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41 Cards in this Set

  • Front
  • Back

Insurance Department and Commisioner

The Department of Insurance of the state of GA has been established, and the Commissioner of Insurance is the chief officer of the department. The Commissioner is elected to office for a term of four years.

Chief Deputy Commissioner

The Commissioner will appoint a Chief Deputy Insurance Commissioner and other such deputies as may be necessary to assist in the performance of the Commissioner's duties.

Examination of Insurers and Rating Organizations

Examinations may be made as often as necessary; but each domestic insurer (one formed under the laws of GA) must be examined not less frequently than once every three years.




Whenever it deemed necessary, but at least once every five years, the commissioner must fully examine each rating organization which is licensed in GA

Cease and Desist Orders

A fine of up to $1,000 for each violation where person did not know


A fine of up to $5,00 for each violation where person knew or reasonably should have known was a violation of the code


Suspension or revocation of the persons license


Any other relief which the Commissioner deems to be reasonable and appropriate

Notice of Hearing

The Commissioner will give notice of the time and place for a hearing at least 10 days in advance

Conduct of Hearing

A hearing will be presided over by the Commissioner or a designated representative. The Commissioner will allow any parties to a hearing to:


-Appear in person or by counsel


-Be present during the giving of all evidence


-Have a reasonable opportunity to inspect all documentary evidence and to examine witnesses


-Present evidence in support of their own interest


-Have subpoenas issue to compel the attendance of witnesses and production of records on their behalf.



What happens to an agent or adjuster for each and every act in violation of the code?

Probation for up to one year.


A fine of up to $1,000 for each act that was not willful


A fine of up to $5,000 for each act that the person knew was in violation



What is a Domestic Insurer?

One formed under the laws of the state of GA

What is a Foreign Insurer?

One formed under the laws of another state

What is an Alien Insurer?

One formed under the laws of any country other that the US, it's states, districts, territories, or commonwealths

Definitions of Licensees...

-An Adjuster is any person who, for a fee, commission, salary, or other compensation, investigates, settles or adjusts insurance claims and reports to an employer or principal solely on behalf of the insurer or an insured.




-An independent adjuster is a person who represents the interests of an insurer; but who is not an employee of the insurer.




-A public adjuster is any person who solicits, advertises for, or otherwise agrees to represent only a person who is insured under a policy covering a fire, windstorm, water damage, and other physical damage to real and personal property other than vehicles licensed for the road, and any such representation shall be limited to the settlement of a claim or claims under the policy for damages to real and personal property, including related loss of income and living expense for losses but excluding claims arising out of any MV accident. A PUBLIC ADJUSTER MAY NOT REPRESENT AN INSURED.

What is an Agency?

a business entity that represents one or more insurers and is engaged in the business of selling soliciting or negotiating insurance



Agent

individual appointed or employed by insurer

Counselor

any person who engages or advertises or holds their self out as engaging in the business of counseling, advising, or rendering opioins as to the terms.

Subagent

Any licensed agent, except those holding limited licenses, who acts for or on behalf of another licensed agent in the solicitation, negotiation, procurement, or making of a contract of an insurance or annuity contract, whether or not the person is designated by the agent as "subagent" or "solicitor" or any other such title.

Adjuster licenses are issued in the following categories:

1. Company or independent adjuster


2. Public Adjuster


3. Workers compensation adjuster


4. crop hail adjsuter

Qualifications for Licenses...

-If applying for a license as a subagent, the applicant must be appointed as a subagent by a licensed agent, subject to issuance of the license


-if applying for a license as a counselor, the applicant must show evidence of having at least five years experience as an agent, subagent, or adjuster; or in some other phase of the insurance business to satisfy the Commissioner that the applicant in qualified to act as counselor.

Additional Qualifications for Adjusters

An applicant for a public adjuster license is also required to have previously filed a bond with the Commissioner. The limit of the required bond for public adjusters is $5,000.

Bond Requirement for Counselors

Must have previously filed a bond with the Commissioner in the amount of $5,000.

Temporary Licenses

Temporary Licenses may be issues upon the


-death


-disability


-absence


-loss of appointment


by the licensee, or to a person who is in training to become an agent for an insurer.




-Death


-Disability or illness


-Service in the armed forces


-Termination of appointment by the insurer.

How long is a temporary license good for?

will be effective for an initial period of six months.




May be renewed for additional periods of three months, but up to a 15 month max from date of first issuance.

Non Resident Licenses

- person is licensed as a agent, broker, counselor, or adjuster of another state


-the person is otherwise qualified for a license in GA, except as to residence


-the laws of the person's state of domicile grant a similar privilege to GA residents who wish to become nonresident licensees of that other state



Continuing Education requirements

All resident licensees licensed for less than 20 years must complete a minimum of 24 continuing education hours every two years.




For resident licensees continually licensed for 20 years or longer, a minimum requirement of 20 continuing education hours must be completed.




The required continuing education hours may be completed in any subjuct area for which the individual is licensed, provided that agents, adjusters and counselors complete a minim of three hours in the subject area of ethics.



Inactive Licenses

When any license has been on inactive status for two consecutive years without a Certificate of Authority for the licensee being filed with and accepted by the Commissioner; the license will be revoked.



Georgia Insurance Guaranty Association

The Georgia Insurers Guaranty Association consists of three accounts:


1. the workers compensation account


2. the automobile account


3. all other covered insurance account




Every insurer authorized to write property or casualty insurance policies in this state must be a member of the insolvency pool and will be liable for assessments pursuant to the insurance code.

The Georgia Automobile Insurance Plan

The Georgia Automobile Insurance Plan was created to provide coverage to eligible risks that seek coverage and are unable to obtain such coverage through the voluntary market.




Any insurance agent holding a valid property and casualty insurance license for the stat of GA can write business through the GAIP

Georgia Motor Vehicle Financial Responsibility Law

Georgia requires owners of vehicles to comply with the financial responsibility laws:




25/50/25




$25,000 each person/$50,000 for all injured parties as a result of bodily injury to a third party/$25,000 for property damage liability

Uninsured Motorist Coverage

Georgia requires that uninsured motorists coverage be carried unless rejected by the insured in writing. The UM limit must equal the bodily injury limit if requested by the insured in writing.





Must unisured motorist property damage be offered?

Yes. It cannot be separated from UMBI; UMPD must include loss of use coverage.

Is underinsured motorist separate from UM?

There is no distinction.

Are stacking limits permitted where the insured owns more than one vehicle with UM coverage applying?

Yes, provided the insured purchases this optional "stacking" coverage. If not purchased, the stacking limits would not apply.

Physical Contact Required?

Yes, unless the description by the claimant of how the occurrence occurred can be corroborated by a second eye witness.

Premium Reduction for Defensive Driving Course

Upon completion of an approved driving course by all drivers, eligibility for reductions in the policy premiums shall continue for a period of three years. provided that not driver under the policy commits a traffic offense or has a claim against the policy based on such driver's fault.

Good Student Discounts

-Under 25 years of age


-is unmarried


-is a driver whose use of automobile is considered by the insurer in determining the applicable rating classification


-is enrolled as a full time student in HS in the JR or SR year or academic course in a college or university or a vocational tech school


-is an honor student (must show that ranks in top 20% of class or has a B or a 3.0 or better or is on the Dean's list or Honor roll)



Cancellation and Nonrenewal of Commercial Lines Insurance

When a commercial property or casualty insurance policy is cancelled because the insured has failed to pay any premium (or installment of premiums) when due, or when a policy that has been in effect for less than 60 days in cancelled for any reason, the insurer must deliver or mail written notice of cancellation to the named insured at least 10 days prior to the effective date of cancellation.




In all other cases of cancellation of a commercial property or casualty policy, except workers compensation insurance, or in the event of nonrenewal, written notice must be delivered or mailed to the named insured at least 45 days before the effective date of cancellation or nonrenewal and an appropriate refund of any unearned premium must be made.




For workers compensation coverage, notice of cancellation or non renewal must be given at least 75 days before the effective date of the termination of coverage.

Cancellation and nonrenewal of Homeowners Policies

When an insurer intends to cancel a homeowners policy, it must give at least 10 days advance notice if cancelling during the first 60 days of coverage or whenever cancelling for nonpayment of a premium, and 30 days advance notice for all other cancellations.

Cancellation and Nonrenewal Automobile or Moror Cycle Insurance

No notice of cancellation of a policy issued for delivery in this state may be mailed or delivered by an insurer or its agent duly authorized to effect such cancellation, except...




The named insured or any other operator either resident in the same household or who customarily operates an automobile insured under such policy




Is or becomes subject to epilepsy or heart attacks and the individual does not produce a certificate from the physician testifying to his unqualified ability to operate a motor vehicle.

Standards for Rate Making. What are the 3 primary goals?

Insurance rates MAY NOT BE:


1. Excessive


2. Inadequate


3. Unfairly discriminatory

Surplus lines, what are the conditions in which surplus lines can be in effect?

Licensees are not permitted to represent an insurer that is not authorized to transact insurance in GA. However, this does not apply to surplus lines insurance which is lawfully transacted in compliance with the requirements of the code. Surplus lines coverage are those that cannot be procured from authorized insurers. When the full amount of insurance required to protect the interest of the insured cannot be obtained from insurers authorized to do business in GA, the surplus amount (designated as surplus line) may be procured from unauthorized insurers subject to the following conditions:




-The insurance must be procured through a licensed surplus line broker


-the full amount or kind of insurance required must not be procurable, alter diligent effort to procure it, from authorized insurers that actually write that particular kind of insurance in GA.


-The amount of insurance placed in an unauthorized insurer must only be the excess over any amount which is procurable from authorized insurers.


-The insurance procured as surplus lines must not be procured for the purpose of securing advantages as to a lower premium rate than would be accepted by an authorized insurer, or advantages in the terms of the policy issued by the surplus lines insurer

Georgia Workers Compensation Coverage

Employer - Every employer, individual, firm, association, or corporation, regularly employing 3 or more persons, part time or full time, shall provide workers compensation coverage insurance. Exempted officers of corporations or exempted members of limited liability companies shall not reduce the number of employees for this purpose.




Employee- "Employee" or "worker" shall include every person, including minors, working full-time or part-time under a contract of hire, written or implied.

Corporate Officers/Limited Liability Company Members

Any officer or member of a limited liability company (maximum of 5) may exempt themselves from coverage by filing a Form WC-10 with their insurance company.