Browse all questions

Every question with its answer and explanation — study by topic or all at once.

California Insurance Code & Ethics

36 questions

1. An agent tells a prospect that a competing insurer is on the verge of financial collapse in order to convince the prospect to buy from her own company. The competitor is in fact solvent. Under the Unfair Practices Act, this conduct is best described as:

a.Twisting, because it involves a misrepresentation about another insurer
b.Defamation of an insurer, because it makes a false statement injuring the reputation of another insurer
c.Boycott or coercion, because it pressures the consumer
d.Permissible competitive speech, because no contract has been signed

Cal. Ins. Code §790.03(b) defines defamation as making, publishing, or circulating any false statement that is calculated to injure any person engaged in the business of insurance. False statements about a competitor's solvency fall squarely within this definition, regardless of whether a sale results.

Cal. Ins. Code §790.03(b)

2. Which of the following actions by an insurer would constitute an unfair claims settlement practice under California law?

a.Requesting reasonable proof of loss before paying a claim
b.Promptly investigating a claim after notice is received
c.Failing to acknowledge and act reasonably promptly upon communications with respect to claims
d.Offering settlement based on a properly conducted investigation

§790.03(h)(2) lists failing to acknowledge and act reasonably promptly on claim communications as one of the enumerated unfair claims settlement practices. The other options describe lawful, expected insurer conduct.

Cal. Ins. Code §790.03(h)

3. An agent convinces a policyholder to surrender an existing whole life policy and buy a new one, primarily to earn a fresh first-year commission, even though the change disadvantages the client. This practice is known as:

a.Twisting
b.Sliding
c.Rebating
d.Commingling

Twisting is inducing a policyholder to lapse, surrender, or replace a policy through misrepresentation or incomplete comparison. When done repeatedly within the same insurer's book of business it is called churning. Both are prohibited by California law.

Cal. Ins. Code §781

4. Which of the following describes rebating?

a.Reducing premium by applying earned policy dividends
b.Offering a group discount lawfully filed in the rate plan
c.Sharing commission with a co-licensed agent of record
d.Returning part of the agent's commission to the applicant as an inducement to buy

Rebating is offering any valuable consideration outside the policy as an inducement to buy. California now permits limited, non-discriminatory rebates if disclosed and offered uniformly, but the textbook definition tested here is the unlawful inducement form.

Cal. Ins. Code §750

5. Under California law, before transacting any insurance business in the state, a person must:

a.Pass a background check only
b.Hold a license issued by the Insurance Commissioner
c.Register with the Department of Managed Health Care
d.File a fictitious business name statement

§1631 makes it unlawful to solicit, negotiate, or effect insurance in California without first being licensed by the Commissioner. A background check (live scan) is part of the application but does not by itself authorize transacting insurance.

Cal. Ins. Code §1631

6. Generally, how many hours of continuing education must a resident life-only or accident & health agent complete during each two-year license period after the first renewal?

a.12 hours, including 1 hour of ethics
b.20 hours, including 2 hours of ethics
c.24 hours, including 3 hours of ethics
d.40 hours, including 4 hours of ethics

§1749 sets the standard renewal CE requirement at 24 hours per two-year period, of which at least 3 hours must be ethics. Newly licensed agents have an enhanced front-loaded requirement under §1749.3.

Cal. Ins. Code §1749

7. A newly licensed California life-only agent must complete how many hours of CE during the first two years of licensure?

a.12 hours
b.15 hours
c.20 hours
d.25 hours

Under §1749.3, newly licensed life-only or A&H agents must complete 25 hours of CE within the first two years, including pre-licensing topics carried into early practice. After that, the 24-hour biennial requirement of §1749 applies.

Cal. Ins. Code §1749.3

8. Premiums collected by an agent from a policyholder, before being remitted to the insurer, are held by the agent in what capacity?

a.Fiduciary capacity, in a premium trust fund
b.Personal capacity, with no special duty
c.Joint capacity with the policyholder
d.As a loan to the insurer

§1733-1734 require licensees to hold all funds received from premiums in a fiduciary capacity, typically in a separately identifiable premium trust fund. Commingling with personal funds is grounds for license discipline.

Cal. Ins. Code §1734

9. Under California replacement regulations, when an applicant indicates a replacement is involved, the agent must:

a.Provide only a verbal disclosure of differences
b.Provide a written notice regarding replacement and submit it to both the new insurer and the existing insurer
c.Wait until the new policy is delivered before notifying the existing insurer
d.Notify the Commissioner directly within 15 days

California's replacement regulations (10 CCR §§2534+) require the agent to provide a Notice Regarding Replacement signed by the applicant and submit copies to both insurers so the existing insurer can preserve the applicant's right to conserve the policy.

10 CCR §2534.4

10. An agent wants to schedule an in-home appointment with a 78-year-old prospect to discuss life insurance and annuity products. What advance notice must the agent provide?

a.No advance notice is required if the prospect calls first
b.12 hours written notice
c.24 hours written notice that states the purpose of the meeting and the right to end the meeting at any time
d.72 hours written notice with the Commissioner's approval

§789.10 protects seniors (65+) by requiring written notice at least 24 hours before an in-home appointment, disclosing the agent's identity, products to be discussed, and the consumer's right to end the meeting or have a third party present.

Cal. Ins. Code §789.10

11. The free-look (right-to-examine) period for an individual life insurance policy issued to a person age 65 or older in California is:

a.10 days
b.15 days
c.20 days
d.30 days

§10127.10 requires a 30-day free look for individual life and annuity policies sold to seniors 65+. Standard adult policies generally carry a 10-day free look.

Cal. Ins. Code §10127.10

12. Before an agent may sell an annuity in California, what training requirement applies?

a.Complete 8 hours of annuity training, including 4 hours specific to California laws, before soliciting annuities
b.Complete 1 hour of generic product training
c.Complete training only if selling to seniors
d.No training is required if the agent already holds a life license

California's annuity training law requires an initial 8-hour annuity course, of which 4 hours must address California-specific suitability and senior protection rules, before an agent may transact annuities.

Cal. Ins. Code §10509.910+

13. California's senior insurance protections (§§785-789.10) impose heightened duties when selling to consumers age:

a.55 and older
b.65 and older
c.70 and older
d.75 and older

California defines a senior for these consumer-protection statutes as a person 65 years of age or older. Heightened standards of disclosure, suitability, and good faith apply.

Cal. Ins. Code §785

14. If a life insurance policy or annuity is sold to a senior using funds from the surrender of an existing annuity, the consumer must receive a written disclosure that includes:

a.Only the new policy's projected returns
b.Only the cost of the new product
c.The effect of the transaction on the senior's existing coverage, including surrender charges and lost benefits
d.A statement that the transaction is approved by the Insurance Commissioner

§789.8 requires a written, signed comparative disclosure of the effect of replacing or surrendering an existing annuity, listing surrender charges, lost benefits, and tax consequences. The Commissioner does not pre-approve sales.

Cal. Ins. Code §789.8

15. Which of the following is a permissible ground for the Commissioner to deny, suspend, or revoke an agent's license?

a.Conviction of a felony or a misdemeanor involving moral turpitude or fraudulent conduct
b.A single missed CE deadline that the agent later cures
c.Disagreement with an insurer's marketing strategy
d.Holding licenses in more than one state

§1668 enumerates grounds for adverse license action including a felony conviction, fraud, dishonesty, or material misrepresentation. Holding non-resident licenses and curing a late CE filing are not grounds for discipline.

Cal. Ins. Code §1668

16. If a licensee's address, name, or background information changes, the licensee must notify the Commissioner within how many days?

a.10 days
b.30 days
c.60 days
d.180 days

§1729.2 requires a licensee to notify the Department of any change in name, residence, or business address, or any background-related event, within 30 days of the change.

Cal. Ins. Code §1729.2

17. For a life insurance policy to be valid in California, the policyowner generally must have an insurable interest in the insured. When must this insurable interest exist?

a.Only at the time of the insured's death
b.Only at the time the claim is filed
c.At the time the contract is made (policy issuance)
d.At all times the policy is in force

Under California law, insurable interest must exist at policy inception. Unlike property insurance (where insurable interest is required at loss), life insurance does not require continued insurable interest after issuance.

Cal. Ins. Code §10110.1

18. The standard free-look period for a non-senior life insurance policy delivered to a California consumer is at least:

a.3 days
b.5 days
c.7 days
d.10 days

§10127.9 mandates at least a 10-day right-to-examine period for individual life insurance policies, during which the owner may return the policy for a full premium refund.

Cal. Ins. Code §10127.9

19. California's prompt payment statute for health insurance claims generally requires an insurer to pay or contest a clean claim within how many working days of receipt?

a.30 working days
b.45 working days
c.60 working days
d.90 working days

§10123.13 requires payment or written contest of a clean claim within 30 working days of receipt; interest accrues on late payments. (HMOs under DMHC have a parallel 45-working-day rule.)

Cal. Ins. Code §10123.13

20. In California, which regulator has primary jurisdiction over Health Maintenance Organizations (HMOs) and most managed-care health plans?

a.California Department of Insurance (CDI)
b.Department of Managed Health Care (DMHC)
c.Office of the Attorney General
d.California Health Benefit Exchange (Covered California)

DMHC regulates HMOs and managed-care plans under the Knox-Keene Act. CDI regulates traditional indemnity and PPO health insurance. Covered California is the marketplace; the Attorney General handles enforcement, not licensing.

Cal. Health & Safety Code §1340+ / Ins. Code §106

21. Under California Insurance Code definitions, an insurance broker represents whom in a transaction?

a.The insurer issuing the policy
b.Both parties equally as a neutral
c.The insured (the consumer)
d.The Commissioner as a state agent

Cal. Ins. Code §33 defines a broker as a person who transacts insurance on behalf of an insured. By contrast, an agent (§31) is authorized to act on behalf of an insurer.

Cal. Ins. Code §31, §33

22. Knowingly presenting a false or fraudulent claim for payment under an insurance policy is, in California:

a.A civil violation only with no criminal consequences
b.An infraction punishable only by fine
c.A misdemeanor in all cases
d.A felony, punishable by imprisonment, fines, and restitution

California treats insurance fraud as a felony under §1871.4 and related provisions, with imprisonment, substantial fines (often 2-5x the fraud amount), and restitution. Insurers must also maintain Special Investigative Units (SIUs).

Cal. Ins. Code §1872.4, §1879

23. Under California's Insurance Information & Privacy Protection Act, when an applicant's personal information will be collected from sources other than the application, the insurer must:

a.Provide a written notice of information practices describing the type of information collected and how it will be used
b.Obtain the Commissioner's written approval before each collection
c.Pay the applicant a disclosure fee
d.Cease all underwriting until the applicant signs a waiver

Article 6.6 (§§791+) requires a Notice of Information Practices describing data categories, sources, uses, and the consumer's rights of access and correction whenever personal data is collected from third parties.

Cal. Ins. Code §791.02

24. Under California's Long-Term Care Insurance Reform Act, the standard free-look period for an individual LTC policy is:

a.10 days
b.20 days
c.30 days
d.60 days

LTC policies issued in California must offer a 30-day right to return for a full refund. This is broader than the 10-day standard life free look and equals the senior life/annuity free look.

Cal. Ins. Code §10232.25

25. The California Insurance Commissioner is selected by:

a.Appointment by the Governor with Senate confirmation
b.Statewide popular election to a four-year term
c.Appointment by the Insurance Department's senior staff
d.Selection by the National Association of Insurance Commissioners

Since Proposition 103 (1988), California is one of the few states where the Insurance Commissioner is independently elected statewide for a four-year term. The office heads the Department of Insurance under Ins. Code §12921 et seq.

Cal. Ins. Code §12921+

26. After a life insurance policy is replaced under California rules, the existing insurer has the right to:

a.Refuse to accept a replacement notice from the agent
b.Charge the policyowner a replacement fee
c.Conserve the policy by communicating with the policyowner during the notice period
d.Cancel the existing policy immediately without any conservation effort

Under §§10509 and 10 CCR §§2534+, the existing insurer is given the chance to conserve the policy, including by sending a comparison and contacting the owner. The replacing insurer and agent must give proper notice so this right is preserved.

Cal. Ins. Code §10509

27. An agent advertises an "educational lunch seminar" for seniors at a local hotel. Under §789.9, which of the following is prohibited?

a.Providing food and beverage as part of the seminar
b.Disclosing the names of insurers being represented
c.Mentioning that annuities will be discussed
d.Failing to disclose in any solicitation that an insurance agent will be present and insurance products may be offered

§789.9 requires that any solicitation to a senior for a seminar or meeting clearly disclose that an insurance agent will be present and that insurance products may be discussed or sold. Hiding the sales nature behind "education" or "estate planning" is a violation.

Cal. Ins. Code §789.9

28. California's annuity suitability rules require an insurer or producer recommending an annuity to a consumer to have reasonable grounds to believe the recommendation is suitable based on:

a.The consumer's age, financial situation, tax status, investment objectives, and other suitability information
b.The producer's commission level for the product
c.The popularity of the product in the producer's office
d.Whether the consumer can be persuaded to buy

§§10509.910+ adopt the NAIC suitability model (with California enhancements) requiring that recommendations be based on documented suitability information about the consumer, not the producer's compensation.

Cal. Ins. Code §10509.915

29. An agent intentionally writes incorrect age on a senior's life insurance application to qualify the applicant for a better rate class. Which of the following best describes the violations?

a.Only a contract violation; the insurer can simply adjust the premium
b.Misrepresentation under §790.03 and fraudulent conduct supporting license revocation under §1668
c.A protected sales practice when done in the client's best interest
d.Permissible because age is verifiable later from the death certificate

Intentionally falsifying application data is a misrepresentation that violates §790.03 and constitutes fraudulent conduct under §1668, exposing the agent to license revocation, fines, and criminal liability. The misstatement-of-age clause adjusts benefits but does not excuse fraud.

Cal. Ins. Code §1668(d), §790.03

30. Soliciting or transacting insurance under a fictitious name (DBA) requires:

a.Prior approval of the name by the Insurance Commissioner
b.Only a county fictitious-name filing
c.Approval by each insurer separately, with no notice to CDI
d.No filing if the agent uses the name in writing only

§1666.5 requires a producer to receive Commissioner approval of any fictitious name (DBA) used to transact insurance, in addition to any county-level fictitious-business-name filing. This is to prevent confusion and consumer deception.

Cal. Ins. Code §1666.5

31. Under California life replacement regulations, the replacing insurer must send the existing insurer a copy of the replacement notice (and any sales material used) within how many working days of receiving the application?

a.1 working day
b.3 working days
c.5 working days
d.10 working days

Under California's replacement regulations (10 CCR §§2534+ / §10509.4), the replacing insurer must notify the existing insurer within a specified window after the application is received — generally within 5 working days for notice and within 10 working days for copies of sales material — to allow conservation efforts.

Cal. Ins. Code §10509.4

32. An agent's appointment with a particular insurer is terminated for cause. The insurer must notify the Commissioner of the termination and the reasons:

a.Only if requested by the Commissioner
b.Promptly, by filing a written notice that may include the cause
c.Only at the next annual renewal cycle
d.Never; appointments are private contractual matters

Insurers must promptly file a Notice of Appointment Termination with CDI and, when the termination is for cause involving violations of law or ethics, disclose the underlying facts so the Department can investigate.

Cal. Ins. Code §1724

33. The maximum administrative penalty per act under §790.035 for a willful unfair or deceptive practice may be up to:

a.$1,000 per act
b.$5,000 per act
c.$10,000 per act
d.$25,000 per act

§790.035 authorizes the Commissioner to assess civil penalties of up to $5,000 per non-willful act and up to $10,000 per willful act of an unfair or deceptive practice.

Cal. Ins. Code §790.035

34. California's replacement regulations apply when:

a.An existing life or annuity policy will be lapsed, surrendered, converted to paid-up, borrowed against to fund the new contract, or otherwise reduced in value as part of the transaction
b.Only when the same insurer issues both the old and new policy
c.Only when the producer changes companies
d.Only when the policyowner is age 65 or older

Replacement is broadly defined: any transaction where existing coverage will be terminated, modified, or used as a funding source for the new contract is a replacement, regardless of insurer or insured age.

Cal. Ins. Code §10168.1

35. Which of the following may the Commissioner do as part of disciplinary action against a producer's license?

a.Place the licensee on probation
b.Suspend the license for a period of time
c.Revoke the license
d.All of the above

Under §§1668-1738, the Commissioner has a graduated toolkit: probation, suspension, restriction, revocation, and monetary penalties may all be imposed depending on the severity of the violation and prior history.

Cal. Ins. Code §1668.5

36. A 17-year-old applicant scores 95% on the agent exam and passes a background check. Can the Department issue a resident life agent license?

a.Yes, because exam performance is the only requirement
b.No, because California requires a producer to be at least 18 years old
c.Yes, with a guardian co-signing all applications
d.Yes, because background check approval supersedes the age requirement

§1633 sets minimum qualifications including age 18+ to be licensed as a producer in California. Exam scores and background checks cannot waive the statutory minimum age.

Cal. Ins. Code §1631, §1633