Ethical Standards for Insurance Agents Sponsored by the Ohio Association of Health Underwriters Doug Anderson Direct: 614-365-2717 [email protected] Holly W. Wallinger Direct: 614-365-2716 [email protected] What does “ethics” mean? “The principles of conduct governing an individual or a group” www.merriam-webster.com Why do we care about ethics? Strong ethics can lead to ~ • Grow your business • Maintain your insurance license • Save the cost of defense! Ohio law says, “No person shall sell, solicit, or negotiate insurance in this state unless the person is licensed for that line of authority in accordance with this chapter.” Ohio Rev. Code 3905.02 What it means to you: You must have a license to sell insurance – and you must keep your license to continue to sell insurance. squirepattonboggs.com 4 What can you do with your license? The issuance of a license will qualify a person to sell, solicit and negotiate insurance within the lines of business for which the agent is licensed. ORC 3905.06 squirepattonboggs.com 5 The Department of Insurance is the regulatory agency charged with supervision of insurers, insurance agents, and insurance-related business. The Superintendent of Insurance may suspend, revoke, or refuse to issue or renew any license of an insurance agent for certain ethical violations. Ohio Rev. Code 3905.14(B) squirepattonboggs.com 6 Consumer Protection & Agent Discipline The mission of the Department of Insurance is to provide consumer protection. The Superintendent oversees and enforces insurance agent discipline as part of the consumer-protection mission. Is the agent honest, trustworthy, knowledgeable and avoid harming consumers? This. Means. You. squirepattonboggs.com 7 Ethical Standards for Agents The Legal Framework Ohio Rev. Code 3905.14(B)(1) – (39) details the violations for which an insurance license may be suspended or revoked and for which civil penalties may be assessed. 39 potential violations = Do not lie, cheat, steal or Do not fail to alert the Department if you did and Do take responsibility squirepattonboggs.com 8 License requirements Apply, Renew, Inform Application requirements: complete pre-licensing education, pass exam, request criminal records check, submit application form, pay fees Renewal requirements: submit renewal application, complete continuing education, pay fees Inform Department of any changes: address, criminal charges, court appearances squirepattonboggs.com 9 License requirements, continued When you apply, renew, and inform . . . Be honest. It’s really the best policy. squirepattonboggs.com 10 Agent discipline The process: Investigations of misconduct, as the result of a consumer complaint, related to another agent’s discipline, or other sources of information “Notice of Opportunity for Hearing” Hearings, recommendations, orders, and appeals Revocation, suspension, civil penalty, costs – or a finding of no discipline squirepattonboggs.com 11 Learn from the mistakes of others. You can’t live long enough to make them all yourself. Eleanor Roosevelt squirepattonboggs.com 12 Review of ethical standards Categories: “Don’t lie”: acts of misconduct, unfair/deceptive trade practices, improper inducements “Don’t cheat”: accepting business from non-licensed person, using dishonest/fraudulent practices, incompetence, failure to comply with any insurance law, improper rebates or inducements “Don’t steal”: improperly withholding or converting money, failure to pay taxes “Do alert”: Report any and all infractions to the Department directly and in application and renewal applications squirepattonboggs.com 13 WARNING: The Department is watching. squirepattonboggs.com 14 Learning from another’s mistake . . . Disciplinary Actions Against Ohio Agents squirepattonboggs.com 15 Agent Ethics: Notice and Hearing Before denying, revoking, suspending, or refusing to issue any license or imposing any penalty the superintendent must provide the agent or applicant with notice and an opportunity for hearing. ORC 3905.14, ORC Ch. 119 squirepattonboggs.com 16 Mr. Russell H. Anderegg 1990: FINRA licensed suspended for 2 years, fined $84,000 2012: Applied for insurance license Answered “no” to question, Have you ever been involved in an administrative action? 2014: Applied for insurance license renewal Answered “no” to question, Have you ever been involved in an administrative action? Did he answer correctly? squirepattonboggs.com 17 ) Examining the Ethical Standards Providing incorrect or misleading information • Providing incorrect, misleading, incomplete, or materially untrue information in a license or appointment application. ORC 3905.14(B)(1) squirepattonboggs.com 18 Examining the Ethical Standards Failure to report administrative actions An insurance agent must notify ODI of any administrative action taken in another jurisdiction or by another agency within 30 days. Mere failure to report an action is not grounds for license suspension or revocation but having a license in another state suspended or revoked is grounds for suspension/revocation of an agent’s Ohio license. Note: the action does not need to relate to an insurance license. Reporting is required if it relates to any professional, occupational or financial license or licensing authority, e.g. FINRA action. ORC 3905.22 squirepattonboggs.com 19 Russell Anderegg The Department issued a Notice for Opportunity for Hearing • Mr. Anderegg failed to appear • Submitted undated “Letter of Explanation” in which he admitted his failure to disclose but stated he thought the violation was “too old and not relevant” • Hearing Officer rejected explanation Result? squirepattonboggs.com 20 Civil penalty $750 Costs $250 squirepattonboggs.com 21 Ms. Angie Price Sold a life insurance policy with premium funded by proceeds from an existing annuity • Answered “no” on client’s behalf to question asking if any existing annuity would be surrendered • Did not provide notice requiring replacement of annuity Aided William Thurman – whose license was revoked in 2007 – with the direct sale of insurance product to clients Did she act appropriately? squirepattonboggs.com 22 Aiding and Abetting • Knowingly aiding and abetting another person or entity in the violation of any insurance law of this state or the rules adopted under it. ORC 3905.14(B)(39) Replacement of life insurance and annuities • Sets forth rules for the replacement of life policies or annuities, including the requirement to provide a specific notice. OAC 3901-6-05 Failing to comply with insurance law or rule • Violating or failing to comply with insurance rule ORC 3905.14(B)(2) squirepattonboggs.com 23 Angie Price The Department issued a Notice for Opportunity for Hearing Ms. Price failed to appear Submitted some written documentation to the Department, including a statement that the Department’s system is “flawed” Client was reimbursed $3,900 from Mr. Thurman to offset $13,500 tax implications of partial surrender of annuity Result? squirepattonboggs.com 24 Angie Price Licensed revoked Barred from participation in the insurance industry or regarding insurance in any manner Costs $3,000 squirepattonboggs.com 25 Mr. Brady Aldinger 2011 – 2013: Accepted premium payments from a consumer and failed to timely forward them to insurers June 2013: Failed to return premium payment to consumer upon nonrenewal of policy ~ did not provide refund until investigation began squirepattonboggs.com 26 Examining the Ethical Standards Premium payments Improperly withholding, misappropriating, or converting any money or property received in the course of doing insurance business, ORC 3905.14(B)(4) squirepattonboggs.com 27 Examining the Ethical Standards(B)) Misappropriation Improperly withholding or misappropriating any money/property received in the course of doing insurance business. -ORFailing to fulfill a refund obligation to a policyholder or applicant in a timely manner. • 30 days after policyholder, applicant or insurer takes action • 30 days after insurer issues refund if agent is to issue portion of the refund • 45 days after date agent’s statement account showing refund ORC3905.14(B) (4),(32) squirepattonboggs.com 28 Brady Aldinger Department issued Notice of Opportunity for Hearing Appeared at hearing, with counsel Admitted to facts of untimely forwarding and return of premium payments Described alcohol problem during that time, and testified that he had voluntarily entered treatment at Cleveland Clinic and is still active with AA Made restitution to clients First and only administrative action (licensed since1995) Result? squirepattonboggs.com 29 Civil penalty $1,500 Costs of $250 Took responsibility Sought professional help for substance abuse Ongoing participation in AA indicated that contributory circumstances unlikely to occur again squirepattonboggs.com 30 15 Minute Break squirepattonboggs.com 31 Mr. James Blyth August 2012: Convicted of Public Indecency (misdemeanor) September 2012: Pled guilty to Forgery (felony) May 2013: Convicted of Forgery May 2013: Applied for renewal of license Answered “no” to questions asking about any misdemeanor or felony convictions October 2013: Convicted of Public Indecency June 2015: Applied for renewal of license Answered “no” to questions asking about any misdemeanor or felony convictions Did not report initial appearances before the court or final dispositions within 30 days of occurrence. squirepattonboggs.com 32 Examining the Ethical Standards(B)) Forgery • Forging any document related to an insurance transaction. • Submitting or using a document that the agent knew or should have known was forged. • Being convicted of, or pleading guilty or no contest to, a misdemeanor involving forgery. ORC 3905.14(B)(7), (11) & (26) squirepattonboggs.com 33 Examining the Ethical Standards Misrepresentation on License Application • Providing incorrect, misleading, incomplete or materially untrue information on license or appointment applications. • Obtaining, maintaining or attempting to obtain or maintain a license through misrepresentation or fraud. ORC (3905.14(B)(1), (3) squirepattonboggs.com 34 Examining the Ethical Standards Criminal Convictions Being convicted of or pleading guilty or no contest to a felony. Being convicted or pleaded guilty or no contest to a misdemeanor involving the misuse of money or property, fraud, forgery, dishonest acts, or breach of a fiduciary duty. ORC 3905.14 (B) (6), (7) squirepattonboggs.com 35 Examining the Ethical Standards Failure to report criminal prosecutions An agent must notify ODI of any criminal prosecution, other than misdemeanor traffic, within thirty days. Note: this reporting obligation applies when an agent has been charged with a crime. Within 30 days after the disposition of the criminal prosecution, the agent must inform the superintendent of the final disposition of the prosecution. ORC 3905.22(B) squirepattonboggs.com 36 James Blyth Department issued Notice of Opportunity for Hearing Appeared at hearing Facts of forgery, public indecency, and alcohol abuse Did not admit to alcohol problem, but did admit to “impulse control” problem Not receiving therapy for behavior control Hearing officer found preponderance of evidence for criminal convictions and for failure to alert Department Result? squirepattonboggs.com 37 License revoked Why? squirepattonboggs.com 38 Mr. Michael Buchanan 2014: Documents containing personal and/or privileged information – including names, addresses, and SSNs of insureds – were found discarded in an open and public Dumptser Files were not related to Mr. Buchanan’s clients but did relate to clients of Mr. Buchanan’s prior business partner News media reported the discovery of the files to the Department Denied any knowledge of the files or how they ended up in Dumpster Denied knowing who could have placed them in the Dumpster Initially told Department investigators that he was not present at the time the files were placed in the Dumpster squirepattonboggs.com 39 Client Confidentiality Loss of Control of Personal Information All insurers and agents are required to report any Loss of Control of policyholder information to ODI within 15 days of discovery of such Loss of Control, if the Loss involves more than 250 residents of Ohio. “Personal Information” is an individual’s first and last name in combination with a SSN, driver’s license number or bank/credit/debit card account number. Bulletin 2009-12 squirepattonboggs.com 40 Demonstrating incompetence Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial irresponsibility, in the conduct of business in this state or elsewhere Ohio Rev. Code 3905.14(B)(9) squirepattonboggs.com 41 Michael Buchanan Department issued Notice of Opportunity for Hearing Appeared at Hearing, with counsel Facts related to prior business relationship, including other agent’s conviction of tax fraud Had to vacate office due to unpaid rent and utilities Files placed in Dumpster were other agent’s files, but Mr. Buchanan did have control over them Changed his story with Department investigators Dumpster open but public access difficult Result? squirepattonboggs.com 42 Civil penalty $1,500 Costs $500 Why? squirepattonboggs.com 43 “Special factors” may be considered when denying a license, imposing suspensions, revocations, fines, or other penalties, and issuing orders. Ohio Rev. Code 3905.14(E) Did the agent act in good faith or make restitution? What was the degree of vulnerability of the person harmed? Was the agent subject to prior administrative actions? How many people were adversely affected? Did the agent voluntarily report violation or obstruct the investigation? If there was a criminal conviction, what was the nature of the offense? And any other factor the Superintendent deems appropriate. squirepattonboggs.com 44 Michael Buchanan Hearing Officer’s consideration of the “special factors”: Conflicting statements and attempt to deflect responsibility Responsible and trustworthy agent before this incident (or no information to the contrary) No information from files used against any insured Not his files, but belonged to the other agent squirepattonboggs.com 45 But wait, there’s more! Michael Buchanan appealed the Department’s order to the Franklin County Common Pleas Court. “Any party adversely affected by any order of an agency issued pursuant to any other adjudication may appeal to the court of common pleas of Franklin county” O.R.C. 119.12 squirepattonboggs.com 46 Appeal of Department Order The Court may reverse, vacate, or modify the Order to the extent it is not supported by reliable, probative, and substantial evidence or if it is not in accordance with law. ORC 119.12 Reviews the record Assesses evidence and witness testimony Must defer to the agency’s findings squirepattonboggs.com 47 Appeal of the Department’s Order Court’s review of the Department’s findings that: Mr. Buchanan did not “disclose” personal privileged information because the files were placed in a hard-toaccess Dumpster ~ there was no “intention” to disclose Mr. Buchanan demonstrated incompetence in allowing sensitive information to be subject to the possibility of disclosure, even if unlikely or unintentional What did the Court decide? squirepattonboggs.com 48 Appeal of Department’s Order The Court reversed the Department as not supported by reliable, probative, and substantial evidence because the Department’s two statements were contradictory. But were they contradictory? squirepattonboggs.com 49 Mr. Glen Buttacavoli 2015: Convicted of Falsification (misdemeanor) Withheld material information in application for Medicaid for a client Failed to disclose a prior transfer of assets that he had handled for the client He knew that the transfer would disqualify the client from Medicaid Only after discovery, repaid $8,600 to Ohio Department of Jobs and Family Services Failed to report initial appearance and final disposition to the Department Failed to report pending disciplinary action before the Ohio Supreme Court Previously entered into Consent Agreement with Department after failure to disclose Department of Commerce’s denial of securities license Agreed to revocation of annuities license Result? squirepattonboggs.com 50 Demonstrating incompetence Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial irresponsibility, in the conduct of business in this state or elsewhere ~ 3905.14(B)(9) Failure to report criminal prosecutions An agent must notify ODI of any criminal prosecution within 30 days of being charged with a crime and within 30 days of disposition of the prosecution ~ 3905.22 Any other factors Special factors to be considered, such as any factors the Superintendent deems appropriate ~ 3905.14(E) squirepattonboggs.com 51 Glen Buttacavoli License revoked Factors: Intentionally withheld information from ODJFS Would not have confessed if not caught History of questionable business practices toward vulnerable senior clients Demonstrated consistent disregard of disclosure duties These factors outweighed mitigation evidence presented squirepattonboggs.com 52 Mr. Angelo Babbaro 2012: Appointment with Insurance Company terminated for cause Provided false information on policy applications from 1999 through mid-2011 Almost 25% of annuity applications contained inaccurate birthdates Resulted in $19,000 in overpayment of commissions Commission was repaid, beginning prior to Department’s investigation Claimed “innocent mistake” due to new computer system Hearing Officer questioned his credibility about mistakes First complaint in over 20 years in insurance business On the board of organ and tissue donation organization Other community involvement Result? squirepattonboggs.com 53 Misrepresentation Intentionally misrepresenting the terms, benefits, value, cost, or effective dates of any actual or proposed insurance contract or application for insurance ~ 3905.14(B)(5) Dishonest practices Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial irresponsibility, in the conduct of business ~ 3905.14(B)(9) Special factors ~ 3905.14(E) squirepattonboggs.com 54 Civil penalty $5,000 Costs $250 Agree? Disagree? squirepattonboggs.com 55 Trisha Devine 2011: Involved in hit-skip accident while driving under the influence and texting while driving Injured a person Turned herself in, pled guilty, 3 years of probation Released after 1 year 2015: Submitted online application for insurance license Disclosed felony convictions Application approved? squirepattonboggs.com 56 Superintendent may refuse to issue license: Felony conviction Having been convicted of or pleaded guilty or no contest to a felony regardless of whether a judgment of conviction has been entered by the court ~ 3905.14(B)(6) Comply with insurance laws and rules Violating or failing to comply with any insurance law, rule, subpoena, consent agreement, or order of the superintendent or of the insurance authority of another state ~ 3905.14(B)(2) Good reputation The applicant is of good reputation and character, is honest and trustworthy, and is otherwise suitable to be licensed ~ 3905.06(A)(1)(h) squirepattonboggs.com 57 Trisha Devine Application approved Turned herself in, demonstrating good behavior Strictly complied with terms of probation, demonstrating striving for redemption Voluntarily disclosed felony convictions on application, demonstrating honesty Employer provided reference, demonstrating strong work ethic and integrity Claims she will never drink and drive or text while driving again squirepattonboggs.com 58 Other Ethics Issues Failure to pay taxes: License may be suspended to provide time to resolve outstanding tax obligation Inform the Department in writing when resolved Other professional license or regulatory registration suspended or revoked Inform the Department before the Department notifies you squirepattonboggs.com 59 Rebates and Inducements Rebate defined. A rebate occurs where the person buying insurance receives some sort of compensation, benefit, or kick-back from an insurer or agent to induce the person to purchase insurance, when the compensation, benefit, or kick-back is not stated in the insurance policy. Inducement prohibited. Insurance agents must not pay any rebate of premium payable on the policy, or any other inducement not plainly specified in the insurance policy, as inducements to insurance. ORC 3933.01 (P&C); 3911.20 (life) squirepattonboggs.com 60 Rebates and Inducements Items worth less than $50 A promotional or advertising item or meal with a fair market value of $50 or less is not valuable consideration when the item or meal is given to induce an individual to obtain a policy quote or general insurance information and the item or meal or other inducement is not tied to the purchase of an insurance policy. (ODI Bulletin 2009-13) squirepattonboggs.com 61 15 Minute Break squirepattonboggs.com 62 Duty to Report Ethical Lapses An insurance agent or managing or general agent engages in an unfair or deceptive practice when it knew or should have known, of an agent’s misconduct related to the sale of A & H insurance and: (a) expressly ratifies or tolerates such conduct; (b) and fails to report it to ODI; and (c) fails to investigate upon the request of the department. Ohio Admin. Code 3901-5-12 squirepattonboggs.com 63 Requests for Information from ODI Under her general authority to enforce the insurance laws, the Superintendent may: • Require any person to file a statement in writing regarding any facts concerning the person's conduct of the business of insurance. • Administer oaths, compel (i.e. subpoena) witnesses to testify; and • Require the production of any book, paper, or document. ORC 3901.04 squirepattonboggs.com 64 Requests for Information from ODI)) Agents may be disciplined for: • Failing to provide a written response to the ODI within 21 calendar days after receipt of any written inquiry from the department. • Failing to appear to answer questions before the superintendent after being notified in writing by the superintendent of a scheduled interview. ORC 3905.14(B)(21), (22) squirepattonboggs.com 65 Department Inquiries Most common department inquiries to agents: Consumer complaints From Consumer Services Division Agent Investigations From Fraud & Enforcement Divisions squirepattonboggs.com 66 Agent Inquiries & Investigations Don’t ignore the regulators ~ take them seriously. Be timely and communicate ~ extensions are often possible. What you say can and will be used against you. ODI can subpoena records, including bank records. You, the agent, may be the last person the investigators speak to – so they will compare what you say with what they already know or think they know. Consider using legal counsel who knows insurance, the ODI, or administrative law ~ at every investigative level squirepattonboggs.com 67 squirepattonboggs.com 68 squirepattonboggs.com 69 squirepattonboggs.com 70 Agent Ethics: Notice and Hearing A person receiving a Notice of Opportunity for Hearing must request a hearing with 30 days in writing to ODI or the hearing will be waived. If a hearing is waived, the Superintendent generally issues an order imposing discipline. Upon issuance of a Notice of Opportunity for Hearing, the agent may submit a public records request to see the investigative file. squirepattonboggs.com 71 Agent Ethics: Notice and Hearing At a hearing, ODI will present evidence and elicit sworn testimony from witnesses and from the agent. In response, the agent may contest the allegations and: • Introduce documentary evidence • Call witnesses • Testify • Produce letters of recommendation and/or character witnesses • Cross examine ODI witnesses At a hearing, witness are sworn-in and must tell the truth under penalty of perjury and a court reporter records all testimony. Both parties have the ability to subpoena witnesses and documents to be produced during the hearing. There is no formal discovery process. squirepattonboggs.com 72 Agent Ethics: Notice and Hearing Following the hearing, the hearing officer issues a recommendation and report. The agent has 10 days to submit any objections to the recommendation and report. The Superintendent will consider the report and recommendation, any objections, and issue a final order. The Superintendent may accept the R&R, modify the findings and propose penalty, or reject the R&R. The Superintendent’s order can be appealed to the court of common pleas. squirepattonboggs.com 73 Agent Ethics: Notice and Hearing Disciplinary Measures Upon finding an agent violated an insurance law, the Superintendent may do any of the following: • Suspend, revoke or refuse to renew a license; • Impose a civil penalty of $25K for each violation; • Impose administrative costs incurred by ODI; squirepattonboggs.com 74 Agent Ethics: Notice and Hearing • Issue a cease and desist order; • Prohibit the person from being employed in the business of insurance in Ohio; • Prohibit the person from having any financial interest in any insurance agency, insurance company, bail bond company or TPA. • Order corrective action; • Accept a surrender for cause for a minimum of five years. squirepattonboggs.com 75 Agent Ethics: Notice and Hearing Mitigating Factors The superintendent may consider the following factors in imposing penalties or issuing orders: 1) Whether the person made restitution; 2) The actual harm or potential for harm to others; 3) The degree of trust placed in the agent by, and the vulnerability of, people who were negatively affected; 4) Any previous administrative actions; squirepattonboggs.com 76 Agent Ethics: Notice and Hearing Mitigating Factors cont. 5) The number of people negatively affected; 6) Whether the agent voluntarily reported the violation, the extent of cooperation and acceptance of responsibility; 7) Whether the agent obstructed or impeded the investigation; 8) The agent’s efforts to conceal the misconduct; squirepattonboggs.com 77 Agent Ethics: Notice and Hearing Mitigating Factors cont. 9) Remedial efforts to prevent future violations; 10) If the person was convicted of a crime, the nature of the offense, whether the conviction was based on acts under any professional license, whether the offense involved the breach of a fiduciary duty, the amount of time that has passed, and the person's activities after the conviction; 11) Any other factors the superintendent determines to be appropriate. squirepattonboggs.com 78 V. Closing Exercise: Ethics Scenarios What you can do to mitigate a bad situation: • Self-report the situation to ODI before ODI learns of the information from other sources. • Cooperate with ODI fully as it investigates the matter • Take full responsibility for your actions • Satisfy all legal obligations including restitution • Be honest with ODI and others • Show that you have learned your lesson and that a similar situation will not happen again • Get professional colleagues and person friends to submit recommendation letters squirepattonboggs.com 79 Agent Ethics: Surrender of a License An agent may surrender a license voluntarily at any time except when under investigation. ORC 3905.16 squirepattonboggs.com 80 Agent Ethics: Modifications of Prior Orders An agent whose license was denied, suspended, revoked or surrendered may submit a written application for modification of the order. The superintendent will hold a hearing to determine whether the previous order should be modified, provided the following conditions are met: • The order was issued more than 5 years ago; • It has been at least 2 years since any previous request; and • The burden of proof is on the person requesting the modification. squirepattonboggs.com 81 John Wagner 2007: Insurance license permanently revoked by Ohio for failure to disclose a cease and desist order from Massachusetts Department of Insurance 2016: Submitted written request for modification of Ohio order and attended hearing via speaker phone More than 5 years had elapsed No record of filing previous request in prior 2 years Established he was a person of good business repute – in insurance industry for 40 years Met other requirements Modification request granted squirepattonboggs.com 82 Closing Exercise: Ethics Scenarios Scenario #1: Signing another person’s name Facts: The insurer won’t accept a form you submitted for the client because it does not include the client’s signature. To make things easy for your client and to avoid delaying the issuance of the policy your client needs, you sign their name and turn in the form. Any problem with this action? squirepattonboggs.com 83 Closing Exercise: Ethics Scenarios Possible violations for signing another person’s name • Forgery • Dishonest practices under a license squirepattonboggs.com 84 Closing Exercise: Ethics Scenarios Scenario #2: Criminal charges are filed and then dropped Facts: You recently sold a car. Shortly afterward, you are charged with odometer tampering. You call the prosecutor, who says he says he made a mistake. The charges are dropped. You do nothing else – are you off the hook? squirepattonboggs.com 85 Closing Exercise: Ethics Scenarios Possible violation for charges brought, then dropped Failing to report criminal charges squirepattonboggs.com 86 Closing Exercise: Ethics Scenarios Scenario #3: Fees As part of their sales practice, Bob and Bonnie Producer tack on a fee as a percentage of the premium for each policy to cover legitimate administrative costs they incur. If the customer asks, Bob and Bonnie explain the fee. Are these fees permissible under Ohio law? squirepattonboggs.com 87 Agent fees: An agent may charge a fee if the fee is: Disclosed to the consumer Not calculated as a percentage of the premium Not refunded, forgiven, waived, offset, or reduced by any commission earned The customer consents Not as a part of application process for personal auto, homeowners, individual life, individual sickness or accident insurance, disability income, or credit insurance ORC 3905.55 squirepattonboggs.com 88 Possible violation for charging fees: Bob and Bonnie calculate their fees as a percentage of the premium, and they don’t disclose the fee unless asked by the client. squirepattonboggs.com 89 Closing Exercises – Ethics scenarios Scenario #4: Referral Fees To thank your clients for referring their friends and neighbors, you give them a $20 Starbucks gift card each time someone they referred buys a policy from you. squirepattonboggs.com 90 Closing Exercise: Ethics Scenarios Possible violation for Starbucks card for referrals: Improper referral fees. Referral fees or compensation cannot be contingent on the purchase of insurance – in the previous scenario, you only rewarded referrals for the purchase of insurance. squirepattonboggs.com 91 Scenario #5: Signing on behalf of client You visit your elderly client at her home to discuss longterm care insurance. After some discussion, your client applies for a policy. You fill out the application, as the client provides answers to its questions. Then she signs the application. Later, you realize that you misspelled her name in two places. You make the corrections and initial the changes with the client’s initials. Any problems here? squirepattonboggs.com 92 Scenario #6: Providing a multi-line discount A new client applies for an automobile policy and tells you that he intends to buy homeowner’s insurance in the next month. As a courtesy, you apply the multiple policy discount that is available for such cross-line policies. Later, you realize that the client never purchased the homeowner’s policy, but the discount rate for auto is still in effect. What should you do? squirepattonboggs.com 93 Ethical Standards for Insurance Agents Sponsored by the Ohio Association of Health Underwriters Doug Anderson Direct: 614-365-2717 [email protected] Holly W. Wallinger Direct: 614-365-2716 [email protected]
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