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Health Insurance > Ch 10 Insurance Regulation > Flashcards

Ch 10 Insurance Regulation Flashcards

1
Q

The authority given by an insurer to an agent to transact insurance or adjust claims on the insurer’s behalf

A

Appointment

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2
Q

To stop or discontinue

A

Cease and desist

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3
Q

Payment to the agent by the insurance company for placing insurance, usually a percentage of the policy premium

A

Commission

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4
Q

The head of the state department of insurance

A

Commissioner

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5
Q

Not subject to an obligation

A

Exempt

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6
Q

A person in a position of trust, someone who handles funds in the trust capacity

A

Fiduciary

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7
Q

An offer that attempts to influence the other party

A

Inducement

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8
Q

Unable to meet financial obligations

A

Insolvent

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9
Q

A formal written law enacted by legislature; insurance statutes can be found in the state insurance code

A

Statute

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10
Q

Insurance that is not available from admitted insurer’s

A

Surplus lines insurance

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11
Q

Insurance applicant must be notified in writing whenever insurers request investigative consumer reports.

A

True

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12
Q

Examination of insurers

A

Five years

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13
Q

Approval period for policy rates

A

30 days

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14
Q

Minimum age to apply for producer license

A

18 years

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15
Q

Producer licensing period

A

2 years

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16
Q

To reinstate voluntarily surrendered or lapsed license

A

One year

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17
Q

Insurer must file a notice a producer appointment

A

15 days

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18
Q

To file notice of termination of producer appointment

A

30 days

19
Q

Maximum time of license probation

A

24 months

20
Q

Maximum term of revocation before person can reapply for license

A

5 years

21
Q

To report change of address or phone number

A

30 days

22
Q

To report administrative action or criminal prosecution against producer

A

30 days

23
Q

CE required every two years

A

24 hours of CE

24
Q

CE credits required an ethics

A

3 hours

25
Q

CE required in a classroom setting (half of the total CE hours)

A

12 hours

26
Q

Producers must keep records of all insurance transactions

A

3 years

27
Q

The maximum allowed value of a gift to a customer to avoid engaging in an unfair trade practice of illegal inducement

A

$100

28
Q

Fine for violation of insurance laws or regulations by a producer

A

$2500

29
Q

Fine for violation of insurance laws by any other person

A

$5000

30
Q

Fine for willful noncompliance with Fair Credit Reporting Act

A

$2500

31
Q

Civil fine for violating regulations of interstate commerce

A

$50,000

32
Q

Licensing process

A
  • Minimum age requirement 18 years old
  • complete required prelicensing education and pass examination
  • submit application fees
  • be a good character, competent, and trustworthy
  • I have not committed any violations that are grounds for license denial
33
Q

Types of licenses

A
  • Individual producer: resident, non-resident
  • Limited lines producer
  • adjuster: investigates, negotiate, and settle the claims under a policy
  • consultant: advises the public about insurance policies for a fee
34
Q

Commissioner of insurance

A
  • appointed by the state governor
  • supervisors operations of the department of insurance
  • enforces insurance code
  • examines all authorized insurers (every five years)
  • issues, renews, suspense in revokes licenses
35
Q

Fair credit reporting act

A
  • protects consumers from circulation of inaccurate and obsolete information
  • consumer reports an investigative consumer reports
36
Q

Insurance fraud

A
  • Active fraud: willfully, and with the intent to deceive, making fall statements or omitting material facts
  • find an improvement for fraud that affects interstate commerce
37
Q

Written consent from insurance regulatory official to allow someone convicted of a crime involving dishonesty to work in the business of insurance

A

1033 waiver

38
Q

Rules regarding disclosure of nonpublic personal information to nonaffiliated third parties

A

Graham Leach Bliley act

39
Q

Do not call list

A
  • National do not call registry
  • strict telemarketing rules
  • insurers must consult current registry every 31 days
40
Q

Whom do insurance agents represent?

A

Insurance agents represent the insurer

41
Q

Who must be licensed as an insurance producer?

A

Anyone who solicits insurance and receives commissions from insurance transactions

42
Q

Can you name some unfair trade practices that produces should avoid?

A

Misrepresentation, rebating, defamation, unfair discrimination, etc.

43
Q

Insurance Guaranty Association

A
  • nonprofit legal entity
  • protects insureds against insolvent insurers
  • funded by member insurers
  • pays up to specified limits
  • illegal to advertise association protection when selling insurance products

Health Insurance (16 decks)

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