Porter Ch 3 Flashcards

1
Q

List 3 circumstances in which State laws and

regulations can be void under the U.S. Constitution:

A
  1. When a state law contradicts a federal law
  2. When the courts determine that a state law interferes with the purpose or results of a federal law although the state law
    does not expressly contradict the federal law
  3. When a state law imposes an improper burden on interstate commerce, even though a federal law does not exist
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2
Q

List the exceptions to the rule that states are given primary regulatory control over the “business of insurance” (where the Federal government is involved)

A

-The Sherman Act prohibits boycott, coercion, and intimidation
-Federal antitrust laws apply to the extent that state laws do not regulate such activities
-Federal laws enacted specifically to regulate the “business of insurance” preempt -any state laws that apply to the same
activities addressed by the federal laws

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3
Q

Briefly describe the current Definition of the “Business of Insurance”:

A

Any activity that has one or more of the following characteristics

  • Insurer spreads or underwrites the policyholder’s risk
  • Insurer and the insured have a direct contractual agreement
  • Activity is unique to entities within the insurance industry
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4
Q

List 2 cases in which the Federal Government does intervene in the “Business of Insurance”

A
  1. Risk Retention Act

2. National Flood Insurance Act

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5
Q

House Energy and Commerce Committee identified three principal causes of Product Liability insurance price and availability crisis of the 1970s. List two.

A
  • Questionable ratemaking and reserving practices of insurers
  • Unsafe products
  • Uncertainties in the tort and legislation system
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6
Q

Briefly describe a contract of adhesion.

A

Contract drawn up by only one party, the insurer. Ambiguous language will be interpreted in favor of the insured

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7
Q

Briefly describe the doctrine of reasonable expectations.

A

Insured’s reasonable expectation of coverage will be honored even if that involves reading the policy provisions in ways not intended by the insurer.

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8
Q

List cases in which the Federal Government regulates the insurance industry.

A
  • Regulation of Securities (issued by insurers)
  • Federal Taxation of Insurance Companies
  • Employee Retirement Income Security Act of 1974
  • OSHA
  • Federal regulation concerning discrimination in employment relationships
  • Federal agencies affecting the insurance industry because they administer federal laws that apply to insurers
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9
Q

List other parties that have influence on insurance regulation:

A
  • Courts
  • Insurance industry Trade Associations
  • Insurance Advisory Organizations
  • Insurance Companies
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10
Q

Briefly describe how the Courts impact insurance regulation:

A
  • policy language
  • policy coverage
  • claims settlement
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11
Q

List some functions of Insurance Industry Trade Associations

A
  • Prompt access to legislative developments
  • Can use association personnel as their lobbying forum
  • Participate on committees in drafting new legislation or influence changes to pending legislation
  • Continually watch for new regulations promulgated by state insurance depts.
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12
Q

List some services of “Insurance Advisory

Organizations”

A

-Primarily deal with filing rates or prospective loss costs and
forms
-Develop rating systems
-Collect and tabulate statistics
-Research topics important to members and the industry
-Provide a forum for discussion of issues important to members
-Educate members, the industry, insurance regulators, and the public about particular issues
-Monitor regulatory issues of concern to members

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13
Q

List some areas of major legislation that have been created due to consumer complaints

A
  • Redlining prohibitions
  • Unfair claims practices laws
  • Unfair trade practices laws
  • Compulsory insurance laws
  • High-risk driver pools
  • FAIR plans
  • Windstorm and other catastrophe pools
  • Tort Reform
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