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B. Producers (Part 3)

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10. Appointment Regulations

Educational Objective
  • I.C2.15. Appointment regulations — be able to identify the notice of appointment filing requirements, inactive license status, and cancellation of a license.

An agent cannot act on behalf of an insurer until the agent becomes appointed by that insurer. A producer who is not acting as the agent of an authorized insurer does not need an appointment.

Once an insurer submits a notice of appointment for an agent, it must file that notice with the Commissioner within 14 days. The agent is legally authorized to conduct business, and the insurer is responsible for the agent's acts, as of the date the appointment is signed.

An appointment ceases when either of the following occurs:

  • The licensee loses their underlying license; or
  • The licensee is terminated by, or otherwise loses their appointment with, the insurer.
Appointment of a Producer
Insurer
  • Appoints a licensed producer to act as its agent
Producer
  • Authorized to transact business on the insurer's behalf
Department of Insurance
  • Insurer files the notice of appointment and pays required fees within 14 days

Life Insurance

Upon signing and submitting an appointment for an original license, an insurer is inherently confirming to the Department of Insurance that the applicant has a good reputation and is worthy to be issued the license. This includes confirmation that the applicant has sufficient experience or education, or will receive sufficient education within 30 days, to meet the requirements of the license. All of this is true for the entity, and each of its natural persons, if the applicant is a business entity. When a licensed business entity adds a person to its license, these same declarations are presumed to have been made about that person.

A life or accident and health agent is allowed to present a coverage proposal to a client for an insurer with whom the agent is not appointed. If the proposal results in an application to the insurer and a policy is issued — which the insurer is under no obligation to do — the insurer is considered to have thereby appointed the agent. Within 14 days, the insurer must file the notice of appointment with the Department. All payments from the client for such a policy must be made payable to the insurer. There are 2 exceptions to this rule:

  • An unappointed agent may not present a proposal or accept an application for an insurer that uses only "career" agents — agents who exclusively represent only that single company or group of companies; and
  • The rule does not apply if the insurer requires that it be the first insurer to which its agents present policy applications.

Disability Insurance

A person licensed as a property and casualty producer, a life producer, or an accident and health or sickness producer may transact disability insurance on behalf of any insurer authorized to transact disability insurance, so long as the producer has filed a notice of appointment for the purpose of transacting disability insurance. This authority becomes effective the day the notice of appointment is signed by the insurer, and applies to transactions occurring after that date, and for purposes of determining the insurer's liability for the acts of its appointed agents.

Inactive License

When licensees have no active appointments, they do not lose their license. The insurance license reflects a licensee's relationship with the Department of Insurance, and a lack of appointments does not change that relationship. A licensee with no appointments has a license that is designated as inactive. Upon being appointed by any insurer, the license becomes active again.

Cancellation of a License by the Licensee

Licensees may surrender their license for cancellation at any time. If the license is in the possession of the licensee, the licensee may surrender it by delivering it to the Commissioner. If the license is in the possession of the insurer or the licensee's employer, the licensee may still surrender the license by delivering a written notice of surrender to the Commissioner.

Acting as an Agent without Appointment (CIC 1704.5)

A licensed life or accident and health agent who is not specifically appointed for a particular insurer may not solicit insurance to a prospective client with that insurer, or pass on an application for insurance to that insurer, if the insurer requires that all of its agents represent only that insurer.

If an insurer does not specifically require all of its agents to be appointed, then any licensed agent may present a proposal for insurance to a potential client on behalf of an insurer for which the agent is not specifically appointed, and may also give an application for insurance to that insurer. If an insurance policy is issued, the insurer is considered to have thereby authorized the agent to act on its behalf, and the insurer is responsible for all actions of the agent related to the application and policy, as if the agent had been properly appointed. An insurer is not obligated to accept an application for underwriting from a life agent.

Some insurers employ exclusive/captive/career agents and will not allow any other agents to sell their products. The Insurance Code stipulates that licensed agents not contracted with such companies are not allowed to present insurance applications to those companies. However, if an insurer does not require that all agents be appointed by it in order to sell its products, an agent is allowed to represent that company to a client and to receive an application for insurance with that company. All payments by the client must be made payable to the insurer, not to the agent. If the insurer does not accept the application, no agency appointment exists. However, the insurer, by issuing a policy in response to such an application, is deemed to have thereby appointed that agent. The insurer must then notify the Commissioner of that appointment within 2 weeks of receiving the application.

11. Miscellaneous Code Requirements and Specifications

Educational Objective
  • I.C2.11. Be able to identify the Code requirements for: a. An agency name and use of name (CIC 1724.5, 1726, 1729.5); b. Change of address (CIC 1729); c. Filing a license renewal application (CIC 1720); d. Printing a license number on documents (CIC 1725.5).

Agency Name, Use of Name (CIC 1724.5, 1729.5)

Every individual and organization licensee, and every applicant for a license, must file with the Commissioner in writing their true name and also all fictitious names under which the individual or organization conducts or intends to conduct business. Individuals and business entities must also file any change in, or discontinuance of, those names. The Commissioner may disapprove the use of any true or fictitious name, in writing, for any of the following reasons:

  • The name may interfere with the business of another, or is too similar to the name of another;
  • The name may mislead the public in any way;
  • The name gives the impression that the licensee is authorized to conduct a type of business it cannot legally conduct — for example, the terms "Chartered Property and Casualty Underwriter" and "Chartered Life Underwriter" are reserved for those who have earned those designations, and "underwriter" may not otherwise be used to imply that the licensee is authorized to act as such (though "underwriter" may be used in the name of an organization of individually licensed producers); or
  • The licensee is already using 2 approved names — except that a licensee who acquires ownership of another licensee may use a maximum of 2 names for each such entity.

A name may also be disapproved if it uses, or similarly misleads with, words or phrases such as advisor, analyst (unless the licensee holds or is applying for a Life and Disability Analyst license), assurance company, department, government, investment, national, state, trust, or underwriter, among others. Similarly, a name may be disapproved if it improperly uses words such as affordable, cash, cheap, discount, elder, expert, legal, protection, secure, and specialist, among others.

Licensees are prohibited from using a true or fictitious name upon the Commissioner's disapproval. If the Commissioner determines that there are mitigating facts related to the continued use of the name, the Commissioner may permit its use, in writing, for a specified reasonable period of time.

If a broker or agent has a contract to provide services for a corporation that holds an insurance license in its own name, or is a stockholder in a licensed corporation, or is a member of an incorporated agency, that broker or agent may use the name of the organization in printed materials, so long as the relationship is clearly identified. Acceptable relationship identifiers include: "Representing ___," "A stockholder of ___," "Placing business through ___," and "Using services of ___."

Any licensed agent or broker who advertises insurance online and transacts insurance in this state must identify the following, even if the agent or broker is not responsible for maintaining the internet presence:

  • The licensee's name as filed and approved by the Commissioner;
  • The licensee's state of domicile and principal place of business;
  • The licensee's California insurance license number; and
  • The word "insurance."

A person is deemed to be transacting insurance in California online if that person:

  • Provides insurance premium quotes to California residents;
  • Accepts applications from California residents; and/or
  • Communicates with California residents regarding the terms of an insurance agreement.

Change of Address (CIC 1729)

All licensees, on their initial license application, must provide their residence, business, and mailing addresses. It is the responsibility of the licensee to notify the Commissioner immediately of any changes in their email, residence, principal business, or mailing addresses, through the use of an electronic service approved by the Commissioner.

Reporting Administrative Actions and Criminal Convictions

According to CIC 1729.2, all licensees and applicants for licenses must report any administrative actions or criminal convictions, and background changes, to the California Department of Insurance Producer Licensing Bureau within 30 days of the final disposition of the matter. Background information that must be reported includes:

  • Misdemeanor or felony convictions;
  • The filing of felony criminal charges against the licensee in state or federal court;
  • Administrative actions regarding an occupational license; and
  • Personal or organizational bankruptcy filings.

Filing a License Renewal Application (CIC 1720)

A licensee must file a renewal application, and pay the applicable renewal fee, before the license expires. A license that is not renewed before its expiration date is subject to a late fee, and the licensee may not transact insurance business until the license is renewed.

Printing a License Number on Documents (CIC 1725.5)

Business cards, websites, and print advertisements used by a licensee to solicit insurance business must disclose the licensee's license number. To ensure that the number is not minimized and would not be missed by a prospective insurance purchaser, the license number must be printed at least as large as the smallest address or telephone number on the same document. For licensees with more than one license, a single license number will suffice. Solicitors must use the license number of their employer.

The first offense is punished by a fine of $200, the second by a fine of $500, and the third by a fine of $1,000. However, a separate penalty cannot be imposed for each piece of illegal material used. There is a process for explaining violations, and the Commissioner has the option to consider extenuating circumstances and relieve the licensee of the penalty. The one exception to the license number requirement is motor club advertisements that include insurance in a general list of services without giving details regarding the insurance products.

Record Maintenance

Educational Objective
  • I.C2.12. Be able to identify the records an insurer and agents must maintain (CIC 10508–10508.5).

One of the challenges facing new agents and brokers is to accept the responsibility to obtain and maintain accurate, legible records, which must be available within 30 days after a request to the insurer from the Department of Insurance. Each admitted insurer must maintain certain records pertaining to the activities of its life, life and disability, and disability agents for a period of 5 years. Life, life and disability, and disability insurance agents must also maintain all applicable records at their principal place of business for a minimum of 5 years. The records must be maintained in an orderly manner and be available for the Commissioner's review at all times.

The records may be in the form of originals, copies, or electronic data-processing records, and must include the following:

  • Name of insured;
  • Name of insurer;
  • Date insurance is effective and any date it ceases to be effective;
  • Renewals;
  • Coverage changes;
  • All information regarding binders;
  • Proposals, including comparisons with existing coverage;
  • Copy of the application or other request for insurance;
  • All correspondence or other written records that describe the transaction, except printed materials in general usage;
  • All correspondence regarding cessation of coverage; and
  • Legally required outline of coverage or disclosure statement.

The following records must be kept regarding policies, premium payments, and commissions:

  • The original policy application;
  • Amount of premiums received by the insurer;
  • Production records showing policies sold by each agent;
  • Itemization of the premium received;
  • All written communications sent by the insurer or its agents to a prospect, applicant, or insured; and
  • A copy of outline of coverage or disclosure statements.

Life Insurance Policy Illustrations

Educational Objective
  • I.C2.13. Be able to identify the requirements applicable to an insurer for life insurance policy illustrations (CIC 10509.950–10509.965).

These laws are intended to ensure that illustrations do not mislead purchasers of life insurance, and to make illustrations more understandable by providing formats and standards to be followed when illustrations are used, and by specifying the disclosures required in connection with illustrations. As often as possible, insurers should eliminate the use of footnotes and caveats, and define terms used in the illustration in language understandable by a typical person.

Each insurer must notify the Commissioner at the time of filing whether a policy is to be marketed with or without an illustration. If the insurer identifies a policy form as one to be marketed without an illustration, any use of an illustration for any policy using that form prior to the first policy anniversary is prohibited. If a policy form is to be marketed with an illustration, the insurer must prepare and deliver a basic illustration.

An illustration used in the sale of a life insurance policy must be clearly labeled "life insurance illustration," and include (but is not limited to) the following information:

  • Name of insurer;
  • Name and business address of producer or insurer's authorized representative, if any;
  • Name, age, and sex of proposed insured, except where a composite illustration is permitted;
  • Underwriting or rating classification upon which the illustration is based;
  • Generic name of the policy, the company product name, if different, and form number;
  • Initial death benefit; and
  • Dividend option election or application of nonguaranteed elements, if applicable.

Producer Application Investigation, Denial, Suspension, and Revocation

Educational Objective
  • I.C2.14. Be able to identify the Code specifications regarding producer application investigation, denial of applications, and suspension or revocation of license (CIC 1666, 1668–1669, 1738).
  • I.C2.24. Be able to identify the alterations an agent may make to an applicant's written disability application (CIC 10382).

The Commissioner is obligated to the consumers of California to assure that all insurance licensees are qualified with regard to their knowledge and character. To this end, the Commissioner is authorized to require the provision of any information or documents necessary to make such a determination. After the investigation is complete, the applicant may be authorized to conduct business.

No alteration of any written application for a disability policy can be made by any person other than the applicant without the applicant's written consent. However, the insurer may make insertions for administrative purposes only, as long as they are not pertaining to the applicant. Making any other alteration without the consent of the applicant is considered a misdemeanor. If the agent alters the application, the insurer will be the liable party.

There are many possible causes given in the Insurance Code for denying an insurance license. These causes apply to legal "persons," which include individuals and business entities such as agencies and corporations. Licensure can be denied if the applicant is found unqualified, or if licensing the applicant would be against the public's best interest. An applicant's license could be denied if the applicant has committed any of the following:

  • Has no intention of selling the insurance permitted by the license;
  • Does not have a good business reputation;
  • Lacks integrity;
  • Was denied or lost another state license within the past 5 years for a reason that would also cause an insurance license to be denied;
  • Has lied on the application;
  • Previously acted dishonestly in business;
  • Exposed the public to loss as a result of incompetence or lack of trustworthiness;
  • Lied about an insurance policy;
  • Has either not done something required by, or has done something forbidden by, the Insurance Code;
  • Has been convicted of (not just charged with) any felony or a misdemeanor violation of insurance law;
  • Has helped someone else commit a crime that would make that other person lose or be denied a license;
  • Has allowed an employee to violate the Insurance Code;
  • Has acted as a licensed person prior to issuance of a license;
  • Has submitted a fraudulent educational certificate; or
  • Does not qualify for a license on a permanent basis, or is denied issuance within 1 year of application or issuance.

The applicant may be denied a license without the right to a hearing if the applicant has a history of any of the following conditions:

  • Felony convictions;
  • Misdemeanor violations of insurance law;
  • Denial of an insurance license within the past 5 years; or
  • Insurance license suspension or revocation within the past 5 years.

Any person caught willfully cheating on the licensing examination will be barred from taking any license examination and from holding an active license for a period of 5 years.

In regard to what may constitute a conviction: any applicant for licensure in California will be considered convicted of a misdemeanor or felony if they were found guilty or convicted after entering a plea of "nolo contendere" ("no contest"). All convictions, at any time in an applicant's past, must be disclosed on the license application — this also applies to convictions for which charges were later dismissed or expunged, or for which a person was placed on probation or received a suspended sentence. If an applicant fails to disclose all convictions, the application for a producer license will be denied (CIC 1729.2).

A permanent license may be revoked for any of the reasons given for which a license could be denied. A hearing would not be allowed if one of the 4 conditions listed above (for denial without a hearing) exists.

Termination of a License, Dissolving Partnerships

A licensee can surrender their insurance license at any time, either by returning the license to the Commissioner or, if not in possession of the license, by sending a notice of resignation.

An insurance license automatically terminates when the licensee dies. If the licensee is an organization, the license will terminate if its partnership, association, or corporation is dissolved. A partnership will also lose its license if it changes the persons serving as partners. When new partners join, a partnership can continue its license if it files notice within 30 days with the Department and the changes are approved. When any of the above organizations cease, they may continue to conduct business under another name if the same people remain involved and the necessary paperwork is completed within 30 days.

Internet Advertisements

A California agent or broker who advertises their services over the internet, regardless of whether the agent/broker created the ad or someone created it on the agent's behalf, must include all of the following information in the ad:

  • The name as it appears on the insurance license, as well as any fictitious name approved by the Commissioner;
  • The state of domicile and the principal place of business; and
  • The license number.

A person is deemed to be transacting insurance when the person advertises on the internet, regardless of whether the agent or broker maintains the internet presence or if it is maintained on the agent's behalf, and does any of the following:

  • Provides an insurance premium quote to a California resident;
  • Accepts an application for coverage from a California resident; or
  • Communicates with a California resident regarding one or more terms of an agreement to provide insurance or an insurance policy.

Duty to Disclose Effective Date of Coverage

When an applicant or insured applies for an insurance policy or pays the initial premium, a producer must disclose the effective date of coverage (if known), or the circumstances under which coverage will be effective as soon as specific conditions are met. This regulation applies only to coverage for personal lines of insurance.