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1. General Insurance Concepts
2. Casualty Insurance Basics
3. Legal Liability Concepts
4. Common Policy Provisions
5. Underwriting
6. Claims Settlement
7. Personal Auto Insurance (PAP)
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Vermont State Regulations & NAIC Insurance Law

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Licensing

Any individual applying for a Vermont resident producer’s license must:

  • Be at least 18 years old
  • Be a resident of Vermont before submitting an application, or maintain the principal place of business in Vermont (8 V.S.A. § 4800(3)(A))

Pre-licensing course and exam

Vermont does not have specific pre-licensing requirements, but a resident applicant must pass the examinations for the lines of authority applied for (Vt. Stat. Ann. tit. 8, § 4813f(a)).

Fingerprints/background check

The Commissioner reviews an applicant’s background before issuing a license, and many states require applicants to submit fingerprints for a state and FBI criminal history check as part of the application.

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

In Vermont, the Commissioner may not grant or continue a license, other than a life insurance license, that is being or will be used to write controlled business, and a license is treated as used for that purpose when commissions from controlled business exceed 25 percent of all commissions in any 12-month period (8 V.S.A. § 4795).

Non-resident license

A producer licensed in another state can obtain a Vermont nonresident license without taking Vermont’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

  • Is currently licensed as a resident, and in good standing, in the home state
  • Has applied (the home-state application or the Uniform Application) and paid the fees
  • Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

  • The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
  • A member or employee of a business entity producer, on the death or disability of its designated producer
  • The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The NAIC’s model act limits a temporary license to 180 days.

Military service

Under the NAIC’s model act, a producer who cannot meet license renewal requirements because of military service, or because of another extenuating circumstance such as a long-term medical disability, may request a waiver of those requirements and of any examination, fine or sanction for missing them.

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

Each state sets its own renewal cycle.

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Under the NAIC’s model act, a lapsed license may be reinstated within 12 months of the renewal due date, for a penalty of double the unpaid renewal fee. Each state sets its own window and fee, and after the window closes the person must qualify for a new license. In Vermont, a producer license expires at 12:01 a.m. on April 1 of the odd-numbered year after it is issued (8 V.S.A. § 4798(b)(1)).

Continuing education

All states, including Vermont, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in Vermont must complete continuing education before renewing their license. The number of hours required is set by state law and published by the state insurance department. In Vermont, a producer renewing a license must have completed 24 hours of continuing education during the preceding two years (8 V.S.A. § 4800a(a)).

Notice of change of name or address

Under the NAIC’s model act, the licensee reports a change of address to the regulator within 30 days of the change.

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Department of Financial Regulation to conduct business in Vermont. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in Vermont must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In Vermont, if a foreign insurer violates the state’s insurance company laws, the Commissioner may revoke its license (8 V.S.A. § 3363). To qualify for authority to transact insurance, a stock insurer must possess and maintain paid-in capital of at least $2,000,000 and, when first authorized, free surplus of at least $3,000,000 (8 V.S.A. § 3304).

Duties of the Commissioner of Financial Regulation

The Department of Financial Regulation is a state agency that affects Vermonters through regulation and monitoring of a broad range of financial industry activities. The department’s role is to protect consumers against unfair and unlawful business practices in banking, securities (investments), insurance, and captive insurance, while also ensuring that licensed entities remain financially healthy.

The Commissioner of the Vermont Department of Financial Regulation is a Vermont state government position and serves as the chief regulator of the state’s financial services sector. The Commissioner of Financial Regulation is appointed by the Governor for a term of 2 years.

The Commissioner is responsible for establishing and enforcing regulations in the Vermont insurance market in a manner that protects consumers and encourages economic development.

Duties of the Commissioner include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution. In Vermont, the Commissioner may report a violation to the Attorney General, who prosecutes it if the Attorney General deems it advisable (8 V.S.A. § 3661(a)(2)).

  • Monitor transactions of all companies including domestic, foreign, and alien insurance companies.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.

  • Approve documentation used by insurance companies such as forms and rates.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but it takes a law officer to arrest and a judge or court of law to issue injunctions or sentence jail time. The Commissioner may refer illegal activity for criminal prosecution.

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been convicted of a felony. In Vermont, a conviction of a misdemeanor involving moral turpitude is also a ground (8 V.S.A. § 4804(a)(7)).

  • Having admitted or been found to have committed any insurance unfair trade practice or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than Vermont.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner may order the producer to cease and desist. A cease and desist order does not, by itself, suspend or revoke a registration. Instead, it requires the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by Vermont law, and may ask a court to review the final order. In Vermont, the Commissioner may issue an order to cease and desist, without a prior hearing, whenever the Commissioner believes a person has violated the law; the order is reviewable de novo in the Vermont Superior Court, and review does not stay its enforcement unless the court so orders (8 V.S.A. § 3661(a)(1)). A civil penalty follows only after notice and an opportunity for hearing (§ 3661(a)(3)), as does suspension or revocation of a license (8 V.S.A. § 4804(a)); hearings follow the Administrative Procedure Act on reasonable notice (8 V.S.A. § 4805; 3 V.S.A. § 809(a)), and a license may be summarily suspended only in an emergency (3 V.S.A. § 814©).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes. In Vermont, the Commissioner may impose an administrative penalty of up to $1,000 for each violation and up to $10,000 for each willful violation, and may report a violation to the Attorney General, who decides whether to prosecute it (8 V.S.A. § 3661(a)(2)-(3)).

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

Depending on the line of insurance and the form, a state may require approval before a form is used, often with a period after which a filing that has not been acted on is deemed approved, or may allow the form to be used as soon as it is filed (“file and use”). In Vermont, a policy, application, rider or endorsement form must be filed with and approved by the Commissioner at least 30 days before it is delivered, and is deemed approved at the end of that period unless the Commissioner acts, with one extension of up to 30 days (8 V.S.A. § 3541(a)-(b)).

If a policy provision conflicts with Vermont law, the policy is read as amended to conform to the law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Vermont requires a producer to keep its records for three years after a personal lines transaction is completed and five years after a commercial lines transaction is completed, completion being the policy’s expiration or cancellation (Vt. Ins. Reg. I-1999-01, § 7.B).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Vermont, but has not passed the appropriate licensing examination, is in violation of regulation. This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in Vermont in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. Vermont’s rule is broader still: it reaches such a statement about the financial condition of any person, calculated to injure that person (8 V.S.A. § 4724(3)). Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited. Vermont also prohibits any act of boycott, coercion or intimidation in the marketing or sale of any insurance contract, whether or not it restrains trade (8 V.S.A. § 4724(4)(B)).

False financial statements

Any licensed producer who makes false statements containing inaccurate material facts, or makes false statements on an application for insurance, is in violation of the state’s unfair trade practices law.

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

States differ on promotional gifts. The NAIC’s model act lets producers and insurers give customers non-cash gifts, meals or charitable donations up to an amount the state considers reasonable, as long as the gift is not conditioned on buying or renewing a policy and is offered without unfair discrimination. Each state sets its own limit. Vermont’s rebating law sets no gift allowance: it bars giving, as an inducement to insurance, any valuable consideration or inducement not specified in the contract (8 V.S.A. § 4724(8)(A)).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

  • Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
  • Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
  • Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
  • In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind. Vermont’s own list bars unfair discrimination on the basis of sex, sexual orientation, gender identity or marital status in underwriting, eligibility or rates, while allowing rates set on reasonable classifications based on relevant actuarial data or actual cost experience (8 V.S.A. § 4724(7)(B)).

Errors & Omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers only honest mistakes that result in (financial) damage to customers or prospects. It does not cover violations of insurance regulation.

Rebating

Vermont licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information are prohibited.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Unfair marketing practices

The Department of Financial Regulation is responsible for establishing minimum standards for full and fair disclosure of policy content. The Department also requires standardization and simplification of the terms used to describe insurance coverage. Advertising may not involve the following:

  • Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities for federal and state regulators across these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

  • When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
  • When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

In states that adopted the NAIC’s Insurance Information and Privacy Protection Model Act, an authorization to collect personal information signed with an application is valid for no more than 30 months for life, health or disability insurance and one year for property or casualty insurance.

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

  • May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
  • Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

  • Be identified clearly as an advertisement
  • Carry accurate header information and a subject line that is not deceptive
  • Include the sender’s valid physical postal address
  • Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Insurance guaranty association

Every state has a property and casualty insurance guaranty association that pays covered claims when a member insurer becomes insolvent. Insurers licensed to write the covered lines in the state must belong to it, and it is funded by assessments on its members.

Each state sets the most its association pays per claim. The NAIC’s model act sets $500,000 per claimant for most covered claims and $10,000 for the return of unearned premium.

Auto insurance state minimum

The “state minimum” auto insurance is the minimum amount of car insurance you must carry in Vermont to legally drive a vehicle. It helps ensure you can pay for others’ injuries and damages if you cause a car accident. Driving without adequate coverage can result in financial repercussions such as fines, license suspensions, vehicle impoundment, and even jail time.

Auto insurance is typically structured as a split limit policy with coverage minimums represented by numbers and slashes. The first number is BI coverage per person, the second is BI coverage per incident (if multiple people are injured), and the third is PD per incident.

In Vermont, the state minimum is 25/50/10. This covers up to $25,000 of Bodily Injury protection for each person involved in an accident, up to $50,000 of Bodily Injuries per incident, and up to $10,000 of Property Damage per incident.

Licensing

  • Minimum age 18; must be Vermont resident or maintain principal place of business in VT (8 V.S.A. § 4800(3)(A))
  • No state pre-licensing course requirement, but must pass exam for lines applied for

Pre-licensing course and exam

  • Vermont has no pre-licensing education mandate
  • Applicant must pass exams per §4813f(a)

Fingerprints/background check

  • Commissioner reviews applicant background
  • Many states require fingerprints for state/FBI criminal history check

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • VT: license (other than life) barred if controlled business commissions exceed 25% of total in any 12-month period (8 V.S.A. § 4795)

Non-resident license

  • No VT exam needed if licensed elsewhere in good standing, applied w/ fees, and home state offers reciprocity
  • Address change: file within 30 days
  • Moving to new state: apply for resident license within 90 days; no repeat of prelicensing/exam for held lines

Temporary license

  • Issued without exam to keep business serviced (e.g., death/disability of producer, military deployment)
  • May require a licensed sponsor
  • NAIC model caps temporary license at 180 days

Military service

  • Waiver available for renewal requirements/exams/fines due to military service or extenuating circumstances (e.g., long-term disability)

Renewal and reinstatement

  • Must pay fee + complete CE by deadline; each state sets own cycle
  • NAIC model: lapsed license reinstated within 12 months for double fee penalty
  • VT license expires 12:01 a.m. April 1 of odd-numbered year (8 V.S.A. § 4798(b)(1))

Continuing education

  • Required in all states for renewal of major lines
  • VT requires 24 hours CE every two years (8 V.S.A. § 4800a(a))

Notice of change of name or address

  • Report address change within 30 days
  • Report administrative actions/criminal prosecutions within 30 days of final disposition/pretrial hearing
  • Must notify regulator before using a business name other than legal name

Company regulations

  • Insurer must get certificate of authority from VT Dept. of Financial Regulation
  • Must file charter, financial statements, meet capital/surplus requirements

Capital and surplus requirement

  • VT stock insurer: min. paid-in capital $2,000,000; free surplus $3,000,000 when first authorized (8 V.S.A. § 3304)
  • Commissioner may revoke foreign insurer’s license for violations (§3363)

Duties of the Commissioner of Financial Regulation

  • Appointed by Governor for 2-year term; protects consumers, ensures financial health of insurers
  • Duties: investigate complaints, monitor insurers, audit producer records, collect fees, impose fines, approve forms/rates
  • Cannot arrest, issue injunctions, or sentence jail time — refers violations to Attorney General

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony conviction (VT also includes misdemeanor involving moral turpitude), unfair trade practices, prior license revocation elsewhere, exam cheating

Cease and desist

  • Orders producer to stop/limit activity; does not itself suspend/revoke license
  • VT: can issue without prior hearing; reviewable de novo in Superior Court (8 V.S.A. §3661(a)(1))

Hearing and penalties

  • Right to notice/hearing before civil penalty or license suspension/revocation
  • VT penalties: up to $1,000 per violation, up to $10,000 for willful violations (§3661(a)(2)-(3))

Unfair claims settlement practices

  • Violations when flagrant/repeated: delaying claims, failing to investigate, denying without investigation, settling below fair market value, altering application info without consent

Policy forms

  • Insurers file forms with Commissioner
  • VT: file 30 days before use, deemed approved unless Commissioner acts; one 30-day extension allowed (8 V.S.A. §3541)
  • Conflicting policy provisions read as amended to match law

Record maintenance

  • VT: keep records 3 years after personal lines transaction; 5 years after commercial lines transaction (Reg. I-1999-01 §7.B)

Fraudulent producer representation

  • Falsely claiming licensure via ads, cards, letterhead, etc. is a violation
  • Can result in suspension/revocation of other licenses held

Misrepresentation

  • Includes inaccurate policy illustrations/comparisons
  • Includes “twisting” — inducing lapse/surrender via false info

False advertising

  • Untrue, deceptive or misleading statements about insurance business = unfair trade practice
  • Applies across all media; intent to deceive not required

Defamation

  • False/malicious statements about insurer’s financial condition = unfair trade practice
  • VT extends this to any person’s financial condition (8 V.S.A. §4724(3))

Boycott, coercion and intimidation

  • Prohibited if it restrains trade/monopolizes insurance business
  • VT bars such acts in marketing/sale regardless of trade restraint (§4724(4)(B))

False financial statements

  • Producers making false material statements on applications violate unfair trade practices law

Illegal inducements

  • Offering unlisted value as inducement to buy insurance is prohibited unless allowed by law
  • NAIC model allows reasonable non-cash gifts if not conditioned on purchase
  • VT has no gift allowance — bars any unlisted inducement (§4724(8)(A))

Unfair discrimination

  • Prohibits differing treatment of same-class/same-risk individuals
  • Cannot discriminate based on sex, marital status, race, religion, national origin
  • VT also bars discrimination based on sexual orientation/gender identity (§4724(7)(B))
  • Reasonable actuarially-based classifications allowed

Errors & Omissions

  • E&O insurance covers professional liability for honest mistakes causing financial harm
  • Does not cover regulatory violations

Rebating

  • VT prohibits giving refunds/discounts/credits to induce insurance purchase
  • Soliciting/negotiating insurance implies licensure

Sharing commission

  • Allowed only between licensed producers in same line
  • NAIC model also allows payment to agencies or non-solicitors

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • Overlaps with defamation if statement is false/malicious about competitor

Unfair marketing practices

  • DFR sets standards for full/fair disclosure and standardized terminology
  • Ads cannot falsely imply government/organization endorsement or misstate claims timelines

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall; allows merging of banks, investment firms, insurers
  • Establishes regulatory framework across financial industries

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Grants limited antitrust exemption
  • Since 2021, exemption excludes health insurance (except narrow data-sharing) (15 U.S.C. §1013©)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body of state insurance regulators (50 states, DC, 5 territories)
  • Establishes standards, conducts peer review, coordinates oversight

Fair Credit Reporting Act

  • Governs use of consumer reports in underwriting
  • Investigative report requests: disclose within 3 days
  • Adverse action: consumer has 60 days to request free report/dispute errors

Privacy Act of 1974

  • Applies only to federal agencies, not private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid max 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • Do Not Call Registry restricts calls to registered numbers
  • Calls allowed only 8 a.m.–9 p.m. local time
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

  • Commercial emails must be labeled as ads, have accurate headers/subject lines
  • Must include sender’s physical address
  • Opt-out must be honored within 10 business days

Insurance guaranty association

  • Pays covered claims when member insurer becomes insolvent
  • Funded by member assessments
  • NAIC model caps: $500,000 per claimant (most claims), $10,000 for unearned premium

Auto insurance state minimum

  • Minimum coverage required to legally drive
  • Format: BI per person / BI per incident / PD per incident
  • Vermont minimum: 25/50/10 ($25,000 BI/person, $50,000 BI/incident, $10,000 PD/incident)

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Vermont State Regulations & NAIC Insurance Law

Licensing

Any individual applying for a Vermont resident producer’s license must:

  • Be at least 18 years old
  • Be a resident of Vermont before submitting an application, or maintain the principal place of business in Vermont (8 V.S.A. § 4800(3)(A))

Pre-licensing course and exam

Vermont does not have specific pre-licensing requirements, but a resident applicant must pass the examinations for the lines of authority applied for (Vt. Stat. Ann. tit. 8, § 4813f(a)).

Fingerprints/background check

The Commissioner reviews an applicant’s background before issuing a license, and many states require applicants to submit fingerprints for a state and FBI criminal history check as part of the application.

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

In Vermont, the Commissioner may not grant or continue a license, other than a life insurance license, that is being or will be used to write controlled business, and a license is treated as used for that purpose when commissions from controlled business exceed 25 percent of all commissions in any 12-month period (8 V.S.A. § 4795).

Non-resident license

A producer licensed in another state can obtain a Vermont nonresident license without taking Vermont’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

  • Is currently licensed as a resident, and in good standing, in the home state
  • Has applied (the home-state application or the Uniform Application) and paid the fees
  • Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

  • The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
  • A member or employee of a business entity producer, on the death or disability of its designated producer
  • The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The NAIC’s model act limits a temporary license to 180 days.

Military service

Under the NAIC’s model act, a producer who cannot meet license renewal requirements because of military service, or because of another extenuating circumstance such as a long-term medical disability, may request a waiver of those requirements and of any examination, fine or sanction for missing them.

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

Each state sets its own renewal cycle.

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Under the NAIC’s model act, a lapsed license may be reinstated within 12 months of the renewal due date, for a penalty of double the unpaid renewal fee. Each state sets its own window and fee, and after the window closes the person must qualify for a new license. In Vermont, a producer license expires at 12:01 a.m. on April 1 of the odd-numbered year after it is issued (8 V.S.A. § 4798(b)(1)).

Continuing education

All states, including Vermont, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in Vermont must complete continuing education before renewing their license. The number of hours required is set by state law and published by the state insurance department. In Vermont, a producer renewing a license must have completed 24 hours of continuing education during the preceding two years (8 V.S.A. § 4800a(a)).

Notice of change of name or address

Under the NAIC’s model act, the licensee reports a change of address to the regulator within 30 days of the change.

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Department of Financial Regulation to conduct business in Vermont. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in Vermont must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In Vermont, if a foreign insurer violates the state’s insurance company laws, the Commissioner may revoke its license (8 V.S.A. § 3363). To qualify for authority to transact insurance, a stock insurer must possess and maintain paid-in capital of at least $2,000,000 and, when first authorized, free surplus of at least $3,000,000 (8 V.S.A. § 3304).

Duties of the Commissioner of Financial Regulation

The Department of Financial Regulation is a state agency that affects Vermonters through regulation and monitoring of a broad range of financial industry activities. The department’s role is to protect consumers against unfair and unlawful business practices in banking, securities (investments), insurance, and captive insurance, while also ensuring that licensed entities remain financially healthy.

The Commissioner of the Vermont Department of Financial Regulation is a Vermont state government position and serves as the chief regulator of the state’s financial services sector. The Commissioner of Financial Regulation is appointed by the Governor for a term of 2 years.

The Commissioner is responsible for establishing and enforcing regulations in the Vermont insurance market in a manner that protects consumers and encourages economic development.

Duties of the Commissioner include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution. In Vermont, the Commissioner may report a violation to the Attorney General, who prosecutes it if the Attorney General deems it advisable (8 V.S.A. § 3661(a)(2)).

  • Monitor transactions of all companies including domestic, foreign, and alien insurance companies.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.

  • Approve documentation used by insurance companies such as forms and rates.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but it takes a law officer to arrest and a judge or court of law to issue injunctions or sentence jail time. The Commissioner may refer illegal activity for criminal prosecution.

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been convicted of a felony. In Vermont, a conviction of a misdemeanor involving moral turpitude is also a ground (8 V.S.A. § 4804(a)(7)).

  • Having admitted or been found to have committed any insurance unfair trade practice or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than Vermont.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner may order the producer to cease and desist. A cease and desist order does not, by itself, suspend or revoke a registration. Instead, it requires the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by Vermont law, and may ask a court to review the final order. In Vermont, the Commissioner may issue an order to cease and desist, without a prior hearing, whenever the Commissioner believes a person has violated the law; the order is reviewable de novo in the Vermont Superior Court, and review does not stay its enforcement unless the court so orders (8 V.S.A. § 3661(a)(1)). A civil penalty follows only after notice and an opportunity for hearing (§ 3661(a)(3)), as does suspension or revocation of a license (8 V.S.A. § 4804(a)); hearings follow the Administrative Procedure Act on reasonable notice (8 V.S.A. § 4805; 3 V.S.A. § 809(a)), and a license may be summarily suspended only in an emergency (3 V.S.A. § 814©).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes. In Vermont, the Commissioner may impose an administrative penalty of up to $1,000 for each violation and up to $10,000 for each willful violation, and may report a violation to the Attorney General, who decides whether to prosecute it (8 V.S.A. § 3661(a)(2)-(3)).

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

Depending on the line of insurance and the form, a state may require approval before a form is used, often with a period after which a filing that has not been acted on is deemed approved, or may allow the form to be used as soon as it is filed (“file and use”). In Vermont, a policy, application, rider or endorsement form must be filed with and approved by the Commissioner at least 30 days before it is delivered, and is deemed approved at the end of that period unless the Commissioner acts, with one extension of up to 30 days (8 V.S.A. § 3541(a)-(b)).

If a policy provision conflicts with Vermont law, the policy is read as amended to conform to the law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Vermont requires a producer to keep its records for three years after a personal lines transaction is completed and five years after a commercial lines transaction is completed, completion being the policy’s expiration or cancellation (Vt. Ins. Reg. I-1999-01, § 7.B).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Vermont, but has not passed the appropriate licensing examination, is in violation of regulation. This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in Vermont in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. Vermont’s rule is broader still: it reaches such a statement about the financial condition of any person, calculated to injure that person (8 V.S.A. § 4724(3)). Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited. Vermont also prohibits any act of boycott, coercion or intimidation in the marketing or sale of any insurance contract, whether or not it restrains trade (8 V.S.A. § 4724(4)(B)).

False financial statements

Any licensed producer who makes false statements containing inaccurate material facts, or makes false statements on an application for insurance, is in violation of the state’s unfair trade practices law.

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

States differ on promotional gifts. The NAIC’s model act lets producers and insurers give customers non-cash gifts, meals or charitable donations up to an amount the state considers reasonable, as long as the gift is not conditioned on buying or renewing a policy and is offered without unfair discrimination. Each state sets its own limit. Vermont’s rebating law sets no gift allowance: it bars giving, as an inducement to insurance, any valuable consideration or inducement not specified in the contract (8 V.S.A. § 4724(8)(A)).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

  • Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
  • Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
  • Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
  • In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind. Vermont’s own list bars unfair discrimination on the basis of sex, sexual orientation, gender identity or marital status in underwriting, eligibility or rates, while allowing rates set on reasonable classifications based on relevant actuarial data or actual cost experience (8 V.S.A. § 4724(7)(B)).

Errors & Omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers only honest mistakes that result in (financial) damage to customers or prospects. It does not cover violations of insurance regulation.

Rebating

Vermont licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information are prohibited.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Unfair marketing practices

The Department of Financial Regulation is responsible for establishing minimum standards for full and fair disclosure of policy content. The Department also requires standardization and simplification of the terms used to describe insurance coverage. Advertising may not involve the following:

  • Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities for federal and state regulators across these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

  • When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
  • When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

In states that adopted the NAIC’s Insurance Information and Privacy Protection Model Act, an authorization to collect personal information signed with an application is valid for no more than 30 months for life, health or disability insurance and one year for property or casualty insurance.

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

  • May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
  • Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

  • Be identified clearly as an advertisement
  • Carry accurate header information and a subject line that is not deceptive
  • Include the sender’s valid physical postal address
  • Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Insurance guaranty association

Every state has a property and casualty insurance guaranty association that pays covered claims when a member insurer becomes insolvent. Insurers licensed to write the covered lines in the state must belong to it, and it is funded by assessments on its members.

Each state sets the most its association pays per claim. The NAIC’s model act sets $500,000 per claimant for most covered claims and $10,000 for the return of unearned premium.

Auto insurance state minimum

The “state minimum” auto insurance is the minimum amount of car insurance you must carry in Vermont to legally drive a vehicle. It helps ensure you can pay for others’ injuries and damages if you cause a car accident. Driving without adequate coverage can result in financial repercussions such as fines, license suspensions, vehicle impoundment, and even jail time.

Auto insurance is typically structured as a split limit policy with coverage minimums represented by numbers and slashes. The first number is BI coverage per person, the second is BI coverage per incident (if multiple people are injured), and the third is PD per incident.

In Vermont, the state minimum is 25/50/10. This covers up to $25,000 of Bodily Injury protection for each person involved in an accident, up to $50,000 of Bodily Injuries per incident, and up to $10,000 of Property Damage per incident.

Key points

Licensing

  • Minimum age 18; must be Vermont resident or maintain principal place of business in VT (8 V.S.A. § 4800(3)(A))
  • No state pre-licensing course requirement, but must pass exam for lines applied for

Pre-licensing course and exam

  • Vermont has no pre-licensing education mandate
  • Applicant must pass exams per §4813f(a)

Fingerprints/background check

  • Commissioner reviews applicant background
  • Many states require fingerprints for state/FBI criminal history check

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • VT: license (other than life) barred if controlled business commissions exceed 25% of total in any 12-month period (8 V.S.A. § 4795)

Non-resident license

  • No VT exam needed if licensed elsewhere in good standing, applied w/ fees, and home state offers reciprocity
  • Address change: file within 30 days
  • Moving to new state: apply for resident license within 90 days; no repeat of prelicensing/exam for held lines

Temporary license

  • Issued without exam to keep business serviced (e.g., death/disability of producer, military deployment)
  • May require a licensed sponsor
  • NAIC model caps temporary license at 180 days

Military service

  • Waiver available for renewal requirements/exams/fines due to military service or extenuating circumstances (e.g., long-term disability)

Renewal and reinstatement

  • Must pay fee + complete CE by deadline; each state sets own cycle
  • NAIC model: lapsed license reinstated within 12 months for double fee penalty
  • VT license expires 12:01 a.m. April 1 of odd-numbered year (8 V.S.A. § 4798(b)(1))

Continuing education

  • Required in all states for renewal of major lines
  • VT requires 24 hours CE every two years (8 V.S.A. § 4800a(a))

Notice of change of name or address

  • Report address change within 30 days
  • Report administrative actions/criminal prosecutions within 30 days of final disposition/pretrial hearing
  • Must notify regulator before using a business name other than legal name

Company regulations

  • Insurer must get certificate of authority from VT Dept. of Financial Regulation
  • Must file charter, financial statements, meet capital/surplus requirements

Capital and surplus requirement

  • VT stock insurer: min. paid-in capital $2,000,000; free surplus $3,000,000 when first authorized (8 V.S.A. § 3304)
  • Commissioner may revoke foreign insurer’s license for violations (§3363)

Duties of the Commissioner of Financial Regulation

  • Appointed by Governor for 2-year term; protects consumers, ensures financial health of insurers
  • Duties: investigate complaints, monitor insurers, audit producer records, collect fees, impose fines, approve forms/rates
  • Cannot arrest, issue injunctions, or sentence jail time — refers violations to Attorney General

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony conviction (VT also includes misdemeanor involving moral turpitude), unfair trade practices, prior license revocation elsewhere, exam cheating

Cease and desist

  • Orders producer to stop/limit activity; does not itself suspend/revoke license
  • VT: can issue without prior hearing; reviewable de novo in Superior Court (8 V.S.A. §3661(a)(1))

Hearing and penalties

  • Right to notice/hearing before civil penalty or license suspension/revocation
  • VT penalties: up to $1,000 per violation, up to $10,000 for willful violations (§3661(a)(2)-(3))

Unfair claims settlement practices

  • Violations when flagrant/repeated: delaying claims, failing to investigate, denying without investigation, settling below fair market value, altering application info without consent

Policy forms

  • Insurers file forms with Commissioner
  • VT: file 30 days before use, deemed approved unless Commissioner acts; one 30-day extension allowed (8 V.S.A. §3541)
  • Conflicting policy provisions read as amended to match law

Record maintenance

  • VT: keep records 3 years after personal lines transaction; 5 years after commercial lines transaction (Reg. I-1999-01 §7.B)

Fraudulent producer representation

  • Falsely claiming licensure via ads, cards, letterhead, etc. is a violation
  • Can result in suspension/revocation of other licenses held

Misrepresentation

  • Includes inaccurate policy illustrations/comparisons
  • Includes “twisting” — inducing lapse/surrender via false info

False advertising

  • Untrue, deceptive or misleading statements about insurance business = unfair trade practice
  • Applies across all media; intent to deceive not required

Defamation

  • False/malicious statements about insurer’s financial condition = unfair trade practice
  • VT extends this to any person’s financial condition (8 V.S.A. §4724(3))

Boycott, coercion and intimidation

  • Prohibited if it restrains trade/monopolizes insurance business
  • VT bars such acts in marketing/sale regardless of trade restraint (§4724(4)(B))

False financial statements

  • Producers making false material statements on applications violate unfair trade practices law

Illegal inducements

  • Offering unlisted value as inducement to buy insurance is prohibited unless allowed by law
  • NAIC model allows reasonable non-cash gifts if not conditioned on purchase
  • VT has no gift allowance — bars any unlisted inducement (§4724(8)(A))

Unfair discrimination

  • Prohibits differing treatment of same-class/same-risk individuals
  • Cannot discriminate based on sex, marital status, race, religion, national origin
  • VT also bars discrimination based on sexual orientation/gender identity (§4724(7)(B))
  • Reasonable actuarially-based classifications allowed

Errors & Omissions

  • E&O insurance covers professional liability for honest mistakes causing financial harm
  • Does not cover regulatory violations

Rebating

  • VT prohibits giving refunds/discounts/credits to induce insurance purchase
  • Soliciting/negotiating insurance implies licensure

Sharing commission

  • Allowed only between licensed producers in same line
  • NAIC model also allows payment to agencies or non-solicitors

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • Overlaps with defamation if statement is false/malicious about competitor

Unfair marketing practices

  • DFR sets standards for full/fair disclosure and standardized terminology
  • Ads cannot falsely imply government/organization endorsement or misstate claims timelines

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall; allows merging of banks, investment firms, insurers
  • Establishes regulatory framework across financial industries

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Grants limited antitrust exemption
  • Since 2021, exemption excludes health insurance (except narrow data-sharing) (15 U.S.C. §1013©)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body of state insurance regulators (50 states, DC, 5 territories)
  • Establishes standards, conducts peer review, coordinates oversight

Fair Credit Reporting Act

  • Governs use of consumer reports in underwriting
  • Investigative report requests: disclose within 3 days
  • Adverse action: consumer has 60 days to request free report/dispute errors

Privacy Act of 1974

  • Applies only to federal agencies, not private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid max 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • Do Not Call Registry restricts calls to registered numbers
  • Calls allowed only 8 a.m.–9 p.m. local time
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

  • Commercial emails must be labeled as ads, have accurate headers/subject lines
  • Must include sender’s physical address
  • Opt-out must be honored within 10 business days

Insurance guaranty association

  • Pays covered claims when member insurer becomes insolvent
  • Funded by member assessments
  • NAIC model caps: $500,000 per claimant (most claims), $10,000 for unearned premium

Auto insurance state minimum

  • Minimum coverage required to legally drive
  • Format: BI per person / BI per incident / PD per incident
  • Vermont minimum: 25/50/10 ($25,000 BI/person, $50,000 BI/incident, $10,000 PD/incident)

Related readings

  • Casualty Insurance Basics
  • Legal Liability Concepts
  • Common Policy Provisions
  • Underwriting
  • Claims Settlement