Key Takeaways
- MISREPRESENTATION is making false or misleading statements about policy terms, benefits, coverage, or the insurer's financial condition
- TWISTING is using misrepresentation to induce a policyholder to replace an existing policy with a new one from a DIFFERENT insurer
- CHURNING is repeatedly replacing policies with the SAME insurer to generate new commissions
- REBATING is offering anything of value not specified in the policy as an inducement to purchase—illegal in most states
- UNFAIR discrimination (based on race, religion, etc.) is prohibited; discrimination based on legitimate risk factors (claims history, driving record) is LEGAL
Unfair Trade Practices
All states have adopted versions of the NAIC Unfair Trade Practices Act. These practices are PROHIBITED and can result in fines, license suspension, or revocation.
Misrepresentation
Definition: Making false or misleading statements about:
- Policy terms, benefits, coverage, or exclusions
- Dividends or future returns
- Financial condition of insurer
- Premium amounts or payment terms
- Legal requirements to purchase insurance
Example: Telling a client that collision coverage includes mechanical breakdown (it doesn't).
Twisting
Definition: Misrepresenting policy terms to induce a policyholder to lapse/cancel existing coverage and purchase a new policy from a DIFFERENT insurer.
| Element | Requirement |
|---|---|
| Misrepresentation | Must involve false or deceptive statements |
| Different Insurer | Typically involves replacing with competitor's policy |
| Intent | To generate new commission |
Example: Falsely claiming a client's current policy "is about to be cancelled" to sell them a new policy.
Churning
Definition: Repeatedly replacing policies with the SAME insurer to generate new commissions.
| Twisting | Churning |
|---|---|
| Different insurer | Same insurer |
| Misrepresentation required | Uses policy values to fund new policy |
| Competition-based | Commission-based |
Example: Every few years, convincing a client to cash in their policy and buy a new one from the same company.
Rebating
Definition: Offering anything of value not specified in the policy as an inducement to purchase.
Examples of Rebating (Prohibited)
- Returning part of commission to buyer
- Paying buyer's premium for a period
- Giving expensive gifts ($25-$100+ depending on state)
- Providing free services not available to all
Allowed Practices
- Policy dividends (specified in contract)
- Nominal promotional items (pens, calendars, typically <$25)
- Published rate reductions available to all
Why Prohibited: Rebating creates unfair discrimination—one buyer gets something others don't.
Unfair Discrimination
Prohibited (Unfair) Discrimination
| Factor | Status |
|---|---|
| Race, color, religion | PROHIBITED |
| National origin | PROHIBITED |
| Gender (for most coverages) | PROHIBITED |
| Marital status (varies) | PROHIBITED in many states |
Legal Underwriting Discrimination
| Factor | Status |
|---|---|
| Loss experience/risk | LEGAL |
| Claims history | LEGAL |
| Driving record (auto) | LEGAL |
| Credit score (where permitted) | LEGAL |
| Occupation | LEGAL |
Exam Key: The word "unfair" is critical. Discrimination based on legitimate, actuarially-justified risk factors is permitted and necessary.
Other Prohibited Practices
Defamation
Making false statements about another insurer or producer.
- Libel: Written defamatory statements
- Slander: Spoken defamatory statements
Coercion and Intimidation
- Threatening to cancel existing coverage unless additional coverage purchased
- Forcing mortgagor to buy from specific company
- Using threats to prevent policyholder from switching insurers
Controlled Business
Writing insurance primarily on own property, family, or business associates.
- Typically limited to 25-50% of total premiums
- Producer should serve general public, not just personal connections
What is the difference between twisting and churning?
An insurance producer offers to give a client a $200 gift card if they purchase a policy. This is an example of:
An insurer charges higher premiums to drivers with multiple at-fault accidents. This is:
12.4 Claims Settlement Practices
Continue learning