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27 Cards in this Set
- Front
- Back
Knowing insurance specific and general legal principles provides the foundation for understanding:
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1-Legal basis of liability
2-Reasons that insurance policies contain provisions 3-Contractual obligations of insureds and insurers |
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Paul vs Virgina
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1869, established that insurance is a contract delivered locally and governed by state law rather than federal
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South Eastern Underwriters Case
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1944, Supreme Court case which ruled that federal law applies in insurance in some cases
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Three most common ways to classify US law
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1-Criminal or Civil Law
2-by Subject Matter 3-as either Substantive or Procedural Law |
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Five sources of law for the each of the fifty-one legal systems of the US
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1-A Constitution
2-The Legislative Branch 3-The Judicial Branch 4-The Executive Branch 5-Administrative Agencies |
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List 4 provisions (other than checks and balances) to the US Constitution relevant to the insurance business
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1- Delegation of powers to Congress
2-Commerce Clause 3-Due Process Clause 4-Equal Protection Clause |
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Original or Federal jurisdiction rests with the Federal courts in the following three cases
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1-Cases involving maritime law
2-Lawsuits in which citizens of different states claim land under grants by different states 3-Cases involving a legal minimum amount in damages between citizens of different states or between citizens of one state and a foreign state |
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Courts in contract cases apply the law of the state with the most significant relationship to the case. In determining the state, the courts consider the following:
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1-Where the parties to the contract live
2-Where the parties entered into the contract 3-Where the parties are to perform the contract |
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The legislative delegation of rulemaking power to an administrative agency is constitutional as long as it meets the following three conditions:
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1-The legislation carefully defines the scope of the delegated power
2-The agency exercises its rulemaking power within the defined scope 3-The rules are subject to judicial review |
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Parties to lawsuits use three discovery tools:
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1-Depositions (oral exam)
2-Interrogatories (written) 3-Motions to produce (physical evidence) |
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Jurisdictions may allow one or both of the following two kinds of verdicts
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1-General Verdict
2-Special Verdict |
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Any time during trial, the judge may take the case from the jury by any one of these actions
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1-Issuing a direct verdict
2-Declaring a mistrial 3-Declaring a nonsuit |
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Agencies rulemaking function: Agencies promulgate the following 3 rules:
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1-Legislative rules
2-Interpretative rules 3-Procedural rules |
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Model State Adminstrative Procedure Act (MSAPA) requires agencies to adhere to 3 basic steps
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1-Publish a notice of intent to adopt a regulation
2-Provide opportunity for public comment 3-Publish the final regulation |
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After agency has reviewed all comments about proposed rule, it can do one of the following:
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1-Adopt the originally proposed rule
2-Make minimal or extensive changes 3-Nullify the proposed rule |
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Agencies Adjudicatory function, Appropriate notice (due process) requires the following 4 points:
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1-Statement of hearing time, place and nature
2-Statement of the hearing's legal authority and jurisdiction 3-Reference to the particular statute or rule involved 4-A short, clear statement of the matters at issue |
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The US Constitution places the following limitations on agency investigations
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1-Fourth Amendment protection against unreasonable searches and seizures
2-Fifth Amendment protection against self-incrimination |
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Judicial review of a case can occur only after the following two requirements have been met
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1-The agency has issued a final order in the case
2-The doctrine called exhaustion of administrative remedies must apply |
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A court can set aside agency action on the following 5 grounds
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1-The action was arbitrary and capricious
2-The action was unconstitutional 3-The action violated statutory authority 4-The action violated agency procedural rules or was illegal 5-The action is unsupportable by substantial evidence in the record |
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The three goals of The Freedom of Information Act of 1966
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1-To ensure an informed citizenry
2-To prevent criminal misuse of information 3-To hold government accountable for the governed |
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McCarran-Ferguson
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permits each state to regulate the business of insurance conducted within its borders
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Federal laws have governed insurance only when one of the following 3 scenerios applies
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1-A federal law applies only to the business of insurance
2-A federal law affects insurers activity that falls outside insurance 3-The state has no law the regulates an aspect of the business of insurance covered by a federal law |
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Three arguments of federal regulation
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1-Fed reg would provide regulatory uniformity across states
2-Fed regulation is more efficient 3-Fed regulation would attract higher-quality personnel |
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Three arguments opposing federal regulation
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1-State regulation more responsive to local needs
2-Unifomity of state laws can be attained through the NAIC 3-Greater opportunities for innovation are possible with state regulation |
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DOI commissioner's responsibilities include (5)
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1-Licensing insurers
2-Monitoring insurer solvency 3-Renewing insurer investments 4-Approving policy forms 5-Setting or approving rates |
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Name (5) of the NAIC's many developed and adopted uniform laws
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1-Competetive rating
2-Reinsurance credit 3-Unfair trade practices 4-Unfair claim settlement 5-Producer licensing |
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The licensing process package must include the following 4 things
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1-Description of insurer management
2-Insurer history 3-List of states in which the insurer is licensed 4-Types of insurance the insurer has written |