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No person may solicit, negotiate, or execute contracts of insurance, or otherwise act as an agent or broker, without a valid license to do so. Performing any of these activities without a license is a misdemeanor, punishable by up to 1 year in county jail, a fine of up to $50,000, or both.
It is unlawful insurance fraud for a person to knowingly make a willful false statement or omission with the intent to deceive, in connection with an application, renewal, claim, premium payment, or an insurer's financial condition.
Under federal law (18 U.S.C. Section 1033), any person engaged in the business of insurance whose activities affect interstate commerce who knowingly makes a false material statement is subject to a fine, imprisonment for up to 10 years, or both — and up to 15 years if the insurer's solvency was jeopardized. Embezzlement carries the same penalties, except that if the amount embezzled is less than $5,000, imprisonment is limited to 1 year.
Federal law also prohibits any person previously convicted of a felony involving dishonesty or breach of trust, or convicted under the Violent Crime Control and Law Enforcement Act of 1994, from engaging in the business of insurance affecting interstate commerce without the written consent of an insurance regulatory official — commonly called a "1033 waiver." The written consent must specifically reference Section 1033. A person who willfully engages in the business of insurance after such a felony conviction, without consent, is subject to a fine, imprisonment for up to 5 years, or both. A civil penalty of up to $50,000, or the amount of compensation received, whichever is greater, may also apply.
The U.S. Attorney General may bring a civil action in federal district court against a person who violates Section 1033. The civil penalty is up to $50,000, or the amount of compensation received, whichever is greater. The Attorney General may also petition the court for an injunction ordering the person to cease violating the law.
Errors and omissions (E&O) insurance protects an agent or broker against financial loss arising from negligent acts, errors, or omissions committed in the course of transacting insurance business.
E&O policies are generally written on a claims-made basis, meaning the policy in force at the time a claim is made responds, regardless of when the negligent act occurred, so long as it occurred after the policy's retroactive date. Most E&O policies require the insured's consent before the insurer settles a claim out of court. Coverage is typically renewed annually, subject to a per-claim deductible (commonly $500 to $1,000 or more), a limit per claim, and an aggregate limit per policy period.
Examples of losses covered by E&O insurance include:
E&O insurance does not cover criminal acts, fiduciary crimes, unfair business practices, or material misrepresentations made with intent to deceive. If a claim arises from conduct resulting in a criminal conviction, E&O insurance will not pay, and the agent is personally liable for the loss.
Every producer faces the risk that an error or omission will cause financial harm to a client. Careful documentation of every transaction is essential. The sales interview and the policy delivery are the two points in the sales process where E&O claims most commonly originate.
A nonadmitted insurer is not licensed to transact business in California. Nonadmitted insurers may be represented only through licensed surplus line brokers, and only after the insurer has obtained a Certificate of Authority allowing surplus line placements. Surplus line brokers provide value by giving access to property and casualty coverage unavailable from admitted insurers.
Except for a surplus line broker, it is a misdemeanor to:
The penalty includes a fine of $500, plus $100 for each month the violation continues, in addition to the general misdemeanor penalty. A surplus line broker must hold an individual surplus line broker license (requiring an existing property and casualty license), pay an application and renewal fee of $700 for a 2-year term, and pay a $24 fee for an organization endorsement or termination notice. Brokers transacting through a licensed organization are exempt from the bond requirement; all other surplus line brokers must file a $50,000 bond.
California's regulatory philosophy holds that insurance has intrinsic value and must be paid for. It is illegal to offer free insurance as an inducement to purchase another product or service. A willful violation may result in suspension or revocation of the offending party's license for up to 1 year.
The following are recognized exceptions to the prohibition on free insurance: