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Life & Health Oregon State Laws > Life & Health > Flashcards

Life & Health Flashcards

1
Q

Anyone who wants to be licensed as a producer must do all of the following:

A
  1. Make application and furnish set of fingerprints to the Director.
  2. Pay the required fees.
  3. Successfully pass the exams for the lines of authority for which the person has applied.
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2
Q

Any producer who moved from Oregon to another state must notify the Director of the change in address within how many days after the change?

A

30 days.

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3
Q

For each 2-year renewal period after issuance of the license, the producer must include in the required hours of completed continuing education (CE) how many credit hours on the subject of professional ethics?

A

3 credit hours of professional ethics.

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4
Q

A producer must notify the Director of what 4 things within 30 days?

A
  1. Change of address.
  2. The opening or closing of a location at which the producer transacts business under the license in Oregon.
  3. Being the subject of any civil or administrative action taken against them by any jurisdiction.
  4. Any criminal prosecution in any jurisdiction.
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5
Q

If the Director determines that a person has engaged in an unfair method of competition, or an unfair or deceptive act or practice, what type of order will be issued?

A

Cease and desist from engaging in such method of competition, act or practice.

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6
Q

A producer must give an insurer at least how many days’ written notice before terminating their appointment with the insurer?

A

30 days.

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7
Q

What are 3 unfair claim settlement practices?

A
  1. Compelling claimants to initiate litigation to recover amounts due by offering substantially less than amounts ultimately recovered in actions brought by such claimants.
  2. Not attempting in good faith to promptly and equitably settle claims in which liability has become reasonably clear.
  3. Failing to promptly settle claims under one coverage of a policy where liability has become reasonably clear in order to influence settlements under other coverages of the policy.
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8
Q

A producer must deposit premium funds received into a premium fund account no later than how many days after they are received?

A

7 days.

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9
Q

What are 3 examples of unlawful discrimination?

A
  1. Permitting individuals of the same class and equal life expectancy to be charged different rates for life insurance or annuities.
  2. Basing eligibility for insurance on the applicant’s age, sex, race, creed, national origin, or marital status.
  3. Refusing to insure, or charging a different rate for life or health insurance to an individual who is, has been, or may be a victim of domestic abuse.
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10
Q

Offering any special favor in dividends or other benefits, or any valuable consideration or inducement not specified in the policy is called:

A

A rebate.

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11
Q

A resident producer must keep records pertaining to the business under the resistant produce license for how many years following expiration of the policy?

A

3 years.

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12
Q

What is the purpose of the Oregon Life and Health Insurance Guaranty Association?

A

To provide protection to policyowners and beneficiaries in the event of insurer impairment or insolvency.

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13
Q

A producer may be licensed in the following classes of insurance:

A 
Life
Health
Property
Casualty
Variable products
Personal lines
Credit
Limited lines
Title
Any other class allowed by law.
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14
Q

Any individual who wants to be licensed as a producer must:

A

Be at least 18 years of age.

Make application to the Director of the department of consumer and business services.

Have not committed any act that is a ground for denial, suspension or revocation.

Pay the required fees.

Complete a course of study for the respective lines of authority.

Pass the examinations for the lines of authority for which the person has applied.

Furniture sets of fingerprints to the Director.

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15
Q

What is a Producer?

A

A person required to be licensed to sell, solicit, or negotiate insurance in Oregon for any class or classes of insurance. Unlicensed persons may not sell, solicit, or negotiate insurance.

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16
Q

What is a Consultant?

A

A person must not act as an insurance consultant unless the person holds a valid license authorizing the person to act as an insurance consultant. A person acts as a consultant if for compensation other than commission from the sale of insurance, engage/attempt to engage in giving advice, counsel, opinion or service with respect to the benefits, advantages or disadvantages of insurance that may be issued in Oregon.

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17
Q

What is an Adjuster?

A

A person licensed to adjust property and casualty insurance, health insurance, or any class of insurance designated by the Director.

18
Q

A nonresident person shall receive a nonresident insurance producer license if the person:

A

Is currently licensed as a resident insurance producer and is in good standing in the person’s home state.

Has submitted the proper request for a nonresident insurance producer license and has paid the applicable fees.

Has submitted or transmitted to the Director of the resident insurance producer license application that the person submitted to the person’s home state, or in lieu of that application, a completed Uniform Application.

Lives in a homestate that grants nonresident insurance producer licenses to residents of Oregon on the same basis.

19
Q

The Director may issue a temporary producer license for up to 180 days without requiring a written exam if the Director determines the license is necessary to service an insurance business in the following cases:

A

To the surviving spouse or court appointed representative of a producer who dies or becomes disabled.

To the member or employee of a business entity that is a producer, when the entities designated individual dies or becomes disabled.

To the designee of a producer entering active service in the US Armed Forces.

When the Director determines that issuing a temporary license is in the public‘s best interest.

20
Q

A producer who allows a license to lapse may apply to reinstate the same license within 12 months from the due date for renewal without having to:

A

Take and pass a written examination.

21
Q

Each 2-year renewal cycle requires how many hours of Continuing Education?

A

24 hours.

3 hours of professional ethics.

3 hours on Oregon statutes and administrative rules, including recent changes.

No more than 4 hours is allowed for approved agency management courses.

No more than 8 hours CE credit will be given in any 1 day.

CE hours are due by the last day of the renewal month.

22
Q

An individual insurance producer who allows their license to lapse may apply to the Director to reinstate the same license within 12 months from the due date for renewal without having to take and pass a written examination. However, the insurance producer must:

A

Pay a reinstatement fee that is double the normal renewal fee.

Complete any CE requirements not satisfied to date, including the period for which the license was lapsed.

23
Q

CE is not required for any person who:

A

Is authorized to transact life insurance only, if the person is 58 years of age or more, has 10 years of experience as a producer, and will be servicing existing policies only.

To whom a license is issued without examination.

24
Q

A producer may not act as an agent unless the producer:

A

Is appointed as an agent by the insurer.

Transacts insurance on behalf of another insurance producer who is an appointed agent of that insurer according to conditions and limitations established by the Director.

25
Q

An insurer must give a producer at least how many days’ written notice prior to the effective date of the termination of the producer’s appointment?

A

90 days.

26
Q

No ensurer may refuse, without just cause, to pay or settle claims arising under coverages provided by its policies with such frequency that it indicates a general business practice, as evidenced by:

A

A substantial increase in the number of complaints against the ensure received by the department of consumer and business services.

A substantial increase in the number of lawsuits filed against the insure or its insureds by claimants.

Other relevant evidence.

27
Q

Required claim communication practices.

An insurer must:

A

Acknowledge the notification of a claim or pay the claim not later than 30 days after receipt of notification of claim.

Furnish the Director with an adequate response no later than 21 days after receipt of an inquiry from the Director about a claim.

Make an appropriate reply, no matter than the 30th day after receipt, to all other pertinent communications about a claim from a claimant that reasonably indicate a response is expected.

Upon receiving notification of claim from a 1st party claimant, provide necessary claim forms, instructions, and assistance no later than 30 days after the receipt of notification so that the claimant can comply with the policy conditions and the insurer’s requirements.

28
Q

An insurer must advise the claimant of the acceptance or denial of the claim within how many days?

A

30 days.

An insurer cannot deny a claim on the grounds of a specific policy provision, condition or exclusion unless the denial includes reference to the provision, condition or exclusion. A claim denial must be in writing, with either a copy or the capability of reproducing its text included in the insurer’s claim file.

29
Q

If an insurer needs more time to determine whether the claim of a first party claimant should be accepted or denied, it must notify the claimant no later than how many days after receipt of the proofs of loss (giving the reason more time is needed)?

A

The 30th day after receipt of the proofs of loss.

If additional time is needed for investigation, the insurer must notify the claimant in writing of the reason 45 days from the date of the initial notification and every 45 days thereafter while the investigation remains incomplete.

30
Q

If an insurer continues negotiations for settlement of a claim directly with the claimant who is neither an attorney nor represented by an attorney until the claimant’s rights may be affected by a statute of limitations or policy time limit, the insurer must give the claimant written notice that the time limit may be expiring and may affect the claimant’s rights. The notice must be given to:

A

First party claimants no less than 30 days before the date on which the insurer believes the time limit may expire.

Third-party claimants no less than 60 days before.

31
Q

A producer must deposit in one or more premium funds trust accounts:

A

All premium funds received under the producers license.

They must be kept separate from all other business and personal funds.

Each trust account must be located in the state unless the Director gives written permission to the insurance producer to keep the account in another state.

In applying for permission, the insurance producer must give written justification for keeping the account outside this state.

32
Q

A producer must deposit premium funds received into a premium fund account no later than:

A

7 days after they received.

When a payment is owed to an insured, the producer must pay the premium funds no later than 30 days after the receipt of the funds.

33
Q

A producer must make the records available with respect to any premium funds received for a period of:

A

3 years following the date of the policy expiration.

The director may, at the expense of the producer, examine or audit any trust account and any accounting records of premium funds as the director determines necessary.

34
Q

A producer may advance return premiums from the producer’s funds, other than from a trust account, in anticipation of receiving a credit for the return premium from the insurer. A producer may not deposit any funds, other than the premium funds, in a premium fund trust account, except as follows:

A

Funds to pay bank charges.

Funds for advancing premiums or establishing reserves for the paying of return premiums.

Funds for contingencies that may arise in the course of receiving and transmitting premiums.

35
Q

 A business entity must notify the Director no later than (how many days) after the authority of a producer to act for the business entity has commenced or terminated?

A

30 days.

36
Q

The receipt of commissions on controlled business is:

A

An unlawful rebate.

37
Q

Controlled business is insurance covering:

A

A producer

Their spouse, employer, employer’s spouse, or any group of employees under a group policy issued to the employer of the producer.

Any person related to the producer, their spouse, employer, or the employer‘s spouse within the second degree by blood or marriage.

If the employer of the producer is a corporation, any person directly or indirectly owning or controlling a majority of the voting stock or controlling interest in such corporation.

If the employer of the producer is a partnership or association, any person owning any interest in such partnership or association.

If the producer is a corporation:
Any person directly or indirectly owning or controlling majority of the voting stock or controlling interest in the insurance producer, and any corporation which is likewise directly or indirectly controlled by the person who so directly or indirectly controls the insurance producer.

Any corporation making consolidated returns for United States income tax purposes with any corporation.

38
Q

If premiums on controlled insurance transacted by an insurance producer payable in one calendar year exceeds the premiums, or with respect to life and health insurance twice the premiums, on other Insurance transacted by the insurance producer payable in the same year, the receipt of commissions upon the excess is an:

A

Unlawful rebate.

39
Q

If a person is required to be licensed as a producer, but they aren’t licensed:

A

An insurer producer may not pay them a commission, service fee, brokerage, or other valuable consideration for selling, soliciting, or negotiating insurance in this state.

No person may except from them a commission, service fee, brokerage, or other valuable consideration for selling, soliciting, or negotiating insurance in this state.

40
Q

A premium discount or rebate is not prohibited if the discount or rebate is:

A

Offered in connection with a program of health promotion or disease prevention.

Paid for participation in a program to promote healthy behaviors.

Offered in connection with a wellness program.

41
Q

An insurer may not base an adverse underwriting decision on:

A

A previous adverse underwriting decision.

Life & Health Oregon State Laws (3 decks)

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