Insurance Ethics Training
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About this ebook
Insurance Ethics Training is a study of ethical practices for insurance agents, examining closely the parties to whom agents owe an ethical responsibility, the law of agency, agent and broker liability, and deceptive trade practices and fair claims handling. This textbook will teach you about the "new focus" on business ethics and give you an understanding of ethical decision making, compare ethic obligations and legal requirements, and help you identify the duties resulting from the law of agency.
Michael Lustig
Michael Lustig is a graduate of the University of San Diego, California and a former Professor at California State University at Pomona and Immaculate Heart College (Los Angeles). He has been a California Real Estate Broker and the Owner and President of Real Estate License Services, a California real estate and insurance licence school, since 1978, offering state-approved license courses in 47 states and the District of Columbia. He is the author of 35 books on real estate and insurance topics.
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Insurance Ethics Training - Michael Lustig
INSURANCE ETHICS TRAINING
Prepared by Michael Lustig
Contributing Editor: Denise Iona
Distributed by:
Real Estate License Services
5059 Newport Ave. #209
San Diego, CA 92107
Phone Toll-Free 1-800-877-5445
Smashwords Edition
© Copyright 2010 - 2006 by Michael Lustig, Real Estate License Services. Copyright registered. All contents protected by laws of copyright. No portion of this book may be reprinted, reproduced, transmitted, stored in a retrieval system or on the Internet, or otherwise utilized in any form or by any means, electronic, mechanical, or otherwise, including photocopying or recording, now existing or hereinafter invented, nor may any part of this book be used for teaching without the prior written consent of Michael Lustig.
Contents
CHAPTER ONE: ETHICS FOR THE INSURANCE INDUSTRY
WHAT IS ETHICS?
LEGAL VS. ETHICAL RESPONSIBILITIES
LEGAL RESPONSIBILITIES OF CONDUCT - CONDUCT BEYOND LEGAL MEASURES
THE NEW FOCUS ON BUSINESS ETHICS
IN THE INSURANCE BUSINESS - WHO IS RESPONSIBLE?
ENCOURAGING ETHICS
AT THE CORPORATE LEVEL - MIDDLE MANAGEMENT - AGENCY LEVEL
ETHICS CAN BE TAUGHT
ETHICS MUST TAKE HIGH PRIORITY
ETHICAL DILEMMAS THAT CHALLENGE
THE ETHICAL COMMUNITY
WHERE DOES ETHICAL FITNESS BEGIN?
CHAPTER TWO: THE LAW OF AGENCY
INTRODUCTION
THE COMMON LAW OF AGENCY
AGENCY LAW AS APPLIED TO THE BUSINESS OF INSURANCE
TYPES OF AGENCY - AN AGENT’S OBLIGATIONS - THE CREATION OF AGENCY - SOURCE OF AUTHORITY - SCOPE OF AUTHORITY - FIDUCIARY DUTIES OF THE AGENT - BREACHES OF FIDUCIARY DUTY - TERMINATION OF AGENCY - STATUTORY DUTIES OF AN AGENT
LIABILITY
PENALTIES
CHAPTER THREE: AGENT AND BROKER LIABILITY
INTRODUCTION
PARTIES TO WHOM DUTIES ARE OWED
DUTIES OWED TO THE STATE - DUTIES OWED TO THE INSURER - DUTIES OWED TO INSUREDS AND CLAIMANTS - DUTIES OWED TO OTHER PARTIES
SPECIAL ETHICAL CONSIDERATIONS
BAD FAITH CLAIMS - SUITABILITY - TRUST FUND HANDLING AND ACCOUNTING - MISREPRESENTATION - THE UNAUTHORIZED PRACTICE OF LAW
THEORIES OF LIABILITY
BREACH OF CONTRACT - NEGLIGENCE - FRAUD
AGENTS AS SPECIALISTS OR EXPERTS
RESPONSIBILITY DETERMINED BY ACTIVITY, NOT BY TECHNICAL DESIGNATION
STANDARDS MUST NOT BE COMPROMISED
THE EVOLUTION OF AGENT LIABILITY
CHAPTER FOUR: CONSUMER PROTECTION
INTRODUCTION
CONSUMER LAW
THE NEEDS OF INSURANCE CONSUMERS - ENFORCEMENT OF CONSUMER LAW
DECEPTIVE TRADE PRACTICES
MISREPRESENTATIONS AND FALSE ADVERTISING OF INSURANCE POLICIES - FALSE INFORMATION AND ADVERTISING GENERALLY - DEFAMATION - BOYCOTT, COERCION, OR INTIMIDATION - FALSE STATEMENTS AND ENTRIES - STOCK OPERATIONS AND ADVISORY BOARD CONTRACTS - UNFAIR DISCRIMINATION - UNLAWFUL REBATES
UNFAIR CLAIMS SETTLEMENT PRACTICES
UNFAIR CLAIMS SETTLEMENT PRACTICES PROHIBITED - UNFAIR CLAIMS PRACTICES DEFINED - MISREPRESENTATION OF POLICY PROVISIONS - FAILURE TO ACKNOWLEDGE PERTINENT COMMUNICATIONS - STANDARDS FOR PROMPT INVESTIGATION OF CLAIMS - STANDARDS FOR PROMPT, FAIR AND EQUITABLE SETTLEMENTS APPLICABLE TO ALL INSURERS
CHAPTER QUIZZES
CHAPTER ONE – ETHICS FOR THE INSURANCE INDUSTRY
CHAPTER TWO – THE LAW OF AGENCY
CHAPTER THREE – AGENT AND BROKER LIABILITY
CHAPTER FOUR – CONSUMER PROTECTION
CHAPTER ONE: ETHICS FOR THE INSURANCE INDUSTRY
WHAT IS ETHICS?
For each of us the word ethics
probably holds a different meaning. For those engaged in business enterprises of whatever nature, in its deepest, broadest, and most idealistic sense, ethics should hopefully refer to the Golden Rule, or the ethic of reciprocity. This is an ethical principle stating that a person has the right to just treatment and the responsibility to ensure justice for others. This is the ethical basis for virtually all moral systems in the world. If only we would all heed this simple lesson. By exercising the Golden Rule standard in business relationships, individuals then would not need to impose their own sometimes faulty personal values or preferences on others.
There is wide public interest in how insurance practitioners conduct their businesses. If the individual ethical performances of agents and brokers become deficient, more government regulations are likely. Such additional government regulation need not materialize if each industry professional makes proper ethical decisions for his or her own business enterprise, recognizing that the best interests of the citizens in the community should be served before his or her own.
Ethics is a system of moral principles, rules, and standards of conduct which define the duties owed by a member of a profession to the public, clients, and other members of his profession. Professional codes of ethics, as a means of establishing ethical standards, maintain a standard of behavior for members of a particular profession and provide an assurance to the public that such professionals possess the qualities of integrity and fairness essential to honest business dealings. The underlying purpose of codes of ethics, whether professional or personal, is to avoid unethical conduct which occurs when one takes advantage of a position of trust solely for his or her own gain and to the detriment of another person.
Insurance professionals should always strive to act in an ethical manner. The public deserves it. In the scope of daily business dealings, however, certain situations may present themselves which encourage unethical behavior, or at least which require carefully examining choices of action. It is critical that producers recognize actions that are considered unethical, and these must be avoided.
Choosing the right insurance professional may be one of the most important financial decisions a person makes. A professional with high standards of ethical fitness can focus on specific concerns, can provide guidance over a lifetime, and will play a significant role