Key Takeaways
- The Illinois Insurance Code prohibits misrepresentation, false advertising, and unfair claims practices
- Rebating is prohibited in Illinois with no exceptions
- Twisting and churning are prohibited practices subject to license revocation and fines
- Illinois requires claims to be acknowledged within 15 days and investigated within 45 days
- Unfair discrimination in underwriting is prohibited except for actuarially justified factors
Unfair Trade Practices
The Illinois Insurance Code (215 ILCS 5) prohibits various unfair or deceptive practices in the P&C insurance industry.
Misrepresentation
Producers and insurers are prohibited from:
False Statements
- Making false statements about policy terms or benefits
- Misrepresenting the financial condition of an insurer
- Using misleading policy illustrations
- Making false statements about competitors
- Misrepresenting the nature of insurance transactions
Examples of Misrepresentation
| Prohibited Statement | Why It's Misrepresentation |
|---|---|
| "This policy covers everything" | No policy covers all losses |
| "Your rates will never increase" | Rates can and do change |
| "This is the only policy you need" | May not be true |
| "You must buy today or lose rate" | False urgency |
| "FAIR Plan is same as regular coverage" | Coverage differs |
False Advertising
Illinois prohibits deceptive insurance advertising:
- Ads must be truthful and not misleading
- Must clearly identify as insurance advertisement
- Cannot use testimonials that are not genuine
- Cannot imply government endorsement
- Must include insurer's name
- Cannot guarantee claims payment beyond policy terms
Rebating
Rebating is offering inducements not specified in the policy:
Prohibited (No Exceptions in Illinois)
- Returning part of premium to insured
- Offering gifts of substantial value
- Paying for referrals to non-licensed persons
- Sharing commission with non-licensed persons
- Any valuable consideration not in the contract
Exam Tip: Illinois has NO rebating exceptions. Even small gifts that are not available to all insureds are technically prohibited.
Not Rebating
- Premium financing arrangements
- Legitimate filed discounts
- Dividends specified in policy
- Promotional items of nominal value available to all
Twisting and Churning
Twisting
Making misrepresentations to induce replacement:
- Falsely claiming existing policy is inadequate
- Misrepresenting policy values
- Hiding costs of replacement
- Exaggerating benefits of new policy
Churning
Excessive replacement of policies to generate commissions:
- Multiple replacements for same client
- Pattern of replacements in book of business
- Ignoring client's best interests
Penalties
| Violation | Potential Penalty |
|---|---|
| First offense | Warning to suspension |
| Per violation | Fines up to $50,000 |
| Pattern of violations | License revocation |
| Consumer harm | Restitution required |
Unfair Claims Practices
Illinois has specific claims handling requirements:
Claims Timeline Requirements
| Action | Timeframe |
|---|---|
| Acknowledge claim | 15 days |
| Begin investigation | Upon receipt |
| Complete investigation | 45 days (extensions available) |
| Accept or deny claim | Within reasonable time after investigation |
| Pay claims | Promptly after settlement |
Prohibited Claims Practices
- Misrepresenting policy provisions to claimants
- Failing to acknowledge claims promptly
- Failing to communicate claim decisions
- Denying claims without reasonable investigation
- Offering substantially less than reasonable value
- Delaying payment to force settlement
- Not attempting good faith settlement when liability clear
Unfair Discrimination
Illinois prohibits unfair discrimination in P&C insurance:
Prohibited Factors
Cannot discriminate based on:
- Race
- Color
- Religion
- National origin
- Physical or mental disability (with exceptions)
- Sexual orientation
- Gender identity
Permitted Underwriting Factors
- Driving record
- Claims history
- Credit-based insurance scores (with disclosures and limitations)
- Territory
- Years of experience
- Property characteristics
Within how many days must an Illinois insurer acknowledge receipt of a P&C claim?
Which of the following is a prohibited practice in Illinois?