Chapter 8 Pt 4 And Ch 9 Flashcards
Temporary license holder can rec a commission from a sale made to all except
License holder’s sister-in-law
License holder’s best friend
Accountant at a rival ins company
License holder’s family doctor
License holder’s sister in law
Applies for life policy. Two years ago suffered head injury from accident and cant remember parts of past, otherwise competent. Has been hospitalized for drug abuse but doesnt remember this when applying for ins. The ins issues policy and learns of his history one year later. What will happen
Policy will not be affected
Policy will be voided
Insurer will sue insured for committing fraud
Policy will not be affected
Which could legally rec commissions from the sale of a life ins policy
Licensed life ins agent
Licensed insurance consultant
Life and health ins counselor
Licensed life ins agent
Newest client was result of referral. To show thanks to referring customer agent could
Thank customer
Return customer’s first premium of new policy
Send customer gift a token of appreciation
Thank customer
Alleged fraud request=
15 days
Example of fiduciary responsibilities
Review of client’s coverage
Offering additional coverage to client
Forwarding premiums to insurer
Forwarding premiums to insurer
The requirement that an agent not co mingle ins Monies with their own funds is known as
Fiduciary responsibility
Premium accountability
Express authority
Fiduciary responsibility
Agent suspects ins fraud being committed notify fraud unit within
30
10
15
90
30
Agent suspects fraud=
30
Insured tells insurer that there is more than one ins policy in force. Insurer sets aside claim until hears what other company will pay. Insurers action will be classified as
Prudent
Coordinated
Proactive
Unfair
Unfair
NOT violation of unfair claims settlement practices act
Failure to respond promptly on claims communications
Delaying settlement bc there is an additional ins policy on a loss
Denying unsubstantiated claim
Refusing to pay claims without conducting a reasonable investigation
Denying an unsubstantiated claim
Applicant properly notifies her insurer of straightforward claim but insurer waits exceedingly long time to process it. Which describes behavior
Unfair claims settlement practice
Fraud
Misrepresentation
Unfair claims settlement practice
Unfair or deceptive acts in connection with sale of ins except
Attempting to settle claim in which liability is clear
Lacking standards for investigation of insured’s claims
Delaying settlement bc there is other ins that will satisfy any portion of the loss
Attempting to settle a claim in which liability is clear
Explains details of ins policy to client. Agent does not realize that state has rewritten two of provisions. Agent inadvertent misrepresents policy making it more attractive. Describes
No misconduct
Fraud
Misrepresentation
No misconduct
Which is NOT in violation of unfair claims settlement practices act?
Denying an unsubstantiated claim
Refusing to pay claims without conducting a reasonable investigation
Failure to respond promptly on claims communications
Delay in g a settlement bc there is an additional ins policy on a loss
Denying an unsubstantiated claim
Notice of claim is submitted to insurer and insurer suspects arson is involved; how long does insurer have to accept or reject claim
15
10
30
60
(Days)
30
Insurer accept or reject claim=
15 days
Arson suspected=
30 days
Receipt of notice of claim within
5
10
15
20
15
All insurers that provide life or accident and health ins coverage in texas must be members of
Naic
Federal association of insurers
Life and health ins guaranty association
Life and health ins guaranty association
At the end of advertisement insurer includes statement that protection is provided by guaranaty association. Which is true
Mentioning guaranty association is mandatory
Advertisements must also include the contact info of association
Mentioning guaranty association is considered to be unfair trade practice
Mentioning ins guaranty association when selling is unfair trade
What is the purpose of the life ins guaranty assoc
Encourage life insurers to write substandard biz
Allow agents to continue to solicit ins even if company is financially impaired
To help protect policy owners and beneficiaries against financial loss caused by the insolvency of an insurance company
To help protect policy owners and beneficiaries against financial loss caused by insolvency of ins company
Who is nonresident agent
Agent that doesn’t earn commission in Tx
Agent who resides in another state but licensed to write ins in Tx
Agent who isn’t us citizen
Resides in another state but licensed to write in Tx
Agents license will terminate within how many days from due date of Contuing education requirements
180
90
60
90
Submits claim for payment of benefits
Disclosure
Dividend
Lapse
Claimant
Claimant
Benefits in ins policy that policyowner cannot lose
Claimant
Nonfortfeiture values
Policy proceeds
Nonforfeiture values
Components not guaranteed in contract or that may fluctuate
Policy proceeds
Rescind
Testimony
No guaranteed elements
No guaranteed elements
The death benefit
Policy proceeds
Rescind
Testimonials
Policy proceeds
Presentation of non guaranteed elements; general rule: include info about insurer, insured, underwriting classifications, policy, benefits and must be clearly labeled
Advertisements
Illustrations
group life
Illustrations
Interest adjusted net cost method: time value of money
Comparative interest rate method: rate of return
Life ins policy comparison methods
Required provisions
Nonfortfeiture law
Life ins policy comparison methods
