Duyệt tất cả câu hỏi
Mọi câu hỏi kèm đáp án và giải thích — học theo chủ đề hoặc tất cả cùng lúc.
Bộ luật bảo hiểm & Đạo đức California
36 câu hỏi1. 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:
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?
§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:
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 §7814. Which of the following describes rebating?
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 §7505. Under California law, before transacting any insurance business in the state, a person must:
§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 §16316. 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?
§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 §17497. A newly licensed California life-only agent must complete how many hours of CE during the first two years of licensure?
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 §1749.38. Premiums collected by an agent from a policyholder, before being remitted to the insurer, are held by the agent in what capacity?
§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 §17349. Under California replacement regulations, when an applicant indicates a replacement is involved, the agent must:
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 §2534.410. 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?
§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 §789.1011. The free-look (right-to-examine) period for an individual life insurance policy issued to a person age 65 or older in California is:
§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 §10127.1012. Before an agent may sell an annuity in California, what training requirement applies?
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:
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 §78514. 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:
§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 §789.815. Which of the following is a permissible ground for the Commissioner to deny, suspend, or revoke an agent's license?
§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 §166816. If a licensee's address, name, or background information changes, the licensee must notify the Commissioner within how many 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 §1729.217. 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?
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 §10110.118. The standard free-look period for a non-senior life insurance policy delivered to a California consumer is at least:
§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 §10127.919. 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?
§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 §10123.1320. In California, which regulator has primary jurisdiction over Health Maintenance Organizations (HMOs) and most managed-care health plans?
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 §10621. Under California Insurance Code definitions, an insurance broker represents whom in a transaction?
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, §3322. Knowingly presenting a false or fraudulent claim for payment under an insurance policy is, in California:
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, §187923. 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:
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 §791.0224. Under California's Long-Term Care Insurance Reform Act, the standard free-look period for an individual LTC policy is:
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 §10232.2525. The California Insurance Commissioner is selected by:
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:
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 §1050927. An agent advertises an "educational lunch seminar" for seniors at a local hotel. Under §789.9, which of the following is prohibited?
§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 §789.928. 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:
§§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 §10509.91529. 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?
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), §790.0330. Soliciting or transacting insurance under a fictitious name (DBA) requires:
§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 §1666.531. 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?
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 §10509.432. An agent's appointment with a particular insurer is terminated for cause. The insurer must notify the Commissioner of the termination and the reasons:
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 §172433. The maximum administrative penalty per act under §790.035 for a willful unfair or deceptive practice may be up to:
§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 §790.03534. California's replacement regulations apply when:
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 §10168.135. Which of the following may the Commissioner do as part of disciplinary action against a producer's license?
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 §1668.536. 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?
§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