Ch 1 - Insurance Regulations - 15% of exam Flashcards
(35 cards)
PA bond requirement
$20,000
NJ bond requirement
$10,000
PA # of days to cancel (rescind)
3 days
NJ # of days to cancel (rescind)
4 days
Must all NJ Contracts be written?
Yes (PA ALSO?)
Where are the various methods listed top the insured that show them ways they can cancel, and what are they?
On the contract. They may email, call, leave a vm, fax.
Where are all records kept?
Bensalem
2 days to send to ins. carrier, relates to what?
The # of BUSINESS days the P.A. firm has to notify the insurer of a contract.
If someone comments or asks about other companies, what do you do?
We’re not allowed to comment.
What is the amount that fines can be issued for per item to a P.A. under the PUBLIC ADJUSTER ACT?
$1,000 per item.
What’s the purpose of the Unfair Insurance Practices Act?
To regulate trade practices in the business of insurance by defining practices that constitute unfair methods of competition, or unfair practices.
What are the amounts that fines can be issued for per item to a P.A. under the UNFAIR INS PRACTICES ACT if the P.A. did NOT know, or should have reasonably known, was a violation?
$1,000 per item, not to exceed $10,000 over six mos.
What are the amounts that fines can be issued for per item to a P.A. under the UNFAIR INS PRACTICES ACT if the P.A. DID KNOW, or should have reasonably known, was a violation?
$5,000 per item, not to exceed $50,000 over six mos.
What’s the amount a fine can be issued per item to a P.A. under the UNFAIR INS PRACTICES ACT for violating a Cease & Desist Order while it’s in effect?
$10,000 per item.
List the 9 examples in the Study Guide that fall under unfair or deceptive trade practices? (under Unfair Ins. Prac, Act)
1) Publishing false illustrations/sales presentations. 2) Misrep of policy benefits, condition or dividend projections. 3) Misrep the name/title/class of a policy. 4) Circulate false/malicious info about a competitor. 5) Deceptive Advertising 6) Making false/derogatory statements of the finances of a person. 7) Entering into an agreement to boycott, coerce, intimidate, or monopoly. 8) Filing false statements of the financial condition of any person. 9) Rebating and inducements
Within how many days must an insurer complete an investigation? If they need more time what must they do?
30 WORKING days to complete the investigation. If more time needed, insurer must send a written notice within 30 days of notification of the claim, stating reasonable explanation for delay and state when a decision of the claim may be expected. They have 45 days to do this, and must repeat every 45 as needed.
If a P.A. happens to also be a contractor, what are the rules to be followed around repairing his own house while waiting for a decision from an insurer?
He’s not allowed to repair prior to: 1) A written decision or 2) Payment of settlement is received. Whichever happens first enables him to begin repair. (IS THIS THE CORRECT POINT OF THE QUESTION?)
Notes: 10 days to notify..REFERS TO WHAT?
?
After a cancellation, the P.A. has how many days to return “negotiable instruments”, and what are examples of them?
15 days. Examples: pictures, contracts, deeds.
How many days does a P.A. have to notify an insurer of an executed contract?
2 BUSINESS days.
Who are checks made out to, and in what order does the check go?
P.A. firm, then Mortgage co., then the insured. (CHECK THIS)
Notes: “Re-read Misreps of Policy Provisions pg. 7, is wordy.”
NEEDED FOR EXAM??
What do I have to know about “The Declarations Page”?
??
Name the 4 responsibilities of the insured under “Duties in the Event of a Loss?”
1) Notify of loss 2) Protect property from further damage 3) Separate damaged from undamaged property 4) Assign a value (The P.A. re-assigns an adjusted value though right? IS INSURED REQUIRED TO ASSIGN AN ESTIMATED VALUE IN THE INITIAL PHONE CALL SUBMITTING THE CLAIM? If yes, can this affect payout?)
