California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 5.9 - Privacy of Nonpublic Personal Information
Article 5 - Additional Provisions
Appendix A - Sample Clauses
If applicable, a licensee may use the following sample clauses in its notices. A group of financial holding company affiliates using a common privacy notice may use these clauses if accurate for each company. These clauses are not exclusive. (Note that disclosure of certain information, such as assets, income and information from a consumer reporting agency, may result in obligations under the federal Fair Credit Reporting Act.)
Categories of information collected
The following language may be used to describe the categories of personal information collected.
We collect personal information about you from:
* Applications or other forms you complete;
* Your business dealings with us and other companies; and
* Consumer reporting agencies.
Categories of information disclosed
The following language may be used to describe the categories of personal information disclosed.
Alternative 1:
We may disclose the following personal information about you:
* Information from your application or other forms, such as your name, address, social security number, assets, income, and beneficiaries;
* Information about your transactions with us, our affiliates or others, such as your policy coverage, premiums, and payment history; and
* Information from consumer reporting agencies, such as your credit history.
Alternative 2:
We may disclose all the information that we collect about you.
To whom information is disclosed
The following language may be used to describe the persons to whom the licensee discloses information.
Alternative 1:
We do not disclose any personal information about you to anyone unless allowed by law. The law allows us to share your financial information with our affiliates to market products or services to you. You cannot prevent those disclosures.
Alternative 2:
We may disclose personal information about you to:
* Financial companies, such as life insurers, automobile insurers, mortgage bankers, securities broker-dealers, and insurance agents;
* Companies, such as retailers, direct marketers, airlines, and publishers; and
* Others, such as non-profit organizations.
Alternative 3:
We may also disclose personal information about you as allowed by law. The law allows us to share your financial information with our affiliates to market products or services to you. You cannot prevent those disclosures.
Explanation of opt out right
The following language may be used to explain the consumer's right to opt out of the disclosure of personal financial information to nonaffiliated third parties and how the consumer may exercise that right, when the licensee discloses personal information as permitted by California Insurance Code Section 791.13(k)(2).
If you don't want us to disclose personal information about you to nonaffiliated companies, you may tell us so. This is known as "opting out". If you wish to opt out, call us at 1-800___-__________ or complete and return the enclosed form. We may share information about you if we do not hear from you within 30 days. However, you may opt-out at any time. Just call or write us. Even if you opt-out, we may still disclose information as allowed by law. This includes disclosing information to our affiliates to market other products or services to you.
Confidentiality and security
The following language may be used to describe how a licensee protects the confidentiality and security of personal information.
We protect your nonpublic personal information. The only employees who have access to that information are those who must have it to provide products or services to you.
