Code of the District of Columbia (a) The Commissioner may examine and investigate the affairs of a person engaged in the business of insurance in the District of Columbia to determine whether the person has been or is engaged in an unfair trade practice, an unfair method of competition, or an unfair or deceptive action practice under this chapter. The Commissioner may suspend or revoke the license or certificate of authority for a person that violates this chapter or a rule or regulation adopted under this chapter, or fails to comply with an order of the Commissioner. (b)(1) The Commissioner may enforce this chapter, or any rules and regulations adopted under this chapter, by issuing an order: (A) To cease and desist from the violation and further similar violations; and (B) Requiring the violator to correct the violation, including the restitution of money or property to a person aggrieved by the violation. (2) If a violator fails to comply with an order issued under paragraph (1) of this subsection, the Commissioner may impose a civil penalty of up to $1,000 for each violation from which the violator failed to cease and desist or which the violator failed to correct. (c) The Commissioner may request the Corporation Counsel of the District of Columbia [Attorney General for the District of Columbia] (“Corporation Counsel”) take appropriate action in the Superior Court of the District of Columbia (“Superior Court”) for the enforcement of an order issued under this section. The Corporation Counsel may also seek, and the Superior Court may order or decree, damages and other relief allowed by law, including restitution. In an action brought by the Corporation Counsel under this section, the Corporation Counsel may be awarded attorney’s fees and costs. (d) In determining the amount of financial penalty to be imposed under subsection (b) of this section, the Commissioner shall consider the following: (1) The seriousness of the violation; (2) The good faith of the violator; (3) The violator’s history of previous violations; (4) The deleterious effect of the violation on the public and the insurance industry; (5) The assets of the violator; and (6) Any other factor relevant to the determination of the financial penalty. Previous § 31–2231.21. “Twisting” prohibited.Next § 31–2231.23. Hearings.The Commissioner has the authority to conduct examinations of an agent or insurer's books and records at any time. Upon receiving a request for records, insurers and/or agents must deliver the records to the Commissioner within 30 days. If the requested files cannot be immediately furnished, on request the agent will be given an additional 60 days to provide the information. Failure to maintain the required files may result in administrative sanctions including fines and suspension or revocation of a person's license. Most administrative sanctions can only be issued following a public hearing into the conduct of the agent. A notice of hearing must be provided to the agent not less than 45 days in advance of the scheduled hearing, and must be accompanied by a pleading that informs the agent of the violations alleged, as well as the possible sanctions that may be applied. There are also civil penalties enumerated for persons who furnish false information to the Commissioner not to exceed $100,000 per violation, as well as a $5,000 penalty for every 30-day period during which the person fails to comply with a request, or up to $10,000 if the person willfully refuses to deliver requested information, up to a maximum of $100,000. For foreign mutual insurers without outstanding capital stock, the value of its assets that is in excess of all expenses, taxes,
indebtedness and reinsurance as provided by law. The paid-in capital of available cash assets must amount to at least $200,000. For the purpose of computing paid-in capital or capital paid-in, shares of stock are not taken as liabilities. The Commissioner has the power to investigate the affairs of any person engaged in the business of insurance to determine whether such person has been or is engaged in any unfair method of competition or unfair or deceptive act or prohibited practice. If it is believed the person has violated a trade practice, the Commissioner will issue a statement of charges, a statement of potential liability for civil penalties, a show cause order as to why a cease and desist should not be issued, and a 30-day notice of a hearing. If the charges are justified, a civil penalty not to exceed $5,000 for each act will be assessed. If the violation is willful, the maximum penalty is $10,000 for each act. A cease and desist order will be placed requiring the individual to refrain from engaging in the prohibited acts. Violation of a cease and desist order imposes a penalty of up to $5,000 per violation or a maximum penalty of $55,000 if the violation is willful. Subsequent violations will lead to suspension or revocation of a license. Every licensee's claim files are subject to examination by the Commissioner at all times. Claims files are required to contain all documents, notes and work papers, including copies of all correspondence, which reasonably pertain to each claim in such detail that pertinent events and the dates of the events can be reconstructed, and the licensee's actions pertaining to the claim can be determined. Insurers are required to maintain claim data so that it is accessible, legible, and retrievable for examination, and must be able to provide the claim number, line of coverage, date of loss, date of acceptance, date of payment, date of denial or closing without payment. This data must be available for all open and closed files for the current year, and the 4 preceding years. Licensees must also record the date the licensee received, transmitted, or mailed every material and relevant document in the file, or otherwise processed anything relevant to a claim. It is an unfair practice for any insurer to discriminate in the investigation or settlement of a claim on the basis of a person's age, race, gender, income, religion, language, sexual orientation, ancestry, national origin, physical disability, or upon the territory of the property or person. Unless the insurer requires additional information to determine liability for a loss, the insurer is generally expected to either affirm or deny a claim within 40 days of notice of the loss. This time limit does not apply to disability income or health insurance. When a claim cannot be resolved within 40 days, the claimant must be notified of this fact and, as discussed previously, the insurer must continue to communicate the status of the claim no less often than every 30 days. When the insurer approves the claim, in whole or in part, and when necessary, upon receipt of a properly executed release, the insurer is required to make payment to the claimant or an assignee, or take action to perform its claim obligation within 30 days. Disability income insurance claims payments must be made at least once every 30 days until the insurer's obligation to pay claims has ended. An individual or group life, annuity, or disability insurer may not refuse to insure, or refuse to continue to insure, or limit the amount, extent, or kind of coverage available to an individual, or charge a different rate for the same coverage solely because of a physical or mental impairment, except where the refusal, limitation or rate differential is based on sound actuarial principles or is related to actual and reasonably anticipated experience. "Physical or mental impairment" is any physical, sensory, or mental impairment that substantially limits one or more of that person's major life activities. Identity of each person who transacted the insurance, renewals, and any change in coverage Agents have a duty to carefully determine the insured's needs and suitability. Failing to meet these needs when making a recommendation can affect the insured's coverage or leave them without coverage due to the agent's neglect. The agent can be held legally responsible for neglect, errors, or omissions when making customer recommendations. E&O insurance is used for the purpose of protecting an agent from this legal liability and provides coverage for legal defense and settlement costs up to a limit. Errors and Omissions insurance is usually offered with a minimum limit of liability of $1 million. Policies usually include a significant retention (or deductible) of $2,500 or $5,000. Most E&O policies are issued on a "claims made" basis, meaning the policy covers claims which arise while the policy is in force, and usually requires continuous coverage from the time of the claim to the time of adjudication. A "tail" provision may be added to cover acts which occurred prior to the inception of the policy. E&O policies also provide limited protection for the negligent acts of an agent's unlicensed employees. But E&O policies never provide coverage for fraud, illegal activities, or criminal acts of the agent or an employee, nor does it provide protection for liability or casualty losses which are normally covered by a commercial liability policy, such as personal injury, property damage, or torts such as libel and slander. Misuse of client funds is also excluded. |
What is the minimum civil fine for violating a cease and desist order of the commissioner quizlet?
zusammenhängende Posts
Urheberrechte © © 2024 de.apacode Inc.
