D.C. Mun. Regs. tit. 26, r. 26-A199
For the purposes of this chapter, the following words and phrases shall have the meanings ascribed:
Birth month - The month of the calendar year in which an individual insurance producer, or an applicant for licensure as an individual insurance producer, was born.
Car rental limited line insurance - Insurance offered, sold, or solicited in connection with and incidental to the rental of rental cars for a period of up to sixty (60) days, whether at the rental office or by pre-selection of coverage in master, corporate, group, or individual agreements that:
(a) Is non-transferable;
(b) Applies only to the rental car that is the subject of the rental agreement; and
(c) Is limited to the following kinds of insurance:
(1) Personal accident insurance for renters and other rental car occupants, for accidental death or dismemberment, and for medical expenses resulting from an accident that occurs during the rental period;
(2) Liability insurance that provides protection to the renters and other authorized drivers of a rental car for liability arising from the operation or use of the rental car during the rental period;
(3) Personal effects insurance that provides coverage to renters and other vehicle occupants for loss of, or damage to, personal effects in the rental car during the rental period;
(4) Roadside assistance and emergency sickness protection insurance; or
(5) Any other coverage designated by the Commissioner.
Credit limited line insurance - Credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection insurance, or any other form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation and that is designated by the Commissioner as limited line credit insurance.
Crop limited line insurance - Insurance providing protection against damage to crops from unfavorable weather conditions, fire or lightning, flood, hail, insect infestation, disease or other yield-reducing conditions or perils provided by the private insurance market, or that is subsidized by the Federal Crop Insurance Corporation, including Multi-Peril Crop Insurance.
Home state - The District of Columbia or any state or territory of the United States in which an insurance producer:
(1) Maintains his or her principal place of residence or principal place of business; and
(2) Is licensed as a resident insurance producer.
License period - The period of time starting on, and including, the day on which an insurance producer license becomes effective and ending on, and including, the day on which the license expires absent renewal. For the purposes of this definition, a license that is renewed becomes effective on the date the renewal is effective.
Surety limited line insurance - Insurance or bond that covers obligations to pay the debts of, or answer for the default of another, including faithlessness in a position of public or private trust. For the purposes of limited line licensing, surety limited line insurance does not include surety bail bonds.
Travel limited line insurance - Insurance coverage for trip cancellation, trip interruption, baggage, life, sickness and accident, disability, and personal effects when limited to a specific trip and sold in connection with transportation provided by a common carrier.
APPENDIX 1 - CASUALTY INSURANCE COURSE REQUIREMENTS
SECTION A
I. PRINCIPLES OF INSURANCE -- 2 Hours
A. Nature of risk
B. Risk management
C. Insurable and noninsurable risk
D. Pooling concept-- law of large numbers
E. Government as insurer
F. Forms of ownership
G. Marketing systems
H. Competition in the industry
I. Functions of insurers
J. Reinsurance
II. General District of Columbia Laws -- 3 Hours
A. Broad powers and duties of the Commissioner of Insurance
B. Knowledge of administrative action process, including hearings and penalties
C. Purpose of licensing, including procedures and who must be licensed
D. Record keeping and changes in agent status, including change of address
E. Agent license expiration, revocation, suspension, and limitation
F. General regulations regarding misrepresentation, knowledge of acts of agent, rebating
G. Regulation of specific insurance contract changes regarding cancellation, nonrenewal, notice of proof of loss, and payment of claims
H. Unfair claims methods and practices--timely payment of claims
I. Fair rating practices
J. Home solicitation requirements
K. Written disclosure of fees other than commissions
III. Ethics -- 3 Hours
A. Fiduciary duties, and responsibilities
B. Conflict of interest
C. Ethical marketing practices, including fair and ethical treatment of policyholders
D. Appropriate claims practices
E. Suitability of product client
F. Social responsibility of an insurance agent
G. Agent/company relationships
H. Maintaining appropriate insurance expertise
I. Education of policyholders
J. Understanding of client needs
SECTION B
IV. Policies, Terms, and Concepts -- 6 Hours
A. Types of policies, bonds, and related terms
1. General liability
a. Owners, landlords, and tenants liability
b. Manufacturers and contractors liability
c. Products and completed operations liability
d. Contractual liability
e. Commercial general liability
f. Premises/operations liability
g. Owners and contractors protective liability
2. Automobile Insurance - personal & family auto and business & commercial auto
a. Physical damage (collision and comprehensive)
b. Uninsured motorists
c. Underinsured motorists
d. Named insureds
e. Insureds
f. Owned automobile
g. Nonowned automobile
h. Temporary substitute auto
3. Workers' compensation
4. Professional liability
5. Umbrella/excess liability
B. Insurance terms and related concepts
1. Risks
2. Hazards
3. Indemnity
4. Insurable interest
5. Actual cash value
6. Negligence
7. Liability
8. Accident
9. Occurrence
10. Burglary
11. Robbery
12. Theft
13. Mysterious disappearance
14. Fidelity (employee dishonesty)
15. Warranties
16. Representations
17. Concealment
18. Bodily injury liability
19. Property damage liability
20. Personal injury liability
21. Limits of liability
22. Deductibles
23. Incidental contracts
24. Binders
C. Policy provisions
1. Declarations
2. Insuring Agreement
3. Conditions
4. Exclusions
5. Definition of the Insured
6. Duties of the Insured
7. Cancellation and Nonrenewal Provisions
8. Supplementary Payment (Additional Coverages)
9. Proof of Loss
10. Notice of Claim
11. Arbitration
12. Pro Rata Liability (Other Insurance)
13. Subrogation
14. Compliance with Provisions of Fair Credit Reporting Act
15. Claims Made Policy Form
16. Salvage
17. Consent to Settle a Loss
18. Limitations
V. District of Columbia Insurance Law -- 6 Hours
A. General rate standards
B. Prohibited classifications of risks
C. Surplus lines
1. Definition
2. Prohibitions and restrictions
3. Responsibilities of agents and brokers
D. Oral contracts
E. Automobile liability
1. Financial responsibility
a. Definitions
b. Persons required to show proof
2. Required coverages and prohibited exclusions Uninsured motorist
3. Cancellation or nonrenewal
4. Responsibility for minors operating motor vehicles
5. District of Columbia Automobile Insurance Plan (DCAIP)
F. Worker's compensation
1. Purpose
2. Definitions
SOURCE: Final Rulemaking published at 50 DCR 10371 (December 5, 2003).
APPENDIX 2 - PROPERTY INSURANCE COURSE REQUIREMENTS
SECTION A
I. Principles of Insurance -- 2 Hours
A. Nature of risk
B. Risk management
C. Insurance and noninsurable risk
D. Pooling concept--law of large numbers
E. Government as insurer
F. Forms of ownership
G. Marketing systems
H. Competition in the industry
I. Functions of insurers
J. Reinsurance
II. General District of Columbia Insurance Laws -- 3 Hours
A. Duties and powers of Insurance Commissioner--statutory and rule-making
B. Knowledge of administrative action process, including hearings and penalties
C. Purpose of licensing, including procedures and who must be licensed
D. Record keeping and changes in agent status, including change of address
E. Agent license expiration, revocation, suspension, and limitation
F. General regulations regarding misrepresentation, knowledge of acts of agent, rebating
G. Regulation of specific insurance contact changes regarding cancellation, nonrenewal, notice of proof of loss, and payment of claims
H. Unfair claims methods and practices--timely payment of claims
I. Fair rating practices
III. Ethics -- 3 Hours
A. Fiduciary duties, and responsibilities
B. Conflict of interest
C. Ethical marketing practices, including fair and ethical treatment of policyholders
D. Appropriate claims practices
E. Suitability of product to client
F. Social responsibility of insurance agent
G. Agent/company relationships
H. Maintaining appropriate insurance expertise
I. Education of policyholders
J. Understanding of client needs
SECTION B
IV. Policies, Terms, and Concepts -- 6 Hours
A. Types of policies
1. Standard fire
2. Personal lines
a. Dwelling and contents
b. CPL (comprehensive personal liability)
c. Homeowners
3. Commercial
a. General property
b. Special multi-peril
c. Business owner policy
d. Business interruption
(i) Gross earnings
(ii) Earnings
(iii) Extra expense
4. Inland marine
a. Personal floaters
b. Commercial floaters
5. Others
a. Flood
b. Watercraft
B. Insurance terms and related concepts
1. Insurance
2. Insurable interest
3. Risk
4. Hazard
5. Peril
a. Specified (named) perils
(i) Standard fire
(ii) Extended coverage
(iii) Broad form
b. All-risk
6. Loss
a. Direct
b. Indirect
7. Proximate cause
8. Deductible
9. Indemnity
10. Actual cash value
11. Replacement cost
12. Limits of liability
13. Coinsurance
14. Pair and set clause
15. Extensions of coverage
16. Additional coverages
17. Accident
18. Occurrence
19. Cancellation
20. Nonrenewal
21. Vacancy and unoccupancy
22. Right of Salvage
23. Abandonment
24. Liability
25. Negligence
C. Policy provisions and contract law
1. Declarations
2. Insuring agreement
3. Conditions
4. Exclusions
5. Definition of the insured
6. Duties of the insured
7. Obligations of the insurance company
8. Mortgagee rights
9. Proof of loss
10. Notice of claim
11. Appraisal
12. Pro rata liability (other insurance)
13. Assignment
14. Subrogation
15. Arbitration
16. Elements of a contract
17. Warranties, representations, and concealment
18. Binders
19. Sources of insurability information
20. Fair Credit Reporting Act
V. District of Columbia Insurance Law -- 6 Hours
A. General rate standards - use and file provisions
B. Prohibited classification of risks
C. Surplus lines
1. Definitions
2. Prohibitions and restrictions
3. Responsibilities of agents and brokers
D. Oral contracts
E. Content of forms
F. Definition of loss
G. Insurance Placement Facility/Fair Plan
SOURCE: Final Rulemaking published at 50 DCR 10371 (December 5, 2003)
APPENDIX 3 - LIFE INSURANCE COURSE REQUIREMENTS
SECTION A
I. Principles of Insurance -- 2 Hours
A. Nature of risk
B. Risk management
C. Insurable and noninsurable risk
D. Pooling concept--law of large numbers
E. Government as insurer
F. Forms of ownership
G. Marketing systems
H. Competition in the industry
I. Functions of insurers
J. Reinsurance
II. General District of Columbia Insurance Laws -- 3 Hours
A. Duties and powers of Insurance Commissioner--statutory and rule-making
B Knowledge of administrative action process, including hearings and penalties
C. Purpose of licensing, including procedures and who must be licensed
D. Record keeping and changes in agent status, including change of address
E. Agent license expiration, revocation, suspension, and limitation
F. General regulations regarding misrepresentation, knowledge of acts of agent, rebating
G. Regulation of specific insurance contract changes regarding cancellation, nonrenewal, notice of proof of loss, payment of claims
H. Unfair claims methods and practices--timely payment of claims
I. Fair rating practices
III. Ethics -- 3 Hours
A. Fiduciary duties, and responsibilities
B. Conflict of interest
C. Ethical marketing practices, including fair and ethical treatment of policyholders
D. Appropriate claims practices
E. Suitability of life products to clients including sales to the elderly
F. Social responsibility of insurance agent
G. Agent/company relationships
H. Maintaining appropriate insurance expertise
I. Education of policyholders
J. Understanding of client needs
SECTION B
IV. Policies, Terms and Concepts -- 6 Hours
A. Types of policies
1. Traditional whole life products
a. Ordinary (straight) life
b. Limited-pay and single-premium life
c. Modified and graded premium whole life
d. Adjustable life
2. Interest-sensitive whole life products
a. Universal like
b. Variable whole life
c. Variable universal life
3. Term life
a. Level, decreasing, and increasing term
b. Renewal term
c. Convertible term
4. Annuities
a. Single, level, and flexible premium
b. Immediate and deferred
c. Fixed and variable--requirement of security license
5. Endowment
6. Combination plans
a. Family policy
b. Family income policy
c. Family maintenance policy
B. Policy riders, provisions, options, and exclusions
1. Policy riders
a. Waiver of premium
b. Guaranteed insurability
c. Payor benefit
d. Accidental death and/or accidental death and dismemberment
e. Term riders
f. Other insureds (e.g., spouse, children, nonfamily)
2. Policy provisions and options
a. Entire contract
b. Insuring clause
c. Free look
d. Consideration clause
e. Owner's rights
f. Primary and contingent beneficiaries
g. Revocable and irrevocable beneficiaries
h. Change of beneficiary
i. Modes of premium payment
j. Grace period
k. Automatic premium loan
l. Reinstatement
m. Policy loan
n. Nonforfeiture options
o. Dividends and dividend options
p. Incontestability
q. Assignment
r. Suicide
s. Misstatement of age
t. Settlement options
u. Conversion options (individual policy)
3. Policy exclusions
C. Completing the application, underwriting, and delivering the policy
1. Completing the application
a. Requiring signatures
b. Changes in the application
c. Consequences of incomplete applications
d. Warranties and representations
e. Collecting the initial premium and issuing the receipt
2. Underwriting
a. Insurable interest
b. Medical; information and consumer reports
c. Fair Credit Reporting Act
d. Risk classification
3. Delivering the policy
a. When coverage begins
b. Obtaining a statement of good health
c. Explaining the policy and its provisions, riders, exclusions, and ratings
D. Taxes, Retirement, and Other Insurance Concepts
1. Third-party ownership
2. Group life insurance
3. Retirement plans
4. Business insurance (e.g., key employee, buy sell agreement, split-dollar, etc.)
5. Social security benefits and taxes
6. Tax treatment of insurance premiums, and proceeds
V. District of Columbia Insurance Law -- 6 Hours
A. Policy provisions
1. Grace period
2. Separate benefits
3. Incontestability
4. Misstatement of age
5. Assignment of rights
6. Designation of beneficiaries
7. Variable contracts
B. Marketing practices
1. Bonuses
2. Replacement of policies
3. Disclosure requirements
4. Suitability
5. Combination sales
6. Record keeping
SOURCE: Final Rulemaking published at 50 DCR 10371 (December 5, 2003)
APPENDIX 4 - ACCIDENT AND HEALTH INSURANCE COURSE REQUIREMENTS
SECTION A
I. Principles of Insurance -- 2 Hours
A. Nature of risk
B. Risk management
C. Insurable and noninsurable risk
D. Pooling concept--law of large numbers
E. Government as insurer
F. Forms of ownership
G. Marketing systems
H. Competition in the industry
I. Functions of insurers
J. Reinsurance
II. General District of Columbia Insurance Law -- 3 Hours
A. Duties and powers of Insurance Commissioner--statutory and rule-making
B. Knowledge of administrative action process, including hearings and penalties
C. Purpose of licensing, including procedures and who must be licensed
D. Record keeping and changes in agent status, including change of address
E. Agent license expiration, revocation, suspension, and limitation
F. General regulations regarding misrepresentation, knowledge of acts of agent, rebating
G. Regulation of specific insurance contract changes regarding cancellation, nonrenewal, notice of proof of loss, and payment of claims
H. Unfair claims methods and practices--timely payment of claims
I. Fair rating practices
III. Ethics -- 3 Hours
A. Fiduciary duties, and responsibilities
B. Conflict of interest
C. Ethical marketing practices, including fair and ethical treatment of policyholders
D. Appropriate claims practices
E. Suitability of accident and health products to clients including specifically sales to the elderly
F. Social responsibility of insurance agent
G. Agent/company relationships
H. Maintaining appropriate Insurance expertise
I. Education of policyholders
J. Understanding of client needs
SECTION B
IV. Policies, Terms, and Concepts -- 6 Hours
A. Types of policies
1. Disability income
a. Individual disability income policy
b. Business overhead expense policy
c. Business health insurance
2. Accidental death and dismemberment
3. Medical expense insurance
a. Basic hospital, medical, and surgical policies
b. Major medical policies
c. Comprehensive major medical policies
d. Health Maintenance Organizations (HMO)
e. Multiple Employer Trusts (MET)
f. Service organizations (Blue Plans)
4. Medicare supplement policies
5. Group insurance
a. Group conversion
b. Differences between individual and group contracts
c. General concepts
B. Policy provisions, clauses, and riders
1. Mandatory provisions
a. Entire contract
b. Time limit on certain defenses (incontestable)
c. Grace period
d. Reinstatement
e. Notice of claim
f. Claim forms
g. Proof of loss
h. Time of payment of claims
i. Payment of claims
j. Physical examination and autopsy
k. Legal actions
l. Change of beneficiary
2. Optional provisions
a. Change of occupation
b. Misstatement of age
c. Illegal occupation
3. Other provisions and clauses
a. Insuring clause
b. Free look (10-day, 20-day, etc.)
c. Consideration clause
d. Probationary (waiting) period
e. Elimination (waiting) period
f. Waiver of premium
g. Exclusions
h. Pre-existing conditions
i. Recurrent disability
j. Coinsurance
k. Deductibles
4. Riders
a. Impairment rider
b. Guaranteed insurability rider
c. Multiple indemnity rider (double, triple)
5. Rights of renewability
a. Noncancellable
b. Cancelable
c. Guaranteed renewable
d. Conditionally renewable
e. Optionally renewable
f. Period of time
C. Social insurance
1. Medicare
2. Medicaid
3. Social security benefits
D. Other insurance concepts
1. Total, partial, and residual disability
2. Owner's rights
3. Dependent children benefits
4. Primary and contingent beneficiaries
5. Modes of premium payments (annually, semiannual, etc.)
6. Nonduplication and coordination of benefits (e.g., primary vs. excess)
7. Occupational vs. Nonoccupational
8. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income, and medical expense, etc...)
E. Field underwriting procedures
1. Completing application and obtaining necessary signatures
2. Explaining sources of insurability information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
3. Upon payment of initial premium, giving prospect conditional receipt, and explaining the effect of that receipt (e.g., medical exam, etc...)
4. Submitting application and initial premium to company for underwriting
5. Assuring delivery of policy to client
6. Explaining policy and its provisions, riders, exclusions, and ratings to clients
7. In cases where initial premium did not accompany application, obtaining signed statement of continued good health, and obtaining premium for transmittal
8. Contract law
a. Requirements of a contract
b. Insurable interest
c. Warranties and representations
V. District of Columbia Insurance Law -- 6 Hours
A. General policy provisions
1. Right of return
2. Right of insurer to contest
3. Pre-existing conditions
4. Application process
5. Grace periods
B. Mandated benefits
1. Handicapped children
2. Newborn children
3. Chiropractors services
4. Alcoholism, drug abuse, and mental and nervous disorders
5. Home health care
6. Skilled nursing care
7. Kidney disease treatment
8. Diabetes
9. Maternity benefits
C. Riders and endorsements
D. Marketing methods and practices
1. Advertising
2. Suitability
3. Outline of coverage
4. Replacement
5. Medicare supplement policies
6. Nursing home policies
7. Continuation and conversion
8. Cancer insurance and other dread disease
E. Health Insurance Risk-Sharing Plan
SOURCE: Final Rulemaking published at 50 DCR 10371 (December 5, 2003)
Appendix 5
CERTIFICATE OF PRELICENSING EDUCATION
I hereby certify that ___ has completed a prelicensing educational course which complies with the requirements in Chapter 1 of Title 26 of the DCMR for the insurance lines of (life & health) (property & casualty). The last day of class/studies for section B of this particular course was (date). I have verified the identification of this applicant by using:
___ District of Columbia driver's license;
___ District of Columbia identification card; or
___ Other (please describe) ___
Authorized Representative
Name of Program
Date
D.C. Mun. Regs. tit. 26, r. 26-A199