NC Statutes
Insurance Information and Privacy Protection Act
Establish standards for collection use, and disclosure of information, maintain a balance between the need for info by those conducting the business of ins and public's need for fairness in insurance info practices, regulatory mechanism to enable natural persons to ascertain what info is being or has been collected, limit the disclosure of info collected, enable insurance applicants and policyholders to obtain the reasons for any adverse underwriting decisions
Safe Driver Incentive Plan (SDIP)
Established to differentiate between safe drivers and those with records of at fault accidents and major or minor moving traffic violation convictions
Illegal
Discrimination in rates, premiums, or policy benefits for persons within the same class or with the same life expectancy
North Carolina Rate Bureau
Duty of every insurer that writes workers compensation insurance and risk that has been certified as "difficult to place" by any fire and casualty agent
$1,000-$5,000
Violation of a company transacting insurance while not authorized to do business within this state penalty amount
uniform application
the current version of the NAIC Uniform Application for resident and nonresident agent licensing
All insurers must be members
Who are the members of the Post Assessment Insurance Guarantee Association
temporary license
the Commissioner may issue a temporary insurance agent license for a max period of 180 days w/o requiring an examination if the Commissioner deems that the temporary license is necessary for the servicing of an insurance business
terminate
the cancellation of the relationship between an insurance agent and the insurer or the termination of an agent's authority to transact insurance
Property
direct or inconsequential loss or damage to property of any kind
commissions/fees can be paid in these circumstances
to a business entity by a person involved, an agent in connection w/ renewals of insurance, or in connection w/ the indirect receipt of commissions where a license is not required
Sell
to exchange a contact of insurance by any means, for money or its equivalent, on behalf of an insurance company
coercion
to require, as a condition to a loan, that the applicant purchase insurance from a specific insurer
Hearing
10 days prior notification, if commissioner suspects its agent has committed a violation or is engaged in an unfair trad practice
Represents the Insured
A broker represents
Represents the Insurer
An agent represents
Judicial Review
Any order or decision of the Commissioner is subject to
Accounts of Post-Assessment Insurance Guarantee Assocation
Automobile insurance, Workers Compensation, all other insurance to which the Article applies
No
Can insurer or reps knowingly issue any policy of insurance in this state that does not conform to the rates, rating plans, classifications, schedules, rules, and standards made and filed by the Bureau?
False Adverstising
Cannot include any untrue, deceptive, or misleading statements that apply to the business of insurance or anyone who conducts it
North Carolina Rate Bureau
Created to provide services and programs to the insurance industry in NC for automobile, property, and workers comp
Brokers License
File a bond for at least $15,000, not terminated within at least 30 days notice
50 days
How many days after the date of filing will the Commissioner give written notice to the Bureau specifying in what respect and what extent the Commissioner contends the filing fails to comply with the requirements
15 days
How many days does a written proof of loss after a notice of the loss be sent in?
at least 15 days in advance
How many days when an insurer changes the coverage other than at the request of the insured or changes the premium rate, give the insured written notice of such change
Between $100-$1,000
How much is the monetary penalty handed down from the commissioner in the even of suspension or revocation
Annually
How often must records of convictions for moving traffic violations to be considered be obtained under SDIP?
Company must pay any penalties and the expense of the investigation
If the commissioner finds that any complaint against a company is justified
An insurer may deviate from the rates promulgated by the Bueau
If the insurer has filed the proposed deviation with the Bureau and Commissioner, based on sound actuarial principles, and approved by Commissioner
Misrepresentation
Illegal act to issue, publish, or circulate any illustration or sales material that is false, misleading, or deceptive as to policy benefits or terms, payment of dividends, etc.
any period of 12 consecutive months
In case of a policyholder, notice required must be provided at lease once in
30 days
Insurance instutition or agent discloses personal info about an applicant/policyholder, must provide notice to them withing how many days
Uniform Unauthorized Insurers Act
No person, corp, assoc. may: act as an agent for any unauthorized insurer, negotiate for or place insurance coverage for another with an unauthorized insurer, aid an unauthorized insurer in effecting insurance or in transacting insurance business in this state, make, negotiate for or place, or aid in negotiating or place any ins contract in this state for an applicant for insurance covering any property or risk
North Carolina Rate Bureau
Must maintain and furnish to the Commissioner on an annual basis the statistics on earning derived by member companies from the investment of unearned premium, loss, and loss expense reserves on nonfleet private passenger motor vehicle insurance policies written in NC
home state
NC and any state of the US which an insurance agent maintains his/her principal place of residence or business and is licensed as an insurance agent
10 days
Notifying the commissioner for change of address, email address, or criminal conviction
Cease and desist order
Occurs after hearing (can be before), if the commissioner determines that a person has violated n insurance statute or regulation
Class I Felony, subject to $2,000-$10,000
Penalty for false financial statements
Notices not required
Policyholder whose last known address is deemed invalid; policy is lapsed, expired, or inactive and has not communicated with the policyholder for a period of 12 consecutive months
Acts of Pretext Interviews
Pretends to be someone else, pretends to represent a person he/she not representing, misrepresents the true purpose of the interview, refuses to identify him or herself upon request
Restricted License
Renewed annually, a foreign military sales agent representing a life insurance company in NC, provided the agent represents the insurance company only in a foreign country or territory and either on a US military installation/personnel
period of 3 years
Surcharges applied to premium under SDIP
License will be automatically suspended
When a person is convicted of a criminal violation of the General Statute
Assumed Name
When an insurance producer conducts business under any name other than the producer's legal name, he or she must notify the commissioner before using
business entity
a corp, association, partnership, limited liability, company, limited liability partnership, or other legal entity. NOT a sole proprietorship
license
a document issued by the commissioner authorization a person to act as an insurance agent for the kinds of insurance specified in the document
embezzlement
a felony if any insurance agent, broker, or administrator, embezzles or fraudulently uses or withholds any money received as a result of acting as an agent/broker/admin (felony). if more than $100k (class C felony) if less than $100k (class H felony)
broker
a licensed agent who procures insurance for a party other than himself thru a duly authorized agent of an insurer that is licensed to do business in NC but for which the broker is not authorized to act as agent (represents the insured or beneficiary)
limited lines agent
a person authorized by the Commissioner to sell, solicit, or negotiate limited lines insurnace
agent
a person licensed to solicit/negotiate a policy of insurance
Producer
a person required to be licensed o sell, solicit, or negotiate insurance (agent, broker, limited rep)
insurance producer
a person required to be licensed to sell, solicit, or negotiate insurance
Class H Felony
a person w/ the intent to injure, defraud, or deceive an insurer, presents a statement as part of a claim for payment knowing it contains misleading/false info concerning the claim is guilty of a
Resident
a person who lives in NC or any county outside this state that borders NC
only at the time the final policy of title insurance is issued
a title insurance company must give notice of its insurance information practices
negotiate
act of conferring directly w/, or offering advice directly to, a purchaser of a particular contract of insurance concerning any of the substantive benefits, terms, or conditions of the contract, only if the person engaged in that act either sells insurance or obtains insurance from insurers or purchasers
commingling
all account records maintained by agents, brokers, and limited reps must be kept separation from any other biz records (no commingling is allowed) and demonstrate at all times that collected funds due to insurers and return premiums due to policyholders are available at all times
contract of insurance
an agreement by which the insurer is bound to pay money or its ewuivalent or to do some act of value to the insured upon, and as an indemniy or reimbursement for the dstruction, loss, or injury in which other party has interest
Prepare or request an investigative consumer report about an individual in connect with an insurance transaction
an application for insurance, policy renewal, policy reinstatement, or a change in insurance benefits
adjuster
an individual who investigates/reports claims arising under insurance contracts
nonresident producer
an individual who is domiciled and licensed as a resident producer in a state other than NC. they will grant the same rights and privileges afforded a resident licensee and, subsequently, is subject to the same revocation, suspension and formal proceedings
Rebating
any inducement offered to the insured in the sale of insurance products that is not specified in the policy
rebating
any inducement offered to the insured in the sale of insurance products that is not specified in the policy
agents liability
any person representing an insurer is personally liable on all contracts of insurance unlawfully made by or through him for any company not authorized to do biz in the state
false statements in applications for insurance
any person who knowingly of willfully makes any false or fraudulent statement or representation in an application for insurance or to obtain a fee/commission/money (class 1 misdemeanor)
false pretenses and cheats
any person who knowingly, by means of any kind of false pretense, obtains or attempts to obtain from any person any money, goods, property, services, or other thing of value with the intent to cheat or defraud any person
Class 1 midemeanor
any person who pretends to be licensed and engages in any form of insurance is guilty of?
Class 1 Misdemeanor
any person who unlawfully solicits, negotiates for, collects a premium for a contract of insurance, or transacts of any unlawful insurance with an insurance company not licensed to do insurance business in NC
Policy renewal notice
at the time of policy renewal date; personal info is collected, notice meeting the requirements has been given within the previous 24 months
Application for Insurance notice
at the time of the delivery and at the time of the collection of personal info
Solicit
attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company
solicit
attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company. NOT a referral to a licensed insurance agent or broker that doesn't include a discussion of specific insurance policy terms & conditions
acting w/o a license
class 1 misdemeanor
agents signing certain blank policies
class 3 misdemeanor - agent/rep who sign any blank contract or policy of insurance. fine of $1k-$5k. one exception - transportation ticket policies of accident insurance and baggage insurance policies can be countersigned when blank thru coin-operated machines
Pretext Interviews
conducted in an attempt to obtain info about a natural person
Casualty
coverage of legal liability, including death, injury or disability, or damage to real and personal property
Commissioner
elected to office by the people, 4 year term, appoints to attorney general
sell
exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company. it does NOT mean a referral to an agent or broker that does not include a discussion of specific insurance
2 years
how many years can a suit be filed where an insurance institution or agent fails to comply with regulations regarding consumer information privacy and consumer rights
bond
in order to receive a broker's license, the applicant must file a BLANK w/ the commissioner for at least $15k
Nonresident Producer
individual who is domiciled and licensed as a resident producer in a state other than NC
unfair discrimination
insurers cant base any standard or rating plan for private passenger automobiles or motorcycles upon the age or sex of the persons insured
unfair discrimination
insurers cant refuse to insure or continue to insure, limit the amount, extent, or kind of coverage available to an individual based off blindness, deafness, race, color, national origin, or ethnic origin
False financial statements
intended to deceive public officials or the general public about the financial condition of an insurer
mirepresentation
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, the payments of dividends, etc. including oral statements
false advertisting
it is prohibited to advertise or circulate any materials that are untrue, deceptive, or misleading
duly licensed agents
may accept any commission, fee, or other valuable consideration for the sale, solicitation, or negotiation of insurnace
renewal or other deferred commissions
may be paid to a person for selling, soliciting, or negotiating insurance if the person was required to be licensed at the time of the sale, solicitation, or negotiation and was so licensed at that time
twisting
misrep, or incomplete comparison of insurance policies that persuades an insured/owner, to his/her detriment, to cancel, lapse, switch policies, or take out a policy with another insurer. this is prohibited
Twisting
misrepresentation or incomplete or fraudulent comparison of insurance policies that persuades an insured/owner, to his/her detriment, to cancel, lapse, switch polices, or take out a policy with another insurer
examples of false advertising
misrepresenting terms, benefits, conditions, or advantages on insurance policies, any dividends to be received or paid out, financial condition of any person or the insurance company, or true purpose of an assignment or loan against a policy
defamation
occurs when an oral or written statement is made that is intended to injure a person engaged in the insurance business
Defamation
oral/written statement is made that is intended to injure a person engaged in the insurance business, statements that are maliciously cirtical
Post-Assessment Insurance Guaranty Association (Guaranty Fund)
provide a mechanism for covered claims when an insurance company becomes insolvent
accident and health insurance
provides coverage to renters and other vehicle occupants for accidental death or dismemberment and for medical expenses resulting from an accident that occurs during the rental period
personal effects insurance
provides coverage to renters and other vehicle occupants for the loss of, or damage to, personal effects that occurs during the rental period
excess liability insurance
provides coverage to the rental car company or franchise and renters and other authorized drivers of rental vehicles
examples of rebates
rebates of premiums payable on the policy; special favors/services; advantages in dividends/benefits; stocks, bonds, securities, and their dividends or profits.
Coercion
requires, as a condition to a loan, that the applicant purchase insurance from a specific insurer
false financial statements
those that are intended to deceive public officials or the general public about the financial condition of an insurer
