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Florida Laws and Rules Pertinent to Life and Health Insurance


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When a stock company turns into a mutual company
When a mutual company turns into a stock company
What is a risk transference?
The act of shifting responsibility to another thru an insurance contract
What is risk reduction?
To lessen the chances of loss.. ex. to but anti-theft device for car
What is risk retention?
The insured retains part of the risk.. ex. auto insurance policy
What is risk management?
*To determine what exposures to loss exist *To determine the seriousness of exposures *To develop a way to minimize the effect of expos
What is pure risk?
Only a chance for loss.. only pure risk are insurable.
What is speculative risk?
Involve the chance of both loss and gain.
What are morale hazards?
Driving recklessly.. the chance of death or injury.
What are physical hazards?
Blindness and deafness.
What are moral hazards?
Alcoholism and drug addiction.
What is a valued contract?
Pays a stated sum regardless: of the actual loss.
What is an Aleatory contract?
Unequal value is given. Low premium and high benefits.
What is an Indemnity contract?
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
What does Florida law require to maintain a license?
Continuing education requirements.Every 2 years... 24 hours. Every 6 years...20 hours.25+ ... 10
Florida requires licensee to notify Department of change of address. When? If not, what?
60 days.. can be fined up to $500.
What are the possible consequences for acting as an agent without proper licensure?
Charges of up to a first degree felony. Responsible for all unpaid claims.Suspension of license.
What is sliding?
When an agent tells a client that there will be no additional charges when there will be. Or charges for add. coverage in quiet
What is Coercion, Boycott and Intimidation?
Forcing somebody to do something against their will with the force of threats.
What is Misrepresentation?
To give an inaccurate or deliberately false account of the nature of somebody or something.
What is Defamation?
An attack on somebody's good name, character or reputation.
What is Unfair Discrimination?
Insurers are prohibited from showing any type of partiality to individuals in regard to their premiums and benefits.
What is the Unfair Claims Settlement Practices Act?
Laws passed by state Legislatures to regulate the behavior of Insurance companies with respect to the payment of claims.
What is the Time Limit on Certain Defenses and how long?`
States that the policy is incontestable after it has been in force for a period of time. Usually 2 years.
What is a Grace Period? How long?
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.
What is Reinstatement? How long?
Automatic after 45 days if the delinquent premium is accepted by the co. without a new application.
What is Notice of Claim? How long?
The policyowner's obligation to the insurer to provide notification of loss after 20 days of the occurence. or asap.
What is Claim Forms?How long?
The company's responsibility to supply a claim form to the insured within 15 days after receiving Notice of Claim.
What is Proof of Loss?How long?
After the company becomes liable for periodic payments, the claimant has 90 days to submit proof of loss.
What is Time Payment of Claims? How long?
Provides for immediate paymentof claims after the insurer receives notification on proof of loss within 45 days after first received.
What is Legal Actions? How long?
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.
What is Controlled Business?
Taking out Life insurance or Annuity contracts covering the agent or family members.Limiting sales to specific groups.
There are four entities that exercise regulatory authority over the insurance industry in Florida. What are they?
The state legislature, the Department of Financial Services, The Office of Ins. Regulation and State court.
What establishes and maintains the legal framework for state laws relating to insurance?
The State Legislature.
What oversees the insurance industry in the accordance with the provisions of the insurance code?
The Department of Financial Services headed by the Cheif Financial Officer.
What is the Cheif Financial Officer responsible for?
(1) Regulation of insurance agents (2)insurance fraud (3) consumer protection
How long must insurance agents keep records if it involves premium payments?
For at least three years.
The office can conduct a hearing anytime they have reason to believe that: What?
Any person that is engaging in anything unfair, Without being properly licensed, or no interest of the public.
What is an admitted insurance company?
One that the Office of Insurance Regulation has licensed to transact ins. business in Fl. with state laws.
What is a nonadmitted insurance company?
It has not been licensed in or authorized to transact insurance business in Florida.
What is a Certificate of Authority?
Must obtain to operate as an insurer in the state.
What is the State Court System?
It identifies and makes legal determinations involving cases of conflict between ins. co. and policyowners and criminal penalties for violatiom.
What are the possible consequences for Acting as an Insurer without proper licensure?
First degree felony charges, Liability for all unpaid claims, and suspension of license.
What is the Leeway or Basket Provision?
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.
What is the Legal Reserve requirement?
It is a certain amount of money that is set aside to fulfill future claims. It is as a liability on co.balance.
What are unauthorized entities?
Nonadmitted, meaning they have not been approved to sell insurance in the state.

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