Lesson 11: NC Statutes & Regulations Pertinent to Life Insurance Questions and Answers Graded A+
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Lesson 11: NC Statutes & Regulations Pertinent to Life Insurance Questions and Answers Graded A+
Contract of Insurance
Agreement by which the insurer is bound to pay money or its equivalent, or do some act of value to the insured upon and as an indemnity or reimbursement for the destruction, lo...
Lesson 11: NC Statutes & Regulations Pertinent to Life
Insurance Questions and Answers Graded A+
Contract of Insurance
Agreement by which the insurer is bound to pay money or its equivalent, or do some act
of value to the insured upon and as an indemnity or reimbursement for the destruction,
loss, or injury of something in which the party has an interest.
Commissioner
Commissioner of Insurance of NC or authorized designee
-Heads state Department of Insurance
-Responsible for fair ratemaking, injury prevention efforts, and close regulation of
insurance solvency and industry practices.
Department
Department of Insurance of NC
NAIC
National Association of Insurance Commissioners
Person
individual, partnership, firm, association, corporation, joint-stock company, trust, any
similar entity, or combination acting together.
Commissioner's Election and Term of Office
-Elected by the people; same as General Assembly and State officers.
-Term begins January 1st after they are elected and is 4 years or until someone else is
elected.
-Governor fills in any vacancy in an unexpired term.
Powers and Duties of Commissioner
-prescribe the necessary forms and financial statements to entities as described in
Chapter 58.
-report any violations of the law by insurance companies to the Attorney General
-give synopsis of any insurance contract offered to citizens
-administer oaths required in the discharge of Commissioner's official duty.
-compile and make available list of rates charged and explanation of coverage for:
Insurance against loss to residential real property and Private passenger (nonfleet)
motor vehicle
-administer and enforce provisions of Patient Protection and Affordable Care Act and
the provisions of the Health Care and Education Reconciliation Act of 2010.
Examination, Hearings, and Investigations
-examinations, hearings, and investigations may be conducted by the Commissioner
personally.
-Commissioner may arrest with warrant or have person arrested if there is evidence of
criminal activity.
-All hearings must be held in ordinance with NC General Statutes and be at a time/place
designated in a written notice by the Commissioner and given to the person cited.
-Notice must state subject of inquiry and any charges.
Restraining Orders; Criminal Convictions
, -Restraining orders are given when any person violates or threatens to violate Chapter
58, or Article A of Chapter 143 of the General Statutes.
-Application must be given in the superior court of any county.
-When licensee is convicted in court, their license is suspended until reinstated by the
Commissioner.
-Conviction: adjudication of guilt, plea of guilt, and plea of nolo contendere.
License Surrender
-Licensee accused of any act, omission, or misconduct that would subject to suspension
or revocation may surrender license for a period of time established by Commissioner.
Notification of Criminal Convictions; Change of Address; Service of Notice;
Contracts for Online Service, Admin Services, or Regulatory Data Systems
-Applicants provide Commissioner with address and email address; has 10 business
days to inform Commissioner of any changes or is subject to a $50 fee.
-Any conviction other than traffic violation must be reported to Commissioner within 10
business days.
-Commissioner will contact licensee directly or send first-class mail for any service
notices.
-Licensees needing to notify Commissioner may do so in writing or with approved online
service.
-Commissioner may work with NAIC to get an online service for licensees.
Civil Penalties or Restitution Violations; Administrative Procedure
After notice to licensee and opportunity for hearing the person may have to pay:
-fine of $100-$1000 ordered by Commissioner based on degree and extent of harm.
-restitution to any person harmed
-restitution to any state agency to cover administrative fees.
Investigation of Charges
Commissioner must investigate any complaint of violations of Chapter 58.
-If complaint is justified, the company is subject to penalties described in Chapter 58 as
well as paying expenses for the investigation.
-If company does not pay, Commissioner is authorized to bring a civil action to the
company for collection of those expenses.
Reporting and Investigation of Insurance and Reinsurance Fraud and the
Financial Condition of Licensees; Immunity from Liability
Any person participating in an investigation is not subject to civil liability for libel or
slander when furnishing information to the Commissioner pertaining to: any
known/suspected fraudulent ins./reins. claim, transaction, or act OR the financial
condition of any licensee. Persons must release any information requested and must
cooperate in investigation.
False Statement to Produce or Deny Benefit of Insurance Policy or Certificate
Class H felony to knowingly present (or assist someone in presenting) false or
misleading information as part of a claim for payment or other insurance benefit.
-Each claim counted separately; if convicted and court imposes probation, defendant
may pay restitution as part of probation.
-Civil conviction may result in paying compensatory damages, attorney's fees, costs,
and reasonable investigative costs to the plaintiff.
Embezzlement by Insurance Agents, Brokers, or Administrators
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