Louisiana Laws (Life/Health Insurance Exam) Already Passed

Louisiana Laws (Life/Health Insurance Exam) Already Passed Who is responsible for making sure the provisions of the Louisiana Insurance Codes are enforced? Commissioner of Insurance The Commissioner may conduct a financial examination of any insurance company as often as deemed appropriate but usually once every how many years? 5 The Commissioner may call and hold hearings if a producer is suspected of violating the Insurance Code. The hearing will be held within how many days of demand? 30 days A producer who holds a resident license in a different state may apply for a nonresident license in Louisiana, as long as both states have a what? Reciprocal Agreement Producers must complete 24 hours of continuing education every _____ years to keep their license active. 2 Insurers are responsible for submitting an appointment notice to the Commissioner within how many days of a producer's appointment or submission of first insurance application? 15 True or False: An agent may legally share commissions only with another agent who is licensed in the same line of insurance, True True or False: A licensee may NOT transact insurance business in Louisiana until the licensee is appointed by an insurer. True What can be described as a company that resides and is incorporated under the laws of the state in which its home office is located? Domestic What can be described as a company whose home office is located in another state? Foreign What can be described as a company that is chartered and organized in any country other than the United States? Alien What is an illegal practice to misrepresent any fact about an insurance policy, such as policy terms, benefits, value, cost, effective date, or existence of a contract of insurance? Misrepresentation What is an illegal practice to falsely advertise or misrepresent insurance products or services in any way? This includes making false statements about the financial condition of an insurer. False Advertising What is an illegal practice to make any public statement or advertisement that contains false information or unsubstantiated criticisms about an insurance company? Defamation of insurer What is an illegal practice to unfairly discriminate against a person in any way on an insurance-related matter? An example would be charging a different rate for someone in the same risk category. Unfair Discrimination Claims settlement practices of insurers are regulated by who? State Insurance Departments This provision states that if the insured's age was misstated on an application, any benefit amounts will be calculated according to how much coverage the premium paid would have purchased for the correct age. Misstatement of Age When the insured and beneficiary both die and there is insufficient evidence that they have died otherwise than simultaneously, the policy proceeds will be distributed as if the insured had survived the beneficiary. Common Disaster Clause Death benefits must be settled within how many days of receipt of proof of death, otherwise the insurer must pay 8% per year interest on the amount due? 60 A provision that the policy (including the endorsements and the attached papers) along with the written application shall constitute the entire contract between the parties. Entire Contract In a health insurance contract, changes may be made only when approved in writing by an officer of the insuring company. Contract Changes The grace period for health and accident insurance is _____ days from the date the premium was due. If premium is paid within the grace period, coverage shall remain in effect. 30 EXCEPT for fraud, the time after issuance of a policy during which an insurance company may contest a health insurance claim due to the statements on an application is 3 years. What is this period called? Contestability Period (Time Limit on Certain Defenses) Written notice of claim for injury or for sickness must be given to the insurer within how many days after the date of occurrence? 20 Written proof of loss must be furnished to the insurer within _____ days after the date of such loss. 90 An insurance company will send forms for filing proof of loss to a claimant within ____ days after company receives notice of a claim. 15 If a health policy is reinstated after it had lapsed for nonpayment, there is a waiting period of _____ days before a claim covering sickness will be covered. Injuries however are effective immediately. 10 There is a waiting period of _____ days to file a lawsuit after a claim for loss has been filed by the insured. No lawsuit may be filed after 1 year has passed from when the claim was submitted. 60 A ____ day free look period is required for long-term care policies 30 Using misrepresentations or inaccurate comparisons to induce a person to terminate or borrow against their current insurance policy to take out an insurance policy with another insure. Twisting Used to induce the purchase of insurance through force, fright, threat, or undue pressure High Pressure Tactics Failing to disclose that the purpose of the marketing effort is insurance solicitation Cold lead advertising Misrepresenting a material fact in selling a long-term care insurance policy Misrepresentation Any Louisiana Corporation that provides enrollees with basic health care services in return for a prepaid charge. Health Maintenance Organization Any person, including a physician or hospital, who is licensed or otherwise authorized in this state to provide health care services. Provider The person who is responsible for payment to an HMO or whose employment or other status is the basis for eligibility for enrollment in an HMO. Subscriber