Florida Laws And Rules Pertinent To Life And Health Insurance

Front 1

When a stock company turns into a mutual company

Back 1

Mutualization

Front 2

When a mutual company turns into a stock company

Back 2

Demutualization

Front 3

What is a risk transference?

Back 3

The act of shifting responsibility to another thru an insurance contract

Front 4

What is risk reduction?

Back 4

To lessen the chances of loss.. ex. to but anti-theft device for car

Front 5

What is risk retention?

Back 5

The insured retains part of the risk.. ex. auto insurance policy

Front 6

What is risk management?

Back 6

*To determine what exposures to loss exist *To determine the seriousness of exposures *To develop a way to minimize the effect of expos

Front 7

What is pure risk?

Back 7

Only a chance for loss.. only pure risk are insurable.

Front 8

What is speculative risk?

Back 8

Involve the chance of both loss and gain.

Front 9

What are morale hazards?

Back 9

Driving recklessly.. the chance of death or injury.

Front 10

What are physical hazards?

Back 10

Blindness and deafness.

Front 11

What are moral hazards?

Back 11

Alcoholism and drug addiction.

Front 12

What is a valued contract?

Back 12

Pays a stated sum regardless: of the actual loss.

Front 13

What is an Aleatory contract?

Back 13

Unequal value is given. Low premium and high benefits.

Front 14

What is an Indemnity contract?

Back 14

Contract that pays an amount to the loss.. to return to original financial position. ex. $100,000 policy with $5,000 actual loss the benefit paid is $5,000

Front 15

What does Florida law require to maintain a license?

Back 15

Continuing education requirements.Every 2 years... 24 hours. Every 6 years...20 hours.25+ ... 10

Front 16

Florida requires licensee to notify Department of change of address. When? If not, what?

Back 16

60 days.. can be fined up to $500.

Front 17

What are the possible consequences for acting as an agent without proper licensure?

Back 17

Charges of up to a first degree felony. Responsible for all unpaid claims.Suspension of license.

Front 18

What is sliding?

Back 18

When an agent tells a client that there will be no additional charges when there will be. Or charges for add. coverage in quiet

Front 19

What is Coercion, Boycott and Intimidation?

Back 19

Forcing somebody to do something against their will with the force of threats.

Front 20

What is Misrepresentation?

Back 20

To give an inaccurate or deliberately false account of the nature of somebody or something.

Front 21

What is Defamation?

Back 21

An attack on somebody's good name, character or reputation.

Front 22

What is Unfair Discrimination?

Back 22

Insurers are prohibited from showing any type of partiality to individuals in regard to their premiums and benefits.

Front 23

What is the Unfair Claims Settlement Practices Act?

Back 23

Laws passed by state Legislatures to regulate the behavior of Insurance companies with respect to the payment of claims.

Front 24

What is the Time Limit on Certain Defenses and how long?`

Back 24

States that the policy is incontestable after it has been in force for a period of time. Usually 2 years.

Front 25

What is a Grace Period? How long?

Back 25

A given # of days in which the premium is due yet stays in force. Weekly = 7 days Monthly = 10 days. All other is 31 days.

Front 26

What is Reinstatement? How long?

Back 26

Automatic after 45 days if the delinquent premium is accepted by the co. without a new application.

Front 27

What is Notice of Claim? How long?

Back 27

The policyowner's obligation to the insurer to provide notification of loss after 20 days of the occurence. or asap.

Front 28

What is Claim Forms?How long?

Back 28

The company's responsibility to supply a claim form to the insured within 15 days after receiving Notice of Claim.

Front 29

What is Proof of Loss?How long?

Back 29

After the company becomes liable for periodic payments, the claimant has 90 days to submit proof of loss.

Front 30

What is Time Payment of Claims? How long?

Back 30

Provides for immediate paymentof claims after the insurer receives notification on proof of loss within 45 days after first received.

Front 31

What is Legal Actions? How long?

Back 31

The insured cannot take legal action against the company in a claim dispute until after 60 days from the time the insured submits proof of loss. Within 5 yrs.

Front 32

What is Controlled Business?

Back 32

Taking out Life insurance or Annuity contracts covering the agent or family members.Limiting sales to specific groups.

Front 33

There are four entities that exercise regulatory authority over the insurance industry in Florida. What are they?

Back 33

The state legislature, the Department of Financial Services, The Office of Ins. Regulation and State court.

Front 34

What establishes and maintains the legal framework for state laws relating to insurance?

Back 34

The State Legislature.

Front 35

What oversees the insurance industry in the accordance with the provisions of the insurance code?

Back 35

The Department of Financial Services headed by the Cheif Financial Officer.

Front 36

What is the Cheif Financial Officer responsible for?

Back 36

(1) Regulation of insurance agents (2)insurance fraud (3) consumer protection

Front 37

How long must insurance agents keep records if it involves premium payments?

Back 37

For at least three years.

Front 38

The office can conduct a hearing anytime they have reason to believe that: What?

Back 38

Any person that is engaging in anything unfair, Without being properly licensed, or no interest of the public.

Front 39

What is an admitted insurance company?

Back 39

One that the Office of Insurance Regulation has licensed to transact ins. business in Fl. with state laws.

Front 40

What is a nonadmitted insurance company?

Back 40

It has not been licensed in or authorized to transact insurance business in Florida.

Front 41

What is a Certificate of Authority?

Back 41

Must obtain to operate as an insurer in the state.

Front 42

What is the State Court System?

Back 42

It identifies and makes legal determinations involving cases of conflict between ins. co. and policyowners and criminal penalties for violatiom.

Front 43

What are the possible consequences for Acting as an Insurer without proper licensure?

Back 43

First degree felony charges, Liability for all unpaid claims, and suspension of license.

Front 44

What is the Leeway or Basket Provision?

Back 44

The Insurance Code contains this provision which spells out the terms that allow domestic insurers the right to invest a certain % of total assets in loans or other.

Front 45

What is the Legal Reserve requirement?

Back 45

It is a certain amount of money that is set aside to fulfill future claims. It is as a liability on co.balance.

Front 46

What are unauthorized entities?

Back 46

Nonadmitted, meaning they have not been approved to sell insurance in the state.