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6

Market Conduct: Reasonable, Equitable and Fair Treatment of Policyholders

Chapter Outline

  • POLICY FORMS

  • Policy Form Content
    Filing Policy Forms
  • RATES
    Property and Liability Insurance Rates
    Life Insurance Rates
    Credit Life Insurance Rates
  • FOUNDATION OF MARKET CONDUCT REGULATION: THE UNFAIR TRADE PRACTICES ACT

  • BUSINESS-GETTING ACTIVITY

  • Misrepresentation in Getting Business
    Disclosure of Price and Other Policy Information
    Replacement
    Free Look
    Rebates
    The State of Marketing Life Insurance: A Crisis in Ethics
  • UNFAIR DISCRIMINATION

  • In General
    Discrimination and Civil Rights
  • POLICYHOLDER DIVIDENDS

  • Mandated Annual Distribution
    Limits on Stockholder’s Charge
    Unfair Discrimination
  • UNFAIR SETTLEMENT PRACTICES

  • PRIVACY

  • Emergence of the Right of Privacy and Information Privacy
    Privacy Legislation and the Insurance Industry
    NAIC Model Privacy Act
    Medical Information Bureau and Privacy
  • GROUP LIFE INSURANCE

  • Nature of Group Insurance
    State Regulation of Group Life Insurance
    Federal Regulation

    In addition to the fundamental insurance regulatory goal of reliability of the insurance mechanism, state laws and regulations reflect a second body of fundamental goals aimed at the conduct of insurer operations in the marketplace. These consist of the goals of (1) reasonableness which seeks to bar mistreatment of the whole body of policyholders, (2) equity which seeks to avoid unfair discrimination as between individual policyholders and (3) fairness which seeks to prevent mistreatment of policyholders as individuals in such areas as claims practices, agent misrepresentations and service. The following areas of regulation seek to foster the achievement of one or more of these three major goals.

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