InsuranceEthicsandResponsibilities PDF
InsuranceEthicsandResponsibilities PDF
InsuranceEthicsandResponsibilities PDF
AND
RESPONSIBILITIES
COPYRIGHT © 2003
AFFORDABLECE-USA
(A Division of the American Safety Council)
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© 2003 AffordableCE-USA
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understanding that the publisher is not engaged in rendering any legal or professional services.
Although professionals prepared this seminar, it should not be used as a substitute for
professional services. If legal or other professional advice is required, the services of a
professional should be sought.
TABLE OF CONTENTS
CHAPTER 1.....................................................................................................1
CONSUMER PROTECTION ............................................................................................ 1
INSURANCE REGULATION............................................................................... 1
FINANCIAL STABILITY ................................................................................. 1
STANDARD PROVISIONS ............................................................................... 1
LICENSING ................................................................................................... 2
RATES ......................................................................................................... 2
CHAPTER 2.....................................................................................................3
BUSINESS ETHICS........................................................................................................... 3
BUSINESS ETHICS DEBATED AND DEFINED ............................................... 3
A SERIOUS MATTER ..................................................................................... 3
ETHICAL DILEMMAS & THE CODE OF ETHICS .............................................. 4
REGULATING MORALITY ............................................................................. 4
INDUSTRY BENEFITS .................................................................................... 4
QUALITIES OF THE HIGHLY ETHICAL INDIVIDUAL ....................................... 5
QUALITIES OF THE HIGHLY ETHICAL INDUSTRY .......................................... 5
CHAPTER 3.....................................................................................................6
TRADE PRACTICES ......................................................................................................... 6
CONSUMER PROTECTION ................................................................................ 6
PROHIBITED ACTIVITIES .................................................................................. 6
MISREPRESENTATION................................................................................... 6
Example .......................................................................................... 6
ALTERING APPLICATIONS ............................................................................ 7
PREMIUM THEFT .......................................................................................... 7
UNLICENSED SALES ..................................................................................... 7
FORGERY ..................................................................................................... 7
MISLEADING SALES TECHNIQUES ................................................................ 8
ILLEGAL REBATES ........................................................................................ 8
Examples ......................................................................................... 8
UNTRUTHFUL POLICY REPLACEMENTS ........................................................ 8
DISCRIMINATION.......................................................................................... 8
UNTRUTHS IN ADVERTISING ........................................................................ 9
CHAPTER 4...................................................................................................10
RESOLVING ETHICAL DILEMMAS ........................................................................... 10
METHODOLOGY – THE ETHICAL CHECKLIST........................................... 10
THE TEN-STEP METHOD ............................................................................ 10
KEY QUESTIONS TO ADDRESS ETHICAL DILEMMAS................................... 11
CHAPTER 5...................................................................................................12
THE INSURANCE PROFESSIONAL............................................................................. 12
ETHICS ARE THE TOP PRIORITY ................................................................... 12
LOFTY GOALS ............................................................................................ 12
MAKING A DIFFERENCE ............................................................................. 12
THE RIGHT STUFF............................................................................................. 13
CODE OF CONDUCT GUIDELINES ................................................................ 13
LIABILITY ........................................................................................................... 14
AVOID LEGAL REPRESENTATIONS ............................................................. 14
CLIENTS FOR LIFE............................................................................................ 14
FEES AND COMMISSION ................................................................................. 15
CHAPTER 6...................................................................................................16
THE AGENCY ................................................................................................................. 16
THE AGENCY RELATIONSHIP ....................................................................... 16
HOW IS AGENCY CREATED ?....................................................................... 16
HOW THE AUTHORITY OF AN AGENT IS CREATED ...................................... 16
LIMITATIONS AND RESPONSIBILITIES ....................................................... 17
THE AGENT AS A FIDUCIARY ....................................................................... 17
LOYALTY ................................................................................................... 17
SKILL AND CARE ........................................................................................ 17
DISCLOSURE .............................................................................................. 18
TIMELINESS ................................................................................................ 18
ACCOUNTABILITY OF FUNDS ...................................................................... 18
SOLE INTEREST .......................................................................................... 18
DILIGENCE IN SOLICITATION OF BUSINESS ................................................. 18
COMPETITIVE FAIR PLAY........................................................................... 19
CHAPTER 7...................................................................................................20
CAPTIVE AGENTS VS. INDEPENDENT AGENTS .................................................... 20
AGENT TYPES .................................................................................................... 20
CAPTIVE AGENT......................................................................................... 20
INDEPENDENT AGENT ................................................................................ 20
PRINCIPAL’S OBLIGATIONS TO THE AGENT............................................. 20
THE EMPLOYMENT AGREEMENT ................................................................ 20
THE PRINCIPAL'S OBLIGATION OF COMPENSATION .................................... 21
INDEMNIFICATION OF AGENT ..................................................................... 21
CHAPTER 8...................................................................................................22
POLICY ILLUSTRATIONS ............................................................................................ 22
ETHICAL PRACTICES REGARDING POLICY ILLUS TRATIONS............... 22
DISCLOSURE .............................................................................................. 22
INTEREST RATES IN POLICY ILLUSTRATIONS ......................................... 22
EXTERNAL GUIDES .................................................................................... 22
DECLARED RATES ...................................................................................... 22
RATE CHANGES ......................................................................................... 22
RETURNS: METHODS OF CREDITING ......................................................... 23
PORTFOLIO M ETHOD .................................................................................. 23
NEW MONEY M ETHOD ............................................................................... 23
THE COMBINATION METHOD ..................................................................... 23
DIVIDENDS ......................................................................................................... 23
MORTALITY ....................................................................................................... 23
EXPENSES ........................................................................................................... 23
VANISHING PREMIUMS .................................................................................. 23
CHAPTER 9...................................................................................................24
CODES OF ETHICS ........................................................................................................ 24
GUIDELINES FOR DEVELOPING A CODE OF ETHICS............................... 24
GUIDELINES FOR DEVELOPING A CODE OF CONDUCT ......................... 24
CHAPTER 10.................................................................................................25
INDUSTRY CODES OF ETHICS SAMPLES ................................................................ 25
NATIONAL ASSOCIATION OF LIFE AND FINANCIAL UNDERWRITERS
................................................................................................................... 25
PREAMBLE ................................................................................................. 25
NATIONAL ASSOCIATION OF HEALTH UNDERWRITERS ....................... 26
NAHU CODE OF ETHICS ............................................................................ 26
THE AMERICAN SOCIETY OF CLU AND CHFC .......................................... 26
CLU & CHFC CODE OF ETHICS ................................................................. 27
MILLION DOLLAR ROUND TABLE................................................................ 28
GENERAL AGENTS AND MANAGERS ASSOCIATION (GAMA) .............. 29
STATEMENT OF PRINCIPLES ....................................................................... 29
NATIONAL ASSOCIATION OF PROFESSIONAL INSURANCE ADJUSTERS
................................................................................................................... 30
RULES OF PROFESSIONAL CONDUCT AND ETHICS ...................................... 30
AMERICAN INSTITUTE FOR CHARTERED PROPERTY AND CASUALTY
UNDERWRITERS CODE OF PROFESSIONAL ETHICS .................... 31
CANONS AND RULES ....................................................................................... 31
CANON 1.................................................................................................... 31
Rules of Professional Conduct ...................................................... 31
CANON 2.................................................................................................... 31
Rules of Professional Conduct ...................................................... 32
CANON 3.................................................................................................... 32
Rules of Professional Conduct ...................................................... 32
CANON 4.................................................................................................... 32
Rules of Professional Conduct ...................................................... 32
CANON 5.................................................................................................... 32
Rules of Professional Conduct ...................................................... 33
CANON 6.................................................................................................... 33
Rules of Professional Conduct ...................................................... 33
CANON 7.................................................................................................... 34
Rules of Professional Conduct ...................................................... 34
CANON 8.................................................................................................... 34
Rules of Professional Conduct ...................................................... 34
CANON 9.................................................................................................... 34
Rules of Professional Conduct ...................................................... 34
CHAPTER 1
CONSUMER PROTECTION
INSURANCE REGULATION
State regulations governing the insurance industry are intended mainly to protect the
consumer from fraud and/or willful intent and to promote fair competition among
insurers. Regulations require a minimum standard of competence to ensure a proficient
business environment.
With the passing of the McCarran-Ferguson Act in 1945, control of the insurance
business was kept at the state level. The federal government will only interfere in the
event that a state’s own governing regulations are proven to be insufficient. Supporters of
state regulation believe that each state is better qualified to provide for the individual
needs of its own populace. Since state regulations have little variation, it is typically
believed that the implementation of a federal control system would be disconcerting to
the general public. When regulating insurance industry practices, states examine the
insurer’s financial stability, the contract’s standard provisions, licensing and rates.
FINANCIAL STABILITY
STANDARD PROVISIONS
Standard provisions and even standard policy formats are required in many states.
Some require terminology used to be basic enough for the novice and terms to be the
same from one provision to the next. Before sale, the proposed policy must be filed
with the state insurance department for approval. If the policy does not meet the
standards set by the state, the state has the right to prohibit the policy’s use.
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LICENSING
The insurance department has the authority to issue, renew, suspend and revoke
licenses. Every company must hold a state business license, and every agent must
hold a license to sell insurance in the state. In many states, insurance adjusters must
also be licensed. In this way, each state can keep track of and maintain its standards
for companies as well as individuals. If any company or individual is found to be in
violation of these standards, their right to do business can be terminated by the
insurance department.
RATES
Insurance companies must submit their rate structure to the state insurance
department for regulation compliance. The state insurance department governs how
rates are determined and applied and specifies that rates must not be excessive,
inadequate or discriminatory so as to overcharge consumers for their coverage;
however, rates must be set at a sufficient amount to cover the insurance company’s
risk and loss factors. Rates cannot discriminate in the respect that certain members
of one group cannot be charged a higher rate in order to supplement lower rates for
other members of the same group.
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CHAPTER 2
BUSINESS ETHICS
BUSINESS ETHICS DEBATED AND DEFINED
Business ethics are the principles of conduct governing an individual or group and
conforming to accepted professional standards of conduct. In essence, learning what is
right and wrong, and then doing what is right. But is there always a right or wrong, rooted
in moral principle, or is it ultimately up to the individual depending upon the situation?
Philosophers have debated the question for thousands of years.
Moral and ethical principles are based upon values such as integrity, honesty, justice and
trustworthiness. How these values are applied is often referred to as moral or ethical
principles. However, an ethical guideline can often become a law or regulation,
depending upon legal interpretation.
A S ERIOUS M ATTER
When most people think of ethics, they think of the golden rule, “Do unto others as
you would have done unto you.” However, during critical times, ethical statements
such as this can go by the wayside. Therefore, adherence to a strict code of ethics
can be a strong deterrent to disaster in business.
3
ETHICAL DILEMMAS & THE CODE OF ETHICS
Complex business transactions can’t always be seen as black and white, but may
often contain gray areas. A code of ethics is the ethical value system to which an
organization aspires. They are normally quite similar to the codes of ethics that most
people live their individual lives by. So why write them down and spell them out if
they are as common as honesty, truth and fairness? Because a code of ethics is an
organic instrument and can often change with the needs of society and the
organization.
REGULATING M ORALITY
There are no excuses for unethical behavior, yet an individual can often be unethical
while remaining within the law. This often times occurs during stressful situations.
However, breaking the law often starts with unethical behavior that has gone
unnoticed. Small transgressions that do not break any laws can lead to larger acts
that do. Therefore, it is imperative that all industry representatives support each other
to maintain a high degree of ethics. The focus of ethics in business should include:
• The application of ethics to the corporate community
• A way to determine responsibility in business dealings
• The identification of important business and social issues
• A business critique
INDUSTRY B ENEFITS
• Improved society;
• A moral course in difficult times;
• Creates strong teamwork and productivity;
• Supports individual growth;
• Keeping policies legal;
• Assists in avoiding criminal acts of omission and lowering fines;
• Helps manage strategic planning, quality and diversity; and
• Promotes a strong public image.
4
Q UALITIES OF THE H IGHLY ETHICAL INDIVIDUAL
• The "good of the consumer" is part of the individual's own
philosophy, in theory and practice;
• The individual's integrity stresses that the other person's interests
are as valuable as his own;
• The individual assumes personal responsibility for his actions, and
is responsible to himself first and then to his organization; and
• The individual sees his activities in terms of purpose, which ties
the individual to the organization, and the organization to the
environment.
5
CHAPTER 3
TRADE PRACTICES
CONSUMER PROTECTION
States require insurance agents to adhere to strict business practices in their everyday
dealings with consumers as a method of consumer protection, and failure to do so can
result in severe consequences. There are certain activities that are prohibited and it is the
agent’s responsibility to adhere to the high ethical standards as well as the insurance
company’s responsibility to do the same.
PROHIBITED ACTIVITIES
M ISREPRESENTATION
Example
• Advising a client that an auto policy will cover liability when it
only covers collision;
• Telling a prospective client that dividends are guaranteed when
they are not;
• An agent telling prospects that he represents several companies
when he represents only one; or
• Talking about a term life insurance policy in such a way to lead the
prospective customer to assume that it will have cash value
accumulation.
It is the agent’s responsibility to know his product and, if presented with an issue he
is unclear about, it is his responsibility to seek clarification before giving any
incorrect information.
6
ALTERING APPLICATIONS
Applications have been altered for many fraudulent reasons; however, any alteration
is illegal.
• Change underwriting information to reduce premium rates;
• Change the type of coverage; or
• Add additional zeroes to the amount of coverage.
PREMIUM THEFT
Premium theft is the ultimate offense an insurance agent can commit and is severely
punished by every state insurance department. This action is not a double-edged
sword, but a triple-edge. It (1) robs the customer of his funds, (2) deprives the
insurance company of its premium payment and (3) robs the customer of the
insurance protection he believes he has purchased. Since no contract is in force until
the insurer receives the premium payment, any inquiry made to the insurance
company will quickly reveal that there is no effective policy.
UNLICENSED SALES
This governing process allows the state to maintain a high standard of consumer
protection. Each member of the insurance industry strives to maintain the standards
established; those who do not may damage the reputations of other members in the
industry.
FORGERY
Forgery is subject to both state and federal prosecution. The technique of tracing a
signature (or “windowing”) has been utilized to obtain an illegal policy loan or to
obtain a change of dividend option, but it is nothing short of illegal and deserves
severe punishment.
7
M ISLEADING SALES TECHNIQUES
ILLEGAL R EBATES
Only two states allow rebating (Florida and California) and their state insurance
departments heavily regulate them. In all other states, the practice is illegal. It
affords buyers of larger policies more financial leverage than buyers of smaller
policies. The smaller policy buyers in some way usually pay for the difference in
funds collected.
Examples
If a policy has been in effect for a long time, the policyholder may not be eligible for
the same coverage and rate on a new policy and therefore would not benefit from a
replacement policy. Policies that have been building cash value may be undermined
by replacement with a new policy that will take many years to accumulate the same
level of cash value. The customer’s welfare is the agent’s top priority.
DISCRIMINATION
Sales and sales practices are directly affected when public attention is called to a
product. Therefore, states set their own regulations to govern insurance advertising.
• Advertisements must not be misleading to the consumer either by
being untruthful or by omission of information.
• The subject matter (insurance) must be clear to the consumer.
• The publication or promotion of higher than normal claims
settlements are usually considered misleading unless the ad
specifically states that the amount is unusual. Such ads may imply
that claims settlements will be generous beyond the terms of the
policy, or that a policy owner will receive special treatment that is
not specified in the policy.
• Technical terms, illustrations and disclosures must be displayed in
such a manner that their meaning is clearly understandable to the
individuals who might purchase the product.
• Statistics used must be relevant and factual, with their source
identified.
• No offer that is in violation of public policy or law may be used.
• Nothing of value that is outside the express terms of the policy
advertised may be used.
• Unfair comparisons of policies or any of their terms is prohibited.
• Third party testimonials must be of the true opinion of the third
party and relate precisely.
• Premium rates stated must be for the exact coverage described.
• Ads may not give the reader the impression that the company or
the policy advertised is approved and/or backed by government
officials, without disclosing that all policies and companies are.
9
CHAPTER 4
RESOLVING ETHICAL DILEMMAS
The following ten-step method can be used to improve decision- making abilities.
• What are the facts in the situation?
• Who are the key stakeholders, what do they value and what are
their desired outcomes?
• What are the underlying drivers causing the situation?
• In priority order, what ethical principles or operating values should
be upheld in this situation?
• Who should have input to, or be involved in, making this decision?
• List any alternative and action plans that would prevent or
minimize harm to the stakeholders, uphold the priority values for
the situation and be a good solution to the situation.
• Build a worst-case scenario for a preferred alternative to see how it
affects the stakeholders. Rethink and revise the preferred
alternative, if necessary.
• Add a preventative ethics element to the action plan that deals with
the underlying drivers causing the situation listed in Step 3.
• Evaluate the chosen decision and action plan against the Ethics
Checklist.
• Decide upon and build an action plan, and implement and monitor
it.
10
K EY Q UESTIONS TO ADDRESS ETHICAL DILEMMAS
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CHAPTER 5
THE INSURANCE PROFESSIONAL
LOFTY GOALS
A professional in the insurance industry must not only comply with the minimum
legal standards established by the state, but adhere to a set of high personal ethical
standards as well. Because of the very nature of the insurance business, clients must
have trust in their agent. If that trust is violated, both parties suffer. The agent loses
business and the client loses trust in the agent that can adversely affect the business
in general. Agents who are tempted by an individual or a situation to act in an
unethical manner must consider the long-term results of those actions, for both the
consumer and himself as well.
M AKING A DIFFERENCE
• An agent may provide the financial planning tools necessary to
enable a child to go to college;
• Assist business partners in designing a buy-sell agreement or
business continuance plan that will save the company in the event
of a partner's death, or casualty to the business;
• Assist a couple plan their retirement years, for a worry- free
retirement; and
• Provide a comfortable lifestyle for policyholder survivors, by
providing a product that was designed to enable them to remain in
their home, and continue their normal standard of living.
12
THE RIGHT STUFF
The agent has the responsibility of being as knowledgeable as possible about the products
and advice he presents to the consumer and therefore must:
• Understand the intricacies of insurance companies and their products;
• Be able to analyze individual needs and continue to support the
policyholder;
• Make appropriate recommendations to the client;
• Motivate people to take action; and
• Understand contractual obligations.
An agent is under constant demand to keep up with the changes in situations, rules,
regulations and products in order to stay on top of his profession and enjoy a lucrative
and successful career.
13
LIABILITY
Just as in one’s personal life, an agent must assume responsibility for any mistakes made
and make every effort to rectify the situation. Protection from liability exposure may be
provided through:
• Awareness and observation of applicable laws and insurance
regulations;
• Awareness of company standards and procedures;
• Performing such services as needs analysis, policy delivery, claims
investigations, etc., with extreme care and due diligence;
• Keeping the lines of communication open between customers and the
company, and quickly responding to their needs; and
• Continuously improving knowledge and skill.
On the other hand, an agent is most likely to encounter problems with errors and
omissions liability by failing to obtain the adequate and correct coverage for a client
and/or failing to maintain that coverage. However, if an agent stays current on products
and procedures, analyzes the needs of the customer, and properly services the customer,
these problems are likely to be avoided.
14
FEES AND COMMISSION
An agent earns commission on the sale of specific insurance products. An insurance
counselor makes recommendations about many products and collects a fee for his general
advice.
An agent mus t be careful not to make unduly influences on a client to purchase a certain
product just so that agent can collect his commission. Most agents recommend their own
company's products when the products are suitable for the client. Many states prohibit
agents from charging fees at all, and some states prohibit charging fees and collecting a
commission on the same policy. However, some states allow collection of both a fee and
commission, but these states have strict guidelines governing the practice. It is an agent’s
obligation to serve his client’s best interest by making objective recommendations and
analyses and therefore, if that agent receives both a commission and a fee from the same
policy, services provided to the client must go above and beyond just the sale of the
policy.
15
CHAPTER 6
THE AGENCY
16
• Implied consent is established through verbalization and occurs
when appropriate actions are taken to carry out the authority
granted to an agent in expressed consent in order to fulfill the
principal’s goals.
• Apparent consent occurs when a principal permits an agent to act
on its behalf without either expressed or implied authority. The
agent’s authority is in most cases limited and even though he may
make decisions on behalf of the principal, often these decisions
have limitations and are subject to the principal’s review.
Since the agent is licensed by the state and employed by the principal, the agent’s
business conduct is subject to scrutiny by both the state and the principal. He is expected
to maintain the highest level of trust and ethical conduct for both parties as well as for the
consumer he services. The agent thus becomes a fiduciary, an individual whose position
or responsibility is dependent upon public trust and confidence.
LOYALTY
A fiduciary always acts on behalf of the client’s best interest. An agent cannot
represent more than the interest of one principal, unless previously authorized. An
agent cannot represent the interest of more than one insurer without the full
knowledge and consent of all parties involved. He cannot receive personal financial
gain other than that specified in his agency agreement.
Full disclosure is critical to the welfare of the client. Should any information remain
undisclosed, the client cannot make a fully informed decision, therefore the client’s
needs are not serviced appropriately. Even if disclosure of an item could deter the
client from acting upon the agent’s recommendations, it is best to avoid any
potential conflicts of interest. It is the fiduciary’s responsibility to keep his ethics and
motivations unquestionable and intact.
TIMELINESS
The insurer’s obligations to the consumer are based on time schedules. Therefore, it
is imperative that all paperwork be submitted on a timely basis to limit the
principal’s risk in the case of a denial and to avoid delaying the underwriting process
for acceptance of a purchased product.
ACCOUNTABILITY OF FUNDS
According to the law, funds that are submitted to the agent are the same as if they
had been delivered directly to the insurance company. The insurance company is
responsible for those funds as soon as they are placed into the agent’s hands. Most
states require premiums to be held in premium funds trust accounts for a time
specified in the agent’s contract with the insurer (usually no more than 90 days). The
agent can then submit the premiums to the insurer, less his portion of commission
earned.
SOLE INTEREST
An agent must act in all transactions to avoid any potential conflict of interest
between himself, the insurer or the insured. An agent has an obligation to the insurer
to represent the product in a skillful and honest manner. Should there be any
misrepresentation wherein the insured’s decision was based on the
misrepresentation, intentional or not, the agent is liable for losses to the insurer, the
insured, or both.
It is the obligation of an agent to solicit business that represents the risk element that
his insurer is willing to take. To solicit higher risk business and omit or alter the
application in an effort to conceal the risk factor is unethical and not in keeping with
the fiduciary responsibility owed the principal.
18
COMPETITIVE FAIR PLAY
When the subject of a competing firm is brought up, it is in the best interest of the
industry not to defame the competitor, but stick to the issues of one product verses
another.
19
CHAPTER 7
CAPTIVE AGENTS VS. INDEPENDENT
AGENTS
AGENT TYPES
CAPTIVE AGENT
A Captive Agent is one who represents the interest of one or more companies and
sells their exclusive products for a commission and/or salary. The insurer owns and
maintains control of all accounts serviced by the agent and the agent must disclose
his interest in any similar business or service. It is up to the principal to determine if
there is a conflict of interest among the companies represented.
INDEPENDENT AGENT
20
THE PRINCIPAL'S OBLIGATION OF COMPENSATION
Compensation is usually dependent upon the nature of the business and whether it is
new or renewal business. It outlines the different rates for different lines of product
sold and a higher commission rate on new business as opposed to renewal business.
It is tempting sometimes to shift policyholders from one company to another at
renewal time for the higher commission rate, but the code of ethics would prohibit
any agent from doing so at the expense of his client.
INDEMNIFICATION OF AGENT
The principal indemnifies the agent from any costs and/or claims made against him
in the carrying out of his duties under his agency relationship with the principal.
However, if the agent is found guilty of breach of duty or is lacking in due diligence,
the agent would be subject to a potential lawsuit and or disciplinary action.
21
CHAPTER 8
POLICY ILLUSTRATIONS
DISCLOSURE
An indexed rate is the interest rate that may be tied to an average rate paid on certain
treasury bills, or the average rate of corporate bonds.
DECLARED RATES
The interest rate is dependent upon the insurance company's investment experience.
RATE CHANGES
A client must be advised about how often the rates may change.
22
RETURNS: METHODS OF CREDITING
PORTFOLIO M ETHOD
Polices are divided into blocks, each block beginning with the current rate at policy
issuance time, then blending with current rates as new premiums are received,
policies mature and/or are reinvested.
DIVIDENDS
The distribution of surplus earnings on policies that pay dividends is usually
accomplished by the contribution principle, whereby surplus is divided and distributed to
class of policy owners on a pro rata formula equal to the contribution each class made to
the surplus. The client should be advised if the insurer under consideration uses the
contribution of another method of distributing surplus earnings.
MORTALITY
The client must be advised whether or not mortality charges are based on current
experience or improvements in current experience.
EXPENSES
The client must be advised of the expenses associated with different types of policies.
VANISHING PREMIUMS
There comes a time in the life of a policy when premiums can be paid by dividends
and/or other accumulated cash values.
23
CHAPTER 9
CODES OF ETHICS
GUIDELINES FOR DEVELOPING A CODE OF ETHICS
• Relevant laws and regulations are reviewed;
• Values which produce the top three or four traits of a highly ethical and
successful service or product in the industry are reviewed;
• Values needed to address current issues in the industry are identified—
descriptions of major issues in the workplace or industry are collected;
• Evaluate the industry's strengths, weaknesses, opportunities and threats;
• Consider the top ethical values that might be prized by the consumer; and
• The top five to ten ethical values, which are high priorities in the industry,
are collected.
24
CHAPTER 10
INDUSTRY CODES OF ETHICS SAMPLES
It is the agent’s inherent role to combine professional duty to the client and to the
company.
To conduct my business in such a way that my example might help raise the professional
standards of those in my profession,
To keep informed with respect to applicable laws and regulations and to observe them in the
practice of my profession.
To cooperate with others whose services are constructively related to meeting the needs of my
clients.
25
NATIONAL ASSOCIATION OF HEALTH UNDERWRITERS
NAHU CODE OF ETHICS
• To hold the selling, service and administration of health insurance
and related products and services as a professional and public trust
and do all in my power to maintain its prestige.
• To keep paramount the needs of those whom I serve.
• To respect my clients’ trust in me, and to never do anything which
would betray their trust or confidence.
• To give all service possible when service is needed.
• To present policies factually and accurately, providing all
information necessary for the issuance of sound insurance
coverage to the public I serve.
• To use no advertising which I know may be false or misleading.
• To consider the sale, service and administration of health
insurance and related products and services as a career, to know
and abide by the laws of any jurisdiction Federal and State in
which I practice and seek constantly to increase my knowledge
and improve my ability to meet the needs of my clients.
• To be fair and just to my competitors, and to engage in no
practices which may reflect unfavorably on myself or my
industry.
• To treat prospects, clients and companies fairly by submitting
applications which reveal all available information pertinent to
underwriting a policy.
• To extend honest and professional conduct to my clients,
associates, fellow agents and brokers, and the company or
companies whose products I represent.
The Code is founded upon the crucial ethics of competent advice and service to the client
and enrichment of public regard for the CLU and ChFC designations. The purpose of the
Code is to provide standards of professional conduct by those involved in providing
insurance, financial planning and economic security.
26
The Code is supported by Guides, which give specificity to the imperatives, with
interpretive comment to assist in understanding. A member is in violation of the Code
when a member has breached an ethical imperative through failure to adhere to one or
more of the Guides. Those who have chosen to enter into membership in the American
Society voluntarily bind themselves to the Code of Ethics of their professional
organization and any violation would expose a member to sanctions, which range from
reprimand to membership revocation.
Guide 1.1: A member shall provide advice and service, which are in the client's best interest.
Guide 1.2: A member shall respect the confidential relationship existing between client and
member.
Guide 1.3: A member shall continue his education throughout his professional life.
Second Imperative: To enhance the public regard for professional designations and allied
professional degrees held by members . . .
Guide 2.1: A member shall obey all laws governing his business or professional activities.
Guide 2.2: A member shall avoid activities which detract from the integrity and
professionalism of the Chartered Life Underwriter designation, the Chartered
Financial Consultant designation, or any other allied professional degree or
designation held by members.
Guide 2.3: A member shall encourage others to attain the Chartered Life Underwriter and/or
the Chartered Financial Consultant designations.
Guide 2.4: A member shall avoid using the Chartered Life Underwriter or Chartered
Financial Consultant designation in a false or misleading manner.
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MILLION DOLLAR ROUND TABLE
Members of the Million Dollar Round Table should be ever mindful that
complete compliance with and observance of the Code of Ethics of the
Million Dollar Round Table shall serve to promote the highest quality
standards of membership. These standards will be beneficial to the public
and the life insurance industry, and its related financial products. Therefore,
members shall:
I. Always place the best interests of their clients above their own direct
or indirect interests.
II. Maintain the highest standards of professional competence and give
the best possible advice to clients by seeking to maintain and improve
professional knowledge, skills and competence.
III. Hold in the strictest confidence, and consider as privileged, all
business and personal information pertaining to their clients' affairs.
IV. Make full and adequate disclosure of all facts necessary to enable
their clients to make informed decisions.
V. Maintain personal conduct which will reflect favorably on the life
insurance industry and the Million Dollar Round Table.
VI. Determine that any replacement of a life insurance or financial product
must be beneficial for the client.
VII. Abide by and conform to all provisions of the laws and regulations in
the jurisdictions in which they do business.
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GENERAL AGENTS AND MANAGERS ASSOCIATION (GAMA)
STATEMENT OF PRINCIPLES
BECAUSE the institution of life insurance renders an economic and social service
that is unique and of great benefit to society, because it is a trusteeship that requires
constant service, and because matters that affect its progress are of vital concern to
all, and because the representatives of life insurance constitute its most important
liaison with the public which it serves; and because it is of the utmost importance to
maintain the high ethical standards of the institution of life insurance;
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• To encourage membership in and support the local Association of Life
Underwriters by attendance and participation in meetings and activities
and to follow their rules of conduct.
• To present fairly and honestly, and without exaggeration, all facts which a
prospective sales associate or manager should have in determining
whether to accept a contract with my field organization.
• To urge any sales associate or manager with whom I am discussing
potential employment to review the sales associate's or manager's current
employment situation with the sales associate's present general sales
associate or manager before reaching a decision.
• To take a leadership role in advocacy of the field organization distribution
system and in the fundamental belief that life and disability insurance are
upon death, disability, old age and during emergencies the best products to
provide cash and income when most needed by my fellow citizens who
seek self-determination and personal freedom.
• In general, I shall endeavor and encourage others to practice the "Golden
Rule" in all aspects of our professional lives and, in so doing, strive to
gain the respect of our contemporaries and lift our profession to the
highest level of public esteem.
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• Members must be fitted, by knowledge and experience, for the
work they undertake. They must not endanger the interests of the
public adjusting profession, or risk injustice to assureds or to the
Insurance Companies, by attempting to handle losses or claims for
which they are not qualified, and for which they cannot find
competent technical assistance.
• Members shall not engage in the unauthorized practice of law.
• Members shall not acquire any interest in salvaged property or
participate in any way, directly or indirectly, in the reconstruction,
repair or restoration of damaged property, except with the
knowledge consent and permission of the assured.
• Members shall be cooperative and assist one another in every
possible way.
• Members shall not disseminate or use any form of agreement,
advertising, or any printed matter that is harmful to the profession
of public adjusting, or which does not comply with the rules and
regulations of the Insurance Department of the state in which such
member is professionally engaged, or which might subject public
adjusting and public adjusters to criticism or disrespect.
CANON 1
CPCUs Should Endeavor at All Times to Place the Public Interest Above Their
Own.
Rules of Professional Conduct
CANON 2
R2.1 A CPCU shall keep informed on those technical matters that are
essential to the maintenance of the CPCU’s professional competence in
insurance, risk management or related fields.
CANON 3
CPCU’s Should Obey All Laws and Regulations, and Should Avoid Any Conduct
or Activity Which Would Cause Unjus t Harm to Others.
Rules of Professional Conduct
CANON 4
CANON 5
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Rules of Professional Conduct
CANON 6
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CANON 7
CANON 8
CPCU’s Should Honor the Integrity and Respect the Limitations Placed Upon the
Use of the CPCU Designation.
Rules of Professional Conduct
R8.1 A CPCU shall use the PCU designation and the CPCU key only in
accordance with the relevant guidelines promulgated by the American
Institute.
R8.2 A CPCU shall not attribute to the mere possession of the
designation depth or scope of knowledge, skills and professional
capabilities greater than those demonstrated by successful completion of
the CPCU program.
R8.3 A CPCU shall not make unfair comparisons between a person who
holds the CPCU designation and one who does not.
R8.4 A CPCU shall not write, speak, or act in such a way as to lead
another reasonably to believe the CPCU is officially representing the
American Institute, unless the CPCU has been duly authorized to do so by
the American Institute.
CANON 9
R9.1 A CPCU shall not initiate or support the CPCU candidacy of any
individual known by the CPCU to engage in business practices which
violate the ethical standards prescribed by this Code.
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R9.2 A CPCU possessing unprivileged information concerning an
alleged violation of this Code shall, upon request, reveal such information
to the tribunal or other authority empowered by the American Institute to
investigate or act upon the alleged violation.
R9.3 A CPCU shall report promptly to the American Institute any
information concerning the use of the CPCU designation by an
unauthorized person.
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