Property and Casualty Insurance. Tennessee. State Law Supplement

Property and Casualty Insurance Tennessee State Law Supplement

Property and Casualty Insurance Tennessee Effective November 10, 2014 State Law Supplement Important: Check for Updates States sometimes revise their exam content outlines unexpectedly or on short notice. To see whether there is an update for this product because of an exam change, go to www.kfeducation.com and check the Insurance Licensing Blog. If there is an update, it will be clearly noted in the blog entries for this state.

At press time, this edition contains the most complete and accurate information currently available. Owing to the nature of license examinations, however, information may have been added recently to the actual test that does not appear in this edition. Please contact the publisher to verify that you have the most current edition. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If legal advice or other expert assistance is required, the services of a competent professional should be sought. TENNESSEE PROPERTY AND CASUALTY INSURANCE LAW SUPPLEMENT, EFFECTIVE NOVEMBER 10, 2014 2014 Kaplan, Inc. The text of this publication, or any part thereof, may not be reproduced in any manner whatsoever without written permission from the publisher. If you find imperfections or incorrect information in this product, please visit www.kfeducation.com and submit an errata report. Published in October 2014 by Kaplan Financial Education. Printed in the United States of America. ISBN: 978-1-4754-2983-1 / 1-4754-2983-5 PPN: 3200-5883

Tennessee Law Supplement 1 INTRODUCTION This supplement focuses on statutes regarding Tennessee insurance law. Key aspects of each statute are discussed to help the student pass the state law portion of the licensing examination. In order to understand the content of this supplement, the student should first study the national insurance License Exam Manual. Thorough preparation for the exam requires the complete study of both the national License Exam Manual and the supplement. I. INSURANCE REGULATION To protect the public interest, the insurance industry is highly regulated. It must meet federal, state, and self regulation. A. REGULATORY OVERVIEW 1. Paul v. Virginia (1869) This case involved one state s (Virginia s) attempt to regulate an insurance company domiciled in another state (New York). The Supreme Court sided against the company, ruling that the regulation of the sale and issuance of insurance was the right of each state. 2. The Armstrong Investigation (1905) Public concern over abuse by insurers caused the New York state legislature to investigate the marketing practices of insurance companies operating in that state. The recommendations resulting from that investigation were adopted by the New York legislature resulting in the New York Insurance Code, which set a precedent and pattern for insurance regulation by other states. 3. US v. Southeastern Underwriters Association (SEUA) (1944) The 1869 decision of Paul v. Virginia held for 75 years before the Supreme Court again addressed the issue of state versus federal regulation of the insurance industry. In the 1944 SEUA case, the court ruled that the insurance industry was subject to a series of federal laws, many of which were in conflict with existing state laws. This ruling held that insurance was a form of interstate commerce subject to regulation by the federal government. The result of this ruling was to shift the balance of regulatory control from the states to the federal government. 4. McCarran-Ferguson Act (1945) The turmoil caused by the SEUA case prompted Congress to enact Public Law 15, the McCarran-Ferguson Act. This law specified that continued state regulation of the insurance industry was in the public s best interest. However, the act stated that the federal government had the right to regulate the business of insurance when state law did not. This act led each state to revise its insurance laws to conform to the federal law and helped eliminate conflicts between state and federal law. Today, the insurance industry is considered to be state regulated because of this law. 5. Fair Credit Reporting Act (1970) This consumer protection bill requires fair and accurate reporting of information about consumers, including applicants for insurance. Insurers must inform applicants about any investigations being made. If any consumer report is used to deny coverage or charge an applicant a higher rate, the insurer must furnish the applicant with the name of the reporting agency conducting the

2 Tennessee Law Supplement investigation. The proposed insured has the right to contact the reporting agency in order to review their personal file. The reporting agency must also inform the proposed insured of all reports released in the last six months. Agencies maintain seven years of records (with the exception of bankruptcies, which are maintained for 14 years). Most insurance companies use retail credit reports and/or Equifax reports in applicant investigations. When misinformation has been uncovered, the reporting agency is allowed up to three months to correct the file. 6. Privacy Act of 1974 The Privacy Act of 1974 requires written consent by the applicant before personal information can be released by any reporting agency. The purpose of this act is to: be fair and impartial in collecting, analyzing, and presenting information and reports; and make it known that the public can expect personal information to be handled in a confidential manner. 7. Disclosure Authorization Applicants for insurance must be given advance notice of the insurer s practices regarding collection and use of personal information. Notice must be given in writing at the time of application. 8. Norris v. State of Arizona (1978) This court decision prohibits the use of sex discrimination in pricing insurance and annuity benefits payable on employer-sponsored benefit plans. B. NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS (NAIC) Created shortly after passage of the McCarran-Ferguson Act, the NAIC is made up of the Commissioners of all 50 states. The NAIC s objectives are to: preserve state regulation of the insurance industry; encourage uniformity in state insurance laws and regulations; assist in the efficient administration of those regulations; and protect the interest of policyowners. The NAIC has been instrumental in developing guidelines and model legislation that assist the industry in conducting its business in a professional and diligent manner, thus creating a higher level of public trust. If a producer s license is suspended or revoked by a Commissioner, the NAIC is informed, then the NAIC downloads the information into its computer and has it available for other states where the producer may apply for licensure. C. STATE REGULATION The state insurance department is generally responsible for: issuing rules and regulations (the Commissioner enforces laws and issues rules based on law only the legislature enacts or passes laws); licensing and supervising insurance companies that operate within the state; licensing and supervising insurance producers and brokers; controlling the types of insurance contracts that may be sold; determining the amount of reserves an insurer must maintain (reserves are the monies the company must set aside to pay future claims and guarantee financial solvency); overseeing insurance marketing practices; and investigating consumer complaints.

Tennessee Law Supplement 3 II. TENNESSEE LAWS AND DEPARTMENTAL RULES COMMON TO ALL LINES OF INSURANCE A. POWERS OF THE COMMISSIONER The Department of Commerce and Insurance and the Commissioner of Commerce and Insurance are responsible for administering Tennessee s insurance laws. The Commissioner of Commerce and Insurance, the chief officer of the Tennessee Department of Commerce and Insurance, is appointed by the Governor. 1. Hearings and judicial review [56-6-112] The provisions of the Uniform Administrative Procedures Act will govern all matters and procedures respecting any hearing, and judicial review of any contested case. Details regarding license probation, suspension, and revocation are outlined in further detail later in this book. a. The Commissioner may authorize any regular salaried employee of the Department to serve as an administrative judge or hearing officer in any contested case arising under this part. b. The Commissioner may serve a notice or order in any contested case arising under this part by registered or certified mail to the licensee s current address of record in the files of the Department. 2. Investigations [56-6-120] For the purpose of making investigations, the Commissioner has inquisitorial powers and is empowered to subpoena witnesses and examine them under oath provided that all testimony, documents, and other evidence obtained by the Commissioner pursuant to this part will be absolutely privileged and not be admissible as evidence in any private civil proceeding. The Department will provide the person with a copy of the inquisitorial order or complaint and copies of statements given by the complainant within 30 days of issuance of the order or receipt of the complaint. Fourteen days written notice of the Commissioner s intent to take testimony is required, and the Commissioner must notify both parties within 30 days of completing or closing an investigation. Investigations must be completed within a two-year period with annual tracking reporting to the Commissioner. 3. Regulatory authority [56-6-107-112] The Commissioner retains the authority to enforce the provisions of and impose any penalty or remedy against any person under investigation for or charged with a violation even if the person s license has been surrendered or has lapsed by operation of law. a. The Commissioner may serve a notice or order in any action arising under this part by registered or certified mail to the insurance producer or applicant at the address of record in the files of the Department. b. Notwithstanding any provisions of law to the contrary, service in the manner set forth herein is deemed to constitute actual service on such insurance producer or applicant. c. The Commissioner oversees licensing of resident and nonresident producers acting in Tennessee. Please refer to later sections for details.

4 Tennessee Law Supplement 4. Penalties [56-6-112(e), 56-1-305] a. If the Commissioner finds that a licensee has violated any statute, rule, or order, the Commissioner may order: the insurer, person, or entity to cease and desist from engaging in the act or practice giving rise to the violation; payment of a monetary penalty of not more than $1,000 for each violation, but not to exceed an aggregate penalty of $100,000 for a violation committed unknowingly, or $25,000 for each violation, not to exceed an aggregate penalty of $250,000 for a violation committed knowingly; and the suspension or revocation of the insurer s, person s, or entity s license. Fines will be used by the state to defray expenses and for consumer awareness programs. b. In determining the amount of penalty to assess, or in determining whether the violation was committed with knowledge and intent, the Commissioner may consider any evidence relative to the following criteria: whether the insurer, person or entity could reasonably have interpreted its actions to be in compliance with the obligations required by a statute, rule, or order; whether the amount imposed will be a substantial economic deterrent to the violator; whether the amount imposed would put the violator in a hazardous financial condition; the circumstances leading to the violation; the severity of the violation and the risk of harm to the public; the economic benefits gained by the violator as a result of noncompliance; and the interest of the public. c. In addition, the Commissioner may consider the insurer s, person s, or entity s efforts to cure the violation. d. No aggregate penalty limits apply to: B. DEFINITIONS failure to file audited statements; failure to file quarterly financial statements; failure to file actuarial opinions; failure to file annual reports; failure to file a risk-based capital report; and violations of orders issued after a contested case hearing. 1. Insurance producer [56-6-102] An insurance producer is a person required to be licensed under the laws of this state to sell, solicit, or negotiate insurance.

Tennessee Law Supplement 5 2. Business entity [56-6-102] A business entity is a corporation, association, partnership, limited liability company, limited liability partnership, or other legal entity. 3. Limited lines producer [56-6-102, 110] A limited lines producer is a person authorized by the Commissioner to sell, solicit, or negotiate limited lines insurance. 4. Unauthorized insurer [56-6-114] An unauthorized insurer has not applied for or has not qualified for a certificate of authority and is not authorized to transact insurance business in Tennessee. A person will be held personally liable (premiums paid and claims) for all insurance contracts unlawfully made in Tennessee with or on behalf of an insurance company that is not authorized to do business in Tennessee. 5. Illegal compensation [56-6-113] a. A person must not accept or share a commission, service fee, brokerage, or other valuable consideration for selling, soliciting, or negotiating insurance in this state if that person is required to be licensed under this part and is not properly licensed. b. Renewal or other deferred commissions may be paid to a person for selling, soliciting, or negotiating insurance in this state if the person was required to be licensed at the time of the sale, solicitation, or negotiation and was properly licensed at that time. c. An insurer or insurance producer may pay or assign commissions, service fees, brokerages, or other valuable consideration to persons who do not sell, solicit, or negotiate insurance unless the payment would violate code. d. An unlicensed person may make a referral to a licensed producer provided that the person does not discuss the specific insurance policy terms and conditions. Except as prohibited by federal law, the unlicensed person may be compensated for the referral. However, an unlicensed person who is neither employed by nor affiliated with the insurance producer may be compensated only if the compensation is a fixed dollar amount, not to exceed $25. An unlicensed person who is either employed by or affiliated with the insurance producer may be compensated only if the compensation is a fixed nominal dollar amount. In either event, the referral compensation shall not depend on whether the referred customer purchases an insurance product from the licensed producer. 6. Fiduciary [56-6-116] When a producer receives premiums in the process of selling insurance, these funds are considered to be held in a fiduciary or trust capacity. They may not be misappropriated, converted, or improperly withheld. Any violation will be grounds for disciplinary action which may include suspension or revocation of the producer s license, sanctions, and penalties. C. LICENSE REQUIREMENTS [56-6-103, 56-6-104, 56-6-105, 56-6-107-111] No company or individual may conduct insurance business in Tennessee without being properly licensed and supervised by the Commissioner or exempt from such licensing or supervision. Insurance companies must obtain a certificate of authority to transact business in Tennessee. Individuals must be licensed as producers before selling insurance.

6 Tennessee Law Supplement 1. Insurance producer [Dept. Rule 0780-1-56, 56-6-106, 56-6-112, 56-6-121] An individual seeking a resident insurance producer s license must file an application with the Commissioner and declare under penalty of refusal, suspension, or revocation of the license that the statements made in the application are true and complete to the best of the individual s knowledge. a. Before approving the application, the Commissioner must be satisfied that the applicant: is at least 18 years old; has not committed any act that is a ground for denial, suspension, or revocation of a license issued in Tennessee; has completed a prelicensing course of study for the lines of authority for which the person has applied that consists of a minimum of 20 hours of coursework for life, accident and health, property, casualty, personal lines, or title insurance; has paid the required fee; and has successfully passed the examination(s) for the line(s) of authority for which the individual has applied. b. A business entity acting as an insurance producer must obtain an insurance producer s license. The entity must file a uniform business entity application with the Commissioner, pay the required fee, and designate an individual licensed producer who will be responsible for the entity s compliance with Tennessee s insurance laws and regulations. c. As stated above, the Commissioner will take appropriate actions in cases requiring license probation, suspension, revocation, or the Commissioner will refuse to renew a license. d. Nonrefundable fees [56-6-121] The following fees are required for licensure: $50 for an insurance producer or limited lines producer license $60 for the renewal of an insurance producer license $30 for the renewal of a limited lines producer license $15 for the appointment or termination of appointment of an insurance producer or limited lines producer by an insurer 2. Agency contracts [56-6-115] An insurance producer must not act as an agent of an insurer unless the insurance producer becomes an appointed agent of that insurer. a. An insurance producer who solicits or negotiates an application for insurance will be regarded, in any controversy arising from the application for insurance or any policy issued in connection therewith between the insured or insured s beneficiary and the insurer, as the agent of the insurer and not the insured or insured s beneficiary. This provision does not affect the apparent authority of an agent.

Tennessee Law Supplement 7 b. To appoint a producer as its agent, the appointing insurer files, in a format approved by the Commissioner, a notice of appointment within 15 days from the date the agency contract is executed or the first insurance application is submitted. c. Upon receipt of the notice of appointment, the Commissioner will verify within a reasonable time not to exceed 30 days that the insurance producer is eligible for appointment. If the insurance producer is determined to be ineligible for appointment, the Commissioner notifies the insurer within five days of the determination. d. An insurer will pay an appointment fee for each insurance producer it appoints. The fees under this section may be paid by the insurer on a quarterly basis. e. An individual not duly licensed as an insurance producer or limited lines producer who solicits a policy of insurance on behalf of an insurer becomes liable for all the duties, requirements, liabilities, and penalties to which an insurance producer of such insurer is subject. 3. Agency contract termination [56-6-117] a. For terminations with or without cause, the company must notify the Commissioner within 30 days, with the cause as applicable, and notice to the producer. A termination fee must be paid. b. The fine for not reporting ranges from $100 to $1,000 per violation. 4. Resident/nonresident [56-6-106, 56-6-108] An individual living outside Tennessee seeking a nonresident insurance producer s license must file an application with the Commissioner. a. The Commissioner may issue an insurance producer s license to any duly qualified nonresident individual as follows. 1.) The person is currently licensed as a resident insurance producer in good standing in his resident state. 2.) The person has submitted the proper application and paid the applicable fees. 3.) The person s home state awards insurance producer licenses to residents of Tennessee on the same basis (a reciprocal agreement). b. A nonresident producer who moves from one state to another or a resident insurance producer who moves from Tennessee to another state must file a change of address and provide certification from the new resident state within 30 days of the change of legal residence. No fee or license application is required.

8 Tennessee Law Supplement 5. Exemptions [56-6-104, 56-6-105, 56-6-109] a. Exceptions to licensing requirements No license as an insurance producer or limited insurance representative is required of: any officer or employee of an insurance company who is paid a salary; persons who administer group plans, annuities, and health plans, where no commission is paid; any officer, director, or employee who assists insurance producers by providing technical advice or assistance not including the sale, solicitation, or negotiation of insurance contracts; any officers or employees engaged in the administration of employee benefit plans for their own employees provided that they are not compensated, directly or indirectly, by the insurance company issuing such insurance; salaried employees of a creditor who enroll debtors under a group credit life or accident and health policy; members of a fraternal benefit society who provide benefits in the case of death or disability resulting from accidents without receiving compensation for enrolling those members; or employees selling insurance incidental to motor vehicle or self-service storage rentals. b. Exemptions from examination The following individuals do not have to take the written examination in order to be licensed as an insurance producer: nonresident producers whose current resident licenses are valid and have been issued a nonresident license by the Tennessee Insurance Department; and nonresident producers who move to Tennessee from a reciprocal state and apply within 90 days to become resident licensees. 6. Pre-licensing education [56-6-105, 56-6-109; Dept. Rules 0780-1-56, 0780-1-74-.01] Applicants for an insurance producer license are required to complete an online or classroom course of study prior to taking the license examination. Courses must be approved by the Commissioner. a. The total hours which an insurance producer is required to take are: 20 hours for life; 20 hours for accident and health; 20 hours for property; 20 hours for casualty; and 20 hours for personal lines. b. The following persons are exempt from the prelicensing education requirements: Persons holding a Chartered Life Underwriter (CLU ) designation for a life line of authority Persons holding a Chartered Property and Casualty Underwriters (CPCU ) designation for property, personal lines, and casualty lines of authority

Tennessee Law Supplement 9 Persons holding a Certified Insurance Counselors (CIC) designation for life, health, property, personal lines, and casualty lines of authority Persons holding a Certified Employee Benefit Specialist (CEBS), Chartered Financial Consultant (ChFC ), Certified Financial Planner TM (CFP ), Fellow of Life Management Institute (FLMI), or Life Underwriter Training Council Fellow (LUTCF) designation for a life line of authority Persons holding a Registered Health Underwriter (RHU), Certified Employee Benefit Specialist (CEBS), Registered Employee Benefit Consultant (REBC), or Health Insurance Advisor (HIA) designation for a health line of authority Persons holding an Accredited Advisor in Insurance (AAI) or Associate in Risk Management (ARM) designation for property, personal lines, and casualty lines of authority Persons holding an insurance degree from an accredited college or university for all lines of authority 7. Temporary license [56-6-111] a. The Commissioner may issue a temporary license as an insurance producer for a period not to exceed 180 days without first requiring an examination, if the Commissioner deems that such temporary license is necessary for the servicing of an insurance business in the following cases: to the designee of a licensed insurance producer entering active service in the armed forces of the United States; to the surviving spouse or next of kin, or to the administrator, executor, or employee of a licensed insurance producer who dies or becomes disabled; and to an applicant who replaces, whether because of retirement, withdrawal, cancellation, or otherwise, a licensed insurance producer in this state. b. The Commissioner will issue a temporary license to the applicant for each company represented. c. A temporary license is non-renewable and expires at the end of the 180-day period. If the producer wishes to remain in a sales capacity beyond the 180th day, it will be necessary for him to be certified for, take, and pass the state s regular license examination. 8. License renewal [56-6-107] An insurance producer license remains in effect for a period of 24 months unless revoked or suspended. a. At the end of the 24 months, the insurance producer license may be renewed by paying the applicable fee and submitting the renewal form prescribed by the Commissioner. b. An insurance producer license will not be renewed unless the insurance producer has completed all continuing education requirements, as established by rule (unless specifically exempt from the requirements).

10 Tennessee Law Supplement c. An insurance producer who allows the license to lapse may, within 12 months from the due date of the renewal fee, reinstate the same license without passing a written examination. However, a penalty of double the unpaid renewal fee will be required for any renewal fee received after the due date. d. A licensed insurance producer who is unable to comply with the license renewal procedures of this section due to military service or some other extenuating circumstance (e.g., a long-term medical disability) may request a waiver of such license renewal procedures. The producer may also request a waiver of any examination requirement or any other sanction imposed for failure to comply with such renewal procedures. e. The license will contain the licensee s name, address, insurance producer number, and the date of issuance, the lines of authority, the expiration date, and any other information the Commissioner deems necessary. f. A licensed insurance producer must inform the Commissioner by any means acceptable to the Commissioner of a change of address within 30 days of the change. Failure to timely inform the Commissioner of a change in legal name or address may result in a disciplinary action. g. In order to assist in the performance of the Commissioner s duties, the Commissioner may contract with non-governmental entities, including the NAIC, to perform any administrative functions, including the collection of fees, related to producer licensing that the Commissioner and the non-governmental entity may deem appropriate. 9. General requirements [56-6-103, 56-6-104] It is illegal to act as an insurance producer or limited lines producer without a license. Individuals cannot sell, solicit, or negotiate insurance in Tennessee for any class of insurance for which they are not specifically licensed. 10. Continuing education [Dept. Rule 0780-1-56; 56-6-107] All insurance producers licensed or renewed on or after January 1, 1997 must complete 24 hours of approved continuing education courses every two years they are licensed. Three hours shall have course concentration in ethics during each biennium. Note: Producers continually licensed since January 1, 1994, do not need to submit continuing education credits at renewal. a. Insurance producers must biennially submit a signed statement on a form approved by the Commissioner listing the continuing education program in which the producer has participated. Producers are required to retain such documents for at least two years after submitting the statement to the Commissioner. Previously approved continuing education courses may not be repeated for two years. A producer may carry over a maximum of 12 hours of excess continuing education credit from one biennium to the next with the exception of ethics courses. b. An instructor of an approved subject is entitled to receive continuing education credit.

Tennessee Law Supplement 11 c. The Commissioner may extend the time to complete the continuing education requirements up to 180 days for reasons of poor health, military service, or other reasonable cause. Producers wishing an extension must apply to the Commissioner in writing. d. Resident producers who are authorized to sell property or property and casualty insurance shall take a one-time approved three-hour course on Federal Flood Insurance. This course will count toward completion of the required 24-hour biennial continuing education requirement when taken and must be completed by the first renewal following January 1, 2012. Proof of satisfactory completion of such a course after January 1, 2008 may exempt the producer from this requirement. D. LICENSE SUSPENSION/REVOCATION 1. General provisions [56-6-112] The Commissioner can place on probation, suspend, revoke, or refuse to issue or renew the license of a producer who has: provided incorrect, misleading, incomplete, or materially untrue information in the license application; violated any law, rule, regulation, subpoena, or order of the Commissioner or of another state s Commissioner; obtained or attempted to obtain a license by fraud or misrepresentation; improperly used notes or any other reference material to complete an examination for an insurance license; improperly withheld, misappropriated, or converted any monies or properties received in the course of doing insurance business; intentionally misrepresented the terms of an insurance contract or application for insurance; was convicted of a felony; admitted to or was found to have committed any insurance unfair trade practice; used any fraudulent, coercive, or dishonest practices, or demonstrated incompetence, untrustworthiness, or financial irresponsibility in the conduct of business; had an insurance producer license or its equivalent denied, suspended, or revoked in any other state, province, district, or territory; forged another person s name to an insurance application or any document related to an insurance transaction; or knowingly accepted insurance business from an individual who is not licensed. 2. Notice [56-6-112] If the Commissioner decides to deny an application for a license, he must notify the applicant and give written notice that the application has been denied within 30 days. a. In addition, the license of a business entity may be suspended, revoked, or refused renewal if the Commissioner finds, after a hearing, that an individual licensee s violation was known or should have been known by any partner, officer, or manager acting on behalf of the partnership or corporation and the violation was not reported to the Commissioner and the business entity did not take any corrective action.

12 Tennessee Law Supplement b. Fines In addition to any license denial, suspension, or revocation, the Commissioner may also fine violators between $100 and $1,000 for each violation of a statute, rule, or order pertaining to the sale, solicitation, or negotiation of insurance in Tennessee. The Commissioner may also impose penalties against any person who is under investigation or charged with violating this section of the insurance code, even if the person s license has been surrendered or has lapsed. E. UNFAIR TRADE PRACTICES 1. False advertising [56-8-104] It is illegal for any producer to formulate or use an advertisement or statement which is untrue, deceptive, or misleading regarding any insurance company or persons associated with that company. 2. Defamation [56-8-104] Making any statement, written or oral, which is false or maliciously critical of the financial condition of an insurance company or a producer representing that company is illegal. 3. Boycotting [56-8-104] It is illegal for any person or organization to try to create a monopoly or restrict fair trade transactions of insurance. 4. Unfair discrimination [56-8-104] Making or permitting any unfair discrimination between individuals of the same class and equal expectation of life or hazard is illegal. a. Requiring information regarding other family members who will not be covered under this plan and basing the rating on the entire family rather than the insured is not allowed. b. Exception Companies are allowed to discriminate when it comes to rating smokers vs. non-smokers. 5. Rebating [56-8-104, 56-6-113] Offering valuable consideration, other than that which is offered in the contract, as an inducement to purchase a policy is illegal. a. Rebating includes kickbacks of commission, extraordinary gifts, payment of consulting fees, or offering to pay the insured s premium. b. Exceptions Companies are allowed to offer: across-the-board reductions in premiums by class of individual; reduced premiums on industrial debit plans reflecting a savings in collection expenses; and readjustments in group rates based on loss or expense experience. 6. Unfair claims settlement practices [56-8-104] Unfair claims settlement practices include: misrepresenting insurance policy provisions relating to coverages provided; failing to acknowledge or act promptly in respect to claims; failing to affirm or deny coverage in a reasonable time following proof of loss;

Tennessee Law Supplement 13 offering substantially less remuneration than the amount ultimately recovered through litigation; attempting to settle a claim for less than the policy provides or printed advertising material implies; and failing to settle a claim when the insurer s liability and responsibility has been clearly established. 7. Other topics [56-8-104] Other unfair trade practices for which the commissioner may take action include: being demonstrably incompetent, untrustworthy, or financially irresponsible; being convicted of a felony in a court of competent jurisdiction; and violating or failing to comply with any insurance law or lawful rule of order of the Commissioner. F. CREDIT INFORMATION [56-5-401 TO 407] 1. An insurer authorized to do business in Tennessee that uses credit information to underwrite or rate risks for personal insurance must not: take an adverse action against a consumer based on credit information, unless an insurer obtains and uses a credit report issued or an insurance score calculated within 90 days of the date the personal insurance policy is first written or renewal is issued (an insurance score is a number or rating derived from an algorithm, computer application, model, or other process that is based in whole or in part on credit information for the purposes of predicting the future insurance loss exposure of an individual applicant or insured); use credit information unless the insurer recalculates the insurance score or obtains an updated credit report no later than 36 months following the last time the insurer obtained current credit information for the insured; the insurer is not required to comply with this rule if: the insured is in the most favorably priced tier of the insurer or within a group of affiliated insurers, for the type of policy covering the insured; the insurer has determined not to use credit information in its reevaluation of the insured upon renewal; or the insurer provides a notice to the insured on an annual basis of the insured s right to voluntarily request that their insurance credit score be rerun and reevaluated based on the current information available for the next effective renewal date of the insured s policy; use the following as a negative factor in any insurance scoring methodology or in reviewing credit information for the purpose of underwriting or rating a policy of personal insurance: credit inquiries not initiated by the consumer or inquiries requested by the consumer for each person s own credit information; inquiries relating to insurance coverage, if so identified on a consumer s credit report; multiple lender inquiries, if coded by the consumer reporting agency on the consumer s credit report as being from the home mortgage industry and made within 30 days of one another, unless only one inquiry is considered; multiple lender inquiries, if coded by the consumer reporting agency on the

14 Tennessee Law Supplement consumer s credit report as being from the automobile lending industry and made within 30 days from one another, unless only one inquiry is considered; or collection accounts with a medical industry code, if so identified on the consumer s credit report; deny, cancel, or nonrenew a policy of personal insurance solely on the basis of credit information, without consideration of any other applicable underwriting factor independent of credit information; base an insured s renewal rates for personal insurance solely upon credit information, without consideration of any other applicable factor independent of credit information; take an adverse action against a consumer solely because the consumer does not have a credit account, without consideration of any other applicable factor independent of credit information; consider an absence of credit information or an inability to calculate an insurance score in underwriting or rating personal insurance, unless the insurer either treats the consumer as if the consumer had neutral credit information as defined by the insurer or unless the insurer treats the consumer in a manner otherwise approved by the Commissioner of Commerce and Insurance; or use an insurance score calculated using income, gender, address, ethnic group, religion, marital status, nationality, education, or occupation of the consumer as a factor. 2. Notice of adverse action If an insurer takes an adverse action based on factors that include credit information, the insurer must provide notice to the consumer that an adverse action has been taken. a. That notice must contain the reason or reasons for the adverse action, described in sufficiently clear and specific language so that a person can identify the basis for the insurer s decision to take an adverse action. b. The notice must include a description of up to four factors that were the primary influences of the adverse action. c. The use of generalized terms such as poor credit history, poor credit rating, or poor insurance score does not meet the explanation requirements of this section. d. Standardized credit explanations provided by consumer reporting agencies or other third-party vendors are deemed to comply with this section. 3. Producers not liable: liability, fees, and costs An insurer will indemnify, defend, and hold an insurance producer harmless from and against all liability, fees, and costs arising out of or relating to the actions, errors, or omissions of an insurance producer who obtains or uses credit history, insurance scores, or both for an insurer, provided the insurance producer follows the instructions of or procedures established by the insurer and complies with any applicable law or act.

Tennessee Law Supplement 15 4. Filing of scoring models and processes Insurers that use insurance scores to underwrite or rate risks must file their scoring models or other scoring processes with the Department of Commerce and Insurance. a. A filing that includes insurance scoring must include loss experience justifying the use of credit information. b. Such filings will be kept confidential by the Commissioner of Commerce and Insurance and will not be construed to be a public record. 5. Use of incorrect or incomplete credit information If it is determined through the dispute resolution process in the federal Fair Credit Reporting Act that the credit information of a current insured was incorrect or incomplete, and if the insurer receives notice of such determination from either the consumer reporting agency or from the insured, the insurer must re-underwrite and re-rate the consumer within 30 days of receiving the notice. 6. Disclosure of use of credit information If an insurer writing personal insurance uses credit information in underwriting or rating a consumer, the insurer or its agent must disclose, either on the insurance application or at the time the insurance application is taken, that it may obtain credit information in connection with such application. G. RATE FILING a. Such disclosure may be either written or provided to an applicant in the same medium as the application for insurance. b. Use of the following sample disclosure statement constitutes compliance with this section: In connection with this application for insurance, we may review your credit report or obtain or use a credit-based insurance score based on the information contained in that credit report. We may use a third party in connection with the development of your insurance score. 1. Rate filing by personal risk insurers (property insurance only) [56-5-305] a. Every insurer of personal risk insurance must file all rates, supplementary rate information, supporting information, policy forms, and endorsements at least 30 days before the proposed effective date. b. The Commissioner may give written notice, within 30 days of the receipt of the filing, that the Commissioner needs additional time, not to exceed 30 days from the date of such notice, to consider the filing. c. Upon written application by the insurer, the Commissioner may authorize rates to be effective before the expiration of the waiting period or an extension thereof.

16 Tennessee Law Supplement d. A filing will be deemed effective unless disapproved by the Commissioner before the expiration of the waiting period or extension. e. Whenever a filing is not accompanied by sufficient supporting information, the Commissioner will inform the insurer of what information is required to complete the filing. The filing will not be deemed to be made until such information is furnished. 2. Rate filing by commercial risk and workers compensation insurers [56-5-306] a. Every insurer of commercial risk insurance must file all rates, supplementary rate information, policy forms and endorsements, not later than 15 days after the effective date. Upon request of the Commissioner, supporting information must also be filed. b. The Commissioner may, after a hearing providing not less than 20 days written notice to the insurer, disapprove any policy form or endorsement already in effect if it does not comply with the law or with rules adopted pursuant to this part or if it contains any provision which is unfair, deceptive or misleading. Any such disapproval order must specify the reasons for the Commissioner s findings and the date, not less than 30 days after issuance of the order, when the disapproval is effective. c. With respect to workers compensation insurance, a rate service organization designated by one or more insurers will develop and file for approval with the Commissioner in accordance with the provisions of this section, a filing on behalf of authorized insurers containing advisory prospective loss costs and supporting actuarial and statistical data for workers compensation insurance. d. Each workers compensation insurer, or group of insurers under common ownership, must individually file the multiplier and supporting information not later than 15 days after the effective date, and at least annually thereafter on March 1. Multipliers must apply to the most recently approved, currently effective advisory prospective loss cost. H. COMMERCIAL RISK INSURANCE 1. Request for loss runs [56-5-323] Within 10 business days of receipt of a written request from an insured or an insured s designee, a commercial lines insurer must furnish, directly to the person designated in the request, a copy of the insured s loss run history for up to the previous three years or complete loss run history with the insurer if the history is less than three years. A written request includes communications made by email or fax. a. If the insurer fails to provide the requested information within the time allowed, the failure will be a violation of the Tennessee Unfair Trade Practices and Unfair Claims Settlement Act, and any requestor may seek enforcement and any remedies allowed under Tennessee law.

Tennessee Law Supplement 17 b. Notwithstanding this part to the contrary, no insurer shall charge any fees to prepare and furnish one three-year loss run history. However, if the insurer provides the loss run history via electronic means, then the insurer may charge a reasonable fee to provide a hard copy of the same report. III. TENNESSEE LAWS AND DEPARTMENTAL RULES PERTINENT TO PROPERTY INSURANCE ONLY A. FIRE INSURANCE 1. Fair value, inspection, and loss [56-7-801 to 803] Fair value is also known as the valued policy law. This law states that the amount listed on the fire insurance policy will be the amount upon which a claim is settled. It was enacted to protect the insured if the insurer contends that a building is over-insured and wants to settle a claim for less than the policy amount. It gives the insurer an incentive to inspect risks and assist insureds in setting the proper insurance amount on the building. Every producer, within 90 days after writing any contract of fire insurance on any building, must personally inspect the property. As a result, no company will knowingly issue, continue, or renew a fire insurance policy on property which exceeds the fair value of the property. If the inspection determines that the fair value is less than the policy amount, the company must adjust that policy amount within 90 days of the policy inception. If no inspection is made and/or no coverage amount is adjusted, the value shown by the policy at the time a loss occurs will be conclusively presumed to be reasonable, and settlement must be made on that basis. a. If buildings insured against loss by fire are totally destroyed by fire, the company will not be liable beyond the actual value of the insured property at the time of the loss or damage. b. If the insured has paid premiums on an amount in excess of the actual value, he will be reimbursed the proportionate excess or premiums paid on the difference between the amount named in the policy and said actual value, with interest at 6% per annum from the date of issue. B. PERSONAL RISK INSURANCE 1. Reason for nonrenewal [56-7-1901, 1902] Any Notice of Nonrenewal is due to the insured 30 days prior to expiration. Unless the nonrenewal notice contains a reason for nonrenewal action, such notice must advise the insured that upon written request of the named insured, mailed or delivered to the insurer not later than 15 days after the effective date of the nonrenewal, the insurer will within 20 days mail to the named insured a written statement specifying a reason for such nonrenewal action. There will be no liability on the part of, and no cause of action of any nature will arise against, any insurer, its authorized representative, its producers, its employees, or against any firm, person, or corporation furnishing information to the insurer, as to reason for nonrenewal.

18 Tennessee Law Supplement 2. Mandated offer of coverage [56-7-130] Every insurer offering homeowner property insurance in Tennessee must make coverage available for insurable sinkhole losses, including contents of personal property contained in the dwelling. The insurer may require an inspection of the property before issuance of sinkhole loss coverage. Nothing in this section mandates that sinkhole loss coverage be included in any homeowner property insurance policy but only that insurers offering homeowner property insurance make such coverage available for optional purchase on request by policyholders. Insurers must make a proper filing with the Department to comply with this section. The insurer may make sinkhole loss coverage available in the homeowner policy itself, by endorsement, or through other coverage that the insurer may arrange, and the insurer may make an additional charge for the coverage. a. Upon receipt of a claim for a sinkhole loss under a policy providing sinkhole loss coverage, an insurer must meet the following standards in investigating the claim: 1.) The insurer must make an inspection of the insured s premises to determine if there has been structural damage to the covered building resulting from possible sinkhole activity. 2.) If, upon the investigation, the insurer determines that there is no sinkhole loss, the insurer may deny the claim. Prior to denying the claim, the insurer must obtain a written certification from an engineer, a professional geologist, or other qualified individual stating that an analysis was conducted of sufficient scope to provide a professional opinion that sinkhole activity did not cause the observed structural damage. C. COMMERCIAL RISK INSURANCE 1. Definitions [56-5-302] a. Commercial risk is all insurance not considered personal risk insurance. Exceptions include: fidelity and surety bonds; and insurance written with a surplus line insurer. b. Nonpayment of premium is failure of the named insured to meet his obligations in connection with the payment of premiums on a policy of commercial risk insurance or any installment of such premium, regardless of to whom it is mailed. 2. Grounds for cancellation [56-7-1803] After a commercial risk insurance policy has been in effect for 60 days, or, if the policy is a renewal, effective immediately, no notice of cancellation will be effective unless it is based on the occurrence of one or more of the following: nonpayment of premium, including nonpayment of any additional premiums, calculated in accordance with the current rating manual of the insurer, justified by a physical change in the insured property or a change in its occupancy or use; conviction of the named insured of a crime having as one of its necessary elements any act increasing any hazard insured against;