State Insurance Regulations Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 State Insurance Regulations flashcards as text
Under state workers' compensation regulations, what does the 'exclusive remedy' doctrine mean for injured employees?
Answer: Workers' comp benefits are the sole remedy against the employer for work-related injuries
The exclusive remedy doctrine bars employees from suing their employer in tort for work-related injuries; workers' compensation is the sole remedy against the employer.
A state insurance regulation requires insurers to maintain claims files for a minimum of how many years after final disposition in most jurisdictions?
Answer: 5 years
Most states require insurers to retain claims files for a minimum of 5 years after final disposition, though some states require longer retention periods.
Under state market conduct examination authority, which activity are examiners specifically authorized to review?
Answer: Claims handling practices, policy issuance, and marketing activities
Market conduct examiners review a broad range of insurer activities including claims handling, underwriting, policy forms, rating, and marketing practices.
Which of the following best describes a 'prior approval' state for insurance rates?
Answer: Insurers must receive state approval before implementing a new rate
In a prior approval state, insurers must submit rates and receive regulatory approval before those rates can be used in the market.
Under the state-based insurance regulatory system, which NAIC model law establishes standards for the investigation and settlement of claims?
Answer: Unfair Claims Settlement Practices Act (UCSPA)
The NAIC's Unfair Claims Settlement Practices Act model law sets minimum standards for claims investigation and settlement that most states have adopted.
When a state statute requires an insurer to pay 'first-party' medical payments (MedPay) regardless of fault, this coverage operates on what basis?
Answer: No-fault basis — coverage pays the insured's medical bills without regard to liability
Medical payments coverage operates on a no-fault basis, reimbursing the insured's medical expenses without requiring proof of another party's liability.
Under state regulation, an insurer that fails to comply with a Market Conduct Examination order may face which consequence?
Answer: Administrative fines, license suspension, or revocation
State insurance departments can impose administrative fines, suspend, or revoke an insurer's license for non-compliance with market conduct examination orders.