Key Takeaways
- NC General Statutes Chapter 58 prohibits misrepresentation, false advertising, and unfair claims practices
- Rebating is prohibited in North Carolina with limited exceptions
- Twisting and churning are prohibited practices subject to license revocation and fines
- North Carolina requires claims to be handled promptly and in good faith
- Unfair discrimination in underwriting is prohibited except for actuarially justified factors
Unfair Trade Practices
NC General Statutes Chapter 58 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 |
| "Beach Plan is same as regular coverage" | Coverage differs |
False Advertising
North Carolina 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
- 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
Limited Exceptions
North Carolina allows some limited exceptions:
- De minimis promotional items (nominal value)
- Legitimate filed discounts
- Dividends specified in policy
Exam Tip: Rebating is generally prohibited in North Carolina. Know what constitutes rebating vs. legitimate practices.
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 | Substantial fines |
| Pattern of violations | License revocation |
| Consumer harm | Restitution required |
Unfair Claims Practices
North Carolina has specific claims handling requirements:
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
- Refusing to pay claims without reasonable basis
Good Faith Requirements
North Carolina insurers must:
- Investigate claims promptly
- Communicate honestly with claimants
- Pay valid claims without unreasonable delay
- Explain claim denials clearly
- Not engage in bad faith claims practices
Unfair Discrimination
North Carolina prohibits unfair discrimination in P&C insurance:
Prohibited Factors
Cannot discriminate based on:
- Race
- Color
- Religion
- National origin
- Sex (with actuarial exceptions)
- Marital status (with exceptions)
Permitted Underwriting Factors
- Driving record
- Claims history
- Credit information (with disclosures)
- Territory
- Years of experience
- Age (with actuarial justification)
Which of the following is considered rebating in North Carolina?
What is "twisting" in North Carolina insurance law?