involving dishonesty to work in the business of insurance