Laws and Rules

An insurer that terminates a producer's appointment must inform the Commissioner within how many days?

30 days

Ethics - Intro

Some situation may be legal but not ethical

Health insurance Free Look

They have 10 until full refund

Claim forms

must be sent within 15 days from notice of claim

What is the maximum amount the Commissioner can fine an insurer for each violation of a cease and desist order?

$10,000

Business Records

All records must be kept for 5 years

Insurable Interest

An individual may not secure a policy on the life of another unless insurable interest exists.

An insurer cannot deny a claim unless

An insurer must offer a reasonable explanation for the denial of a claim

Commissioner of Insure

Appointed and serves will of governor. Enforce, carry out laws. Adopting rules and regulations, maintaining records that insurers need to file. Examine company every 5 years.

Stock Company -

Insurance company that is owned and controlled by stock holders, provide the capital and share profits

Lapse notice does not apply

to individual policies where the premiums are paid monthly of more frequently

Colorado Insurance Guaranty Association (CIGA)

Provides claim payments of admitted insolvent insurers, Can't be used in sales pitch

The incontestability of a Life or Health Insurance Policy generally becomes effective after how many years?

2 years

Ultimately, who is responsible for a producer-generated advertisement?

Insurer

Interest on Death Benefits

Insurers must pay interest on death proceeds from date of death

What's most important?

Making sure applications and premium receipts are prompts

Policy Delivery

Most policies are issued as applied for, policy owner will have prompt delivery of policy

Notice of claim

Must be given the insurer within 20 days after date of occurance

Conditional Receipt

Normally given when the applicant pays the initial premium, at the time the application policy is signed, must be proved insurable

Agency contract

allow the producer to act on behalf of the insurance company

Agency

relationship between two parties, Producer and insurance company

A company that has not been authorized to operate in Colorado is known as

A nonadmitted insurer

Conservation

A producers attempt to stop the policy replacement process

Policy Summary and buyer guide

Delivered no later than the delivery of policy. If not taken in person, sent no more than five days after they receive the application

Mutual company

insurance company owned and controlled by policyowners, elect a board and collect dividends

Credit Life Insurance

insurance on the life of a debtor, in connection with a loan for a period of no longer than 10 years

Preexisting Conditions

issues the existed, were treated, or diagnosed 6 Months before employment

If an insurance company wishes to discriminate rates based on gender, it must

it must be justified by actuarial statistics.

Suicide Provision

Once a policy has been in force for one year, an insurance company can no longer contest death claim

If a producer completes an insurance application, collects the initial premium, and issues the appropriate receipt,

If a producer completes an insurance application, collects the initial premium, and issues the appropriate receipt, coverage will be contingent upon the insurer's underwriting policies

Interest on life insurance proceeds is

Interest on life insurance proceeds is required if the claim was not paid within 30 days of the date insurer received the claim

If a producer chooses to conduct business under an assumed name, when must notification be given to the Commissioner?

Prior to using the assumed name

On June 1, 2004 G takes out a $20,000 Whole Life insurance policy with an Accidental Death and Dismemberment rider. On July 15, 2005 G intentionally overdoses on sleeping pills and takes her own life. What will G's beneficiary receive as a death benefit?

"$20,000". Colorado does not allow an insurer to deny a life insurance claim due to suicide after the policy has been in force for 1 year.

Which of the following statements is true regarding the replacement of a life insurance policy in Colorado?

"The replacing insurer must maintain copies of all records regarding replacement for at least 5 years"

A license is deemed to be used for controlled business if during any 12-month period

"the licensee's total premiums on controlled business exceeded the total premiums on all other business". A license is deemed to be used for controlled business if the licensee's total premiums on controlled business exceeded the total premiums on all other business during any 12-month period.

An producer who violates a cease and desist order may, after a hearing, be fined up to

$500

US Patriot Act - Insurers must report -

-Cash payment in excess of $10,000 - purchase of insurance no consistent with needs - beneficiary is not clearly related -

To be licensed to sell life, accident, and health insurance in Colorado, an applicant must complete

100 hours

T calls to file a claim on his health insurance policy. Within how many days must the insurer provide T's proof of loss forms?

15 days

Renewing a producer's license requires __ hours of continued education every 2 years.

24

Free look for long term care policies

30 days

A group life insurance policyholder must be given a grace period for premium payment of how many days?

31 days

A producer must remit premiums to the insurer within ___ days after receipt.

45

When replacing an existing life insurance policy, the replacing insurer must notify the existing insurer within

5 days

Definition of small employer

50% of the time had 50 or less employees

Market Conduct -

Combination of both ethics and compliance, how producers conduct themselves with ethics and laws and regulations

If a producer is found to be writing primarily controlled business,

Commissioner will not renew the license

In Colorado, a life insurance applicant has __ days after policy delivery for a full refund of premium if not satisfied for any reason.

Free look for for individual life is 15 days

Free-Look Period

Period of 15 days up policy delivery, policy owner has 15 days to decide, a full refund will be given

Why are stock insurance companies non-participating?

Policy owners do not share in profits

When may the Commissioner conduct an examination of an insurance company?

as often as deemed necessary

Health and accident insurance grave periods

no less than 7 days for weekly premium, 10 days for monthly, 31 days for all others

If a producer is going to deposit any premium into a bank account prior to remitting the funds to the insurer, he/she must use a

separate insurance trust account

Colorado's replacement rules apply to all of the following types of insurance EXCEPT

single premium policies

Anyone giving false information to Commissioner

up to $5,000 fine, jail up to 3 months, charged with misdemeanor

If an annuity application was not taken in person, an insurer must provide the applicant a Buyer's Guide

within 5 business days of the insurer receiving the application