Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This regulation effectuates and aids in the
interpretation of the provisions of section 375.141.1(8), RSMo, which relates
to the competence and trustworthiness of insurance producers. The regulation
requires insurance producers to comply with certain minimum requirements in
transactions involving personal insurance policies. It is promulgated pursuant
to the provisions of section
374.045,
RSMo and implements the provisions of section
375.141,
RSMo.
(1) Document and
Premium Handling Standards. When dealing with any personal insurance policy,
every insurance producer shall comply with the following standards of
promptness regarding securing and amending coverage, providing written evidence
of insurance transactions, and handling premiums, except to the extent these
actions are the responsibility of the insurer. Where it is the insurer's
responsibility to take these actions, this responsibility shall be delineated
in a written document, a copy of which shall be retained by the licensee and
available for examination by the department.
(A) Every insurance producer shall handle
every application for new coverage under a personal insurance policy and every
request for amendments to an existing policy in a manner which will secure the
new or amended coverage as soon as is reasonably possible, unless a longer time
is permitted under a written agreement between the licensee and the insured or
prospective insured. If within thirty (30) days of the original application for
insurance the licensee has not yet secured an insurer willing to provide
coverage, the licensee immediately shall inform the prospective insured of this
fact in writing.
(B) Whenever an
insurer requires additional information prior to issuing a new personal
insurance policy, or prior to renewing, continuing, or amending an existing
policy, the insurance producer through whom the insured or prospective insured
applied for or procured the coverage shall inform, at the earliest reasonable
opportunity, the insured or prospective insured of the need for the additional
information from the insured or prospective insured.
(C) Every insurance producer shall provide
every purchaser of a personal insurance policy with written evidence of
coverage at the time coverage is bound or the policy is issued, whichever
occurs earlier, or as soon after as is reasonably possible, but in no event
later than thirty (30) days after the date the coverage is bound or the policy
is issued. A written binder or insurance policy shall constitute written
evidence of coverage for purposes of this subsection. Any application forms,
riders, or endorsements associated with the policy which are not provided along
with written evidence of coverage shall be provided to the insured as soon as
is reasonably possible. When an insurer declines to cover a prospective
insured, the insurer's written denial of coverage shall be provided by the
licensee to the prospective insured as soon as is reasonably possible, but in
no event later than thirty (30) days after the date the coverage is
denied.
(D) Insurance producers
shall remit all premium payments associated with a personal insurance policy to
those persons entitled to them as soon as is reasonably possible after their
receipt by the licensee, but in no event later than thirty (30) days after the
date of receipt, provided, however, that premiums may be remitted at a later
point in time if the licensee is so authorized under a written agreement
between the licensee and the person legally entitled to the premiums. In no
event, however, shall a licensee retain premium payments if to do so will
result in the failure to obtain or continue coverage on behalf of an insured or
prospective insured.
(2)
No insurance producer or a member of the insurance producer's immediate family
shall, at any time, be named as a beneficiary or contingent beneficiary or
shall acquire any ownership interest in any insurance policy held by an
insurance client or former or prospective insurance client. Such a prohibition
would not apply if there exists a relationship between the insurance client or
former or prospective insurance client and the insurance producer or immediate
family of the insurance producer which gives rise to an insurable
interest.
(3) No insurance producer
shall obtain or solicit for a loan from an insurance client or former or
prospective insurance client or any type of ownership interest in any insurance
policy held by an insurance client or former or prospective insurance client.
This prohibition shall not apply-
(A) When it
is the usual occupation or practice of the insurance client or former or
prospective insurance client to receive and process loan applications and to
provide loans to the public as an owner, officer, director, or employee of an
institution in the business of providing such loans; or
(B) When there exists a relationship between
the insurance client or former or prospective insurance client and the
insurance producer which gives rise to an insurable interest.
(4) Receipts for Cash Premiums
Payments.
(A) Whenever a cash premium payment
is received by an insurance producer for a personal insurance policy, a written
receipt shall be executed by the licensee and given to the person making the
premium payment. The receipt shall bear the words Receipt or Premium Receipt
and shall include the following information:
1. The name of the insured;
2. The name of the insurer, where one (1) has
been selected;
3. The date of the
cash payment;
4. The amount of the
cash payment;
5. The policy number,
if available, or other information which will describe the insurance coverage
for which the cash premium was paid;
6. The signature of the licensee or an
employee of the licensee duly authorized in writing to accept these payments or
to execute the receipts; and
7. Any
comment required under subsection (4)(D) of this rule.
(B) Use of the form, Exhibit A, included
herein, shall be deemed to satisfy the requirements of this section. Other
receipt forms which contain the information required by this section may also
be used. Methods of documenting the payment of premiums which do not satisfy
all the requirements of this section, such as the use of premium payment books
for debit plans, shall be deemed to satisfy this section only if their use for
this purpose has been approved in writing by the director.
(C) A copy of the cash premium receipt shall
be given to the person making the cash premium payment. An additional copy
shall be retained by the licensee for the licensee's records as provided in
section (5) of this regulation, unless other records of the licensee and the
insurer document the information required under subsections (4)(A) and (D) of
this rule for purposes of inspections or examinations by the
director.
(D) No insurance producer
shall accept a cash premium payment for new coverage under a personal insurance
policy where the licensee has not selected an insurer with whom to place the
coverage unless the cash premium receipt bears a comment indicating that an
insurer has not yet been selected and that coverage currently does not yet
exist.
(5) Minimum
Record Keeping Requirements for all Insurance Producers.
(A) Every insurance producer shall maintain a
complete set of records for each personal insurance policy applied for or
procured through the licensee, except to the extent the maintenance of these
records is, in whole or in part, the responsibility of the insurer. Where it is
the insurer's responsibility to maintain these records, this responsibility
shall be delineated in a written document(s), a copy of which shall be retained
by the licensee. The records which must be maintained shall include, but not be
limited to, the following:
1. Any policy
applications, declaration pages, endorsements, riders, or binders associated
with the policy;
2. Any written
correspondence or copies of records transmitted to or received by the licensee
concerning the policy;
3. Any
documents associated with any claims filed with the licensee under the policy;
and
4. Any receipts or other
documents associated with any premium payments made to the licensee under the
policy, including receipts for cash premium payments required under section (4)
of this regulation.
(B)
The records required to be maintained under this section shall be open to the
inspection or examination of the director or his/her agents, and shall be
maintained in an orderly manner so that the information in the records is
readily available during the inspection or examination. The requirement of this
subsection shall be deemed satisfied whenever a requested record can be
retrieved from its storage location within five (5) business days of a request
by the director or the director's designee.
(C) An insurance producer operating under an
exclusive contract with an insurer, including one (1) insurer and its
subsidiaries or affiliates, upon termination of the agency appointment, shall
be required to maintain only those records as the contract authorizes him/her
to retain, provided that the insurer shall bear responsibility for maintaining
all other records which otherwise would have been required to be maintained by
the insurance producer.
(D) All
records required to be maintained under this section shall be maintained for as
long as the personal insurance policy in question is in force and for at least
three (3) years thereafter.
(6) It shall be a dishonest or unethical
practice in the business of insurance for an insurance producer to use a
senior-specific certification or professional designation that indicates or
implies in such a way as to mislead a purchaser or prospective purchaser that
the insurance producer has special certification or training in advising or
servicing seniors in connection with the solicitation, sale, or negotiation of
an insurance product, or in the provision of advice as to the value of or the
advisability of purchasing or selling an insurance product, either directly or
indirectly through publications or writings, or by issuing or promulgating
analyses or reports related to an insurance product.
(A) The prohibited use of such certifications
or professional designation includes, but is not limited to, the following:
1. Use of a certification or professional
designation by a person who has not actually earned or is otherwise ineligible
to use such certification or designation;
2. Use of a nonexistent or self-conferred
certification or professional designation;
3. Use of a certification or professional
designation that indicates or implies a level of occupational qualifications
obtained through education, training, or experience that the insurance producer
using the certification or professional designation does not have;
and
4. Use of a certification or
professional designation that was obtained from a designating or certifying
organization that:
A. Is primarily engaged in
the business of instruction in sales or marketing;
B. Does not have reasonable standards or
procedures for assuring the competency of its certificants or
designees;
C. Does not have
reasonable standards or procedures for monitoring and disciplining its
certificants or designees for improper or unethical conduct; or
D. Does not have reasonable continuing
education requirements for its certificants or designees in order to maintain
the certificate or designation.
(B) There is a rebuttable presumption that a
designating or certifying organization is not disqualified solely for purposes
of paragraph (6)(A)4. above, when the designation or certification from the
organization does not primarily apply to sales or marketing and when the
organization has been accredited by:
1. The
American National Standards Institute (ANSI);
2. The National Commission for Certifying
Agencies; or
3. Any organization
that is on the United States Department of Education's list entitled
"Accrediting Agencies Recognized for Title IV Purposes."
(C) In determining whether a combination of
words (or an acronym standing for a combination of words) constitutes a
certification or professional designation indicating or implying that an
adviser has special certification or training in advising or servicing senior
citizens or retirees, factors to be considered shall include:
1. Use of one or more words, such as
"senior," "retirement," "elder," or like words, combined with one or more
words, such as "certified," "registered," "chartered," "adviser," "specialist,"
"consultant," "planner," or like words, in the name of the certification or
professional designation; and
2.
The manner in which those words are combined.
(D) For purposes of this rule-
1. "Certification or professional
designation" does not include a job title within an organization that is
licensed or registered by a state or federal financial services regulatory
agency, when that job title:
A. Indicates
seniority or standing within the organization; or
B. Specifies an individual's area of
specialization within the organization;
2. "Elderly or senior person" is a person
sixty (60) years of age or older; and
3. "Federal financial services regulatory
agency" includes, but is not limited to, any agency that regulates-
A. Insurers;
B. Insurance producers;
C. Broker-dealers;
D. Investment advisers; or
E. Investment companies as defined under the
Investment Company Act of 1940.
(E) Nothing in this rule shall limit the
director's authority to enforce existing provisions of law.
(F) This section shall take effect on January
1, 2009.
EXHIBIT A
PREMIUM RECEIPT
Amount of payment: $ ______________ . __________ Date of
Payment: __________ / __________ / _________
Name of Insurance Company:
________________________________________________________________
Policy Number or Description:
_______________________________________________________________
Name of Insured:
__________________________________________________________________________
Comment:
_________________________________________________________________________________
Insurance Producer's Signature:
________________________________________________________________________
KEEP THIS RECEIPT AS PART OF YOUR RECORDS FOR YOUR
OWN PROTECTION.
*Original authority: 374.045, RSMo 1967, amended 1993, 1995
and 375.141, RSMo 1961, amended 1965, 1967, 1981, 1984, 1989, 1993,
2001.
