New Hampshire State Regulations & NAIC Insurance Law
Licensing
Any individual applying for a New Hampshire resident producer’s license must be at least 18 years old and must have New Hampshire as the home state, the state of the applicant’s principal place of residence or principal place of business (N.H. Rev. Stat. Ann. § 402-J:2, III).
Pre-licensing course and exam
New Hampshire does not have specific pre-licensing requirements, but a resident applicant must pass the examinations for the line or lines of authority applied for (N.H. Rev. Stat. Ann. § 402-J:6, I); the Insurance Department has not required a prelicensing course since July 11, 2008 (New Hampshire Insurance Department, Producers/Adjusters FAQ).
A New Hampshire applicant who fails the producer examination, or fails to appear for it as scheduled, must reapply and pay all required fees again before being rescheduled for another examination (N.H. Rev. Stat. Ann. § 402-J:5, IV).
Fingerprints/background check
The Commissioner reviews an applicant’s background before issuing a license.
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.
In New Hampshire, an applicant for an agent’s license who receives in any calendar year more than 10 percent of total commissions or premiums from insurance on the applicant’s own property, or on property of persons the law lists, among them the applicant’s employer and employees, is deemed to be licensed primarily to insure that property, and the Commissioner does not issue the license unless the applicant shows otherwise (N.H. Rev. Stat. Ann. § 402:74).
Non-resident license
A producer licensed in another state can obtain a New Hampshire nonresident license without taking New Hampshire’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.
New Hampshire follows the model: unless denied licensure, a nonresident receives a New Hampshire producer license if currently licensed as a resident and in good standing in the home state, having submitted the request for licensure and paid the fees, having submitted the home-state application or a completed uniform application, and if the home state awards nonresident producer licenses to New Hampshire residents on the same basis (N.H. Rev. Stat. Ann. § 402-J:8, I).
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
Under the NAIC’s model act, the regulator may also issue one in any other circumstance where it finds that the public interest will best be served.
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.
New Hampshire may issue a temporary producer license for up to 180 days without an examination where it is necessary for servicing an insurance business: to a member or employee of a business entity producer on the death or disability of its designated individual, to the designee of a producer entering active service in the armed forces, or in any other circumstance where the public interest will best be served (N.H. Rev. Stat. Ann. § 402-J:11, I).
Military service
In New Hampshire, a licensed producer who cannot comply with license renewal procedures because of military service or another extenuating circumstance may request a waiver of those procedures, and of any examination requirement or other fine or sanction imposed for failing to comply with them (N.H. Rev. Stat. Ann. § 402-J:7, IV).
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.
A New Hampshire producer license is a two-year license: an individual’s license expires on the last day of the birth month, the first one at the second birth month after it is issued, and it then renews for two full years (New Hampshire Insurance Department, Producers/Adjusters FAQ).
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 New Hampshire, a producer whose license lapses may reinstate it within 24 months of the renewal fee’s due date without an exam, with a penalty of double the unpaid renewal fee (N.H. Rev. Stat. Ann. § 402-J:7, III).
Continuing education
All states, including New Hampshire, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in New Hampshire 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 New Hampshire, every 2 years, at least 60 days before the license’s renewal date, a producer must be certified as having completed approved continuing education, part of it in ethics, and a nonresident who has met the home state’s requirements is excused (N.H. Rev. Stat. Ann. § 402-J:7-a). The Insurance Department’s rule applies this to producers licensed in life insurance (including annuities), variable contracts, sickness, accident and health insurance, and all lines of property and casualty insurance, but not to persons engaged in the sale of physical damage only, motor vehicle warranty, travel accident, home warranty or title insurance, and passing the state licensing exam satisfies the renewal that follows it (N.H. Code Admin. R. Ins 1302.02(a), (c), 1302.03(g)). The requirement is 24 hours of continuing education every 2 years, of which at least 3 and no more than 10 must be courses approved for ethics credit (N.H. Rev. Stat. Ann. § 402-J:7-a).
Notice of change of name or address
A New Hampshire licensee informs the Commissioner of a change of address within 30 days of the change (N.H. Rev. Stat. Ann. § 402-J:7, VI); the Insurance Department says this includes email addresses (New Hampshire Insurance Department, Producer Licenses).
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 Insurance Department to conduct business in New Hampshire. 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 New Hampshire 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 New Hampshire, the Commissioner may revoke or restrict an insurer’s license for the causes and in the manner the law prescribes, and must revoke the license of a foreign company whose affairs are, in the Commissioner’s opinion, in an unsound or failing condition (N.H. Rev. Stat. Ann. §§ 405:13, 405:14). These provisions govern insurance companies not organized under New Hampshire law. Such a company’s license runs until June 14 and may be renewed each year on June 14 so long as the company complies with the law and NAIC guidelines, the Commissioner regards it as safe, reliable and entitled to confidence, and it continues to conduct a meaningful insurance business in New Hampshire (N.H. Rev. Stat. Ann. §§ 405:1, 405:12, I). Such a stock company organized before January 1, 2026 must at all times maintain paid-up capital of at least the minimum required at the time it was organized (N.H. Rev. Stat. Ann. § 405:2).
Medigap policies
To reduce confusion among the many types of Medicare supplement policies, federal law requires national standardization of Medigap policies. Insurers must offer a limited number of standardized Medigap plans developed by the NAIC.
Currently, the available plans are A, B, C, D, F, G, K, L, M, and N. Plans E, H, I, and J have been eliminated. In addition, Plans C and F are not available to individuals who became newly eligible for Medicare on or after January 1, 2020.
Plan A includes the “core” benefits (Parts A and B co-payments, 365 additional days of hospitalization, and the first 3 pints of blood). Its core benefits also include the Part A hospice care coinsurance or copayment. If an insurer sells any Medigap policies in the state, it must offer Plan A.
In New Hampshire, the issuer delivers the Guide to Health Insurance for People with Medicare (the Buyer’s Guide) to the applicant at the time of application and provides an Outline of Coverage to every applicant at the time the application is presented, obtaining an acknowledgment of receipt of each; a direct response issuer obtains neither acknowledgment, and delivers the Guide on request but no later than when the policy is delivered (N.H. Code Admin. R. Ins 1905.19(a)(6), (d)(1)).
Duties of the Insurance Commissioner
The New Hampshire Insurance Commissioner is an appointed state executive position in New Hampshire state government. The commissioner serves five-year terms, oversees the Insurance Department, and is responsible for enforcing and executing the insurance laws of the state.
The Commissioner is responsible for establishing and enforcing regulations in the New Hampshire insurance market in a manner that protects consumers and encourages economic development.
Those duties include:
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Investigate all claims and complaints of legal violations relating to insurance.
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If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.
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Monitor transactions of all companies including domestic, foreign, and alien insurance companies.
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Audit the books and records of any resident producer as frequently as necessary. Under the NAIC’s examination model, the regulator may examine any person subject to its authority, nonresident producers included, as often as it considers appropriate. In New Hampshire, where the Commissioner has reasonable grounds to believe there is noncompliance with or violation of law, regulation or order, the Commissioner may examine the accounts, records, documents and transactions of any insurance producer, adjuster or insurer representative, or of anyone holding out as one, as often and to the extent the Commissioner deems advisable (N.H. Rev. Stat. Ann. § 400-A:37, II(a)).
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Collect all fees associated with producers and insurers.
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Determine and administer fines associated with violations for insurers and producers.
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Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.
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Approve documentation used by insurance companies such as forms and rates.
Suspend, revoke or non-renew
The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:
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Providing false information on the application for an insurance license.
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Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license. New Hampshire’s ground is broader: providing incorrect, misleading, incomplete or materially untrue information in the license application (N.H. Rev. Stat. Ann. § 402-J:12, I(a)).
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Being found guilty of a violation or the noncompliance of insurance regulations and laws…
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Committing fraud while attempting to obtain an insurance license.
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Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.
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Providing false information in reference to the terms and conditions of an insurance contract.
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Having been convicted of a felony.
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Having admitted or been found to have committed any insurance unfair trade practice or fraud.
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Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.
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Having had a prior insurance license revoked or suspended in a state other than New Hampshire. Under the NAIC’s model act, a license denied in another state is also a ground.
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Using another person’s identity and forging their name on an insurance application.
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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 suspend or revoke the recipient’s registration. However, it does require 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 New Hampshire law, and may ask a court to review the final order. In New Hampshire, the Commissioner issues orders upon hearing, with written notice at least 10 days in advance (N.H. Rev. Stat. Ann. §§ 400-A:14, I, 400-A:18, I). A person aggrieved by an act or order of the Commissioner applies in writing for a hearing within 30 days after the person knew or reasonably should have known of it, unless another law sets a different period, and the hearing is first scheduled within 60 days of the application (N.H. Rev. Stat. Ann. § 400-A:17, III).
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. Some violations are also crimes.
In New Hampshire, the Commissioner may fine a producer up to $2,500 per violation, alone or together with probation, suspension, revocation or refusal to issue or renew the license (N.H. Rev. Stat. Ann. § 402-J:12, I), and may impose up to $2,500 for each act or practice found to violate the unfair trade practices law (N.H. Rev. Stat. Ann. § 417:10, I).
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. New Hampshire’s own list, worded differently from the list below, makes each of its acts an unfair claim settlement practice when an insurer commits it without just cause and not merely inadvertently or accidentally; among them is attempting settlement or compromise of a claim on the basis of an application altered without notice to, or knowledge or consent of, the insured (N.H. Rev. Stat. Ann. § 417:4, XV(a)).
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Unreasonably delaying the investigation or payment of claims by requiring both a formal proof of loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form.
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Failing, in the case of claims denials or offers of compromise settlement, to promptly provide a reasonable and accurate explanation of the basis for such actions.
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Refusing to pay claims without conducting a reasonable investigation.
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Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.
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Denying a claim without conducting a thorough investigation.
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Attempting to settle or settling a claim for less than the amount a reasonable person would believe the insured or beneficiary was entitled to by reference to written or printed advertising material accompanying or made part of an application.
Policy forms
Insurers file their policy forms with the Commissioner.
In New Hampshire, a life insurance or annuity form may not be issued or delivered until it has been submitted to the Commissioner for review, and the Commissioner may disapprove it within 30 days after it is filed (N.H. Rev. Stat. Ann. § 408:4). An accident or health policy form may not be used until 30 days after it is filed unless the Commissioner approves it sooner (N.H. Rev. Stat. Ann. § 415:1). A property and casualty form is filed for a 30-day waiting period, which the Commissioner may extend by up to 30 days, and is deemed to meet the law’s requirements unless disapproved within that period (N.H. Rev. Stat. Ann. § 412:5, I).
Under the usual conformity rule, which many states’ insurance codes write into law, a policy provision that conflicts with state law does not make the policy invalid: the policy is read as amended to conform to the law.
An individual health policy may also carry the optional uniform provision “Conformity with State Statutes”: a provision that, on the policy’s effective date, conflicts with the statutes of the state where the insured resides is amended to conform to their minimum requirements.
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.
New Hampshire requires the producer of record, where the insurer does not keep the information, to keep a file for each policy sold for the current year plus 5 years (N.H. Rev. Stat. Ann. § 400-B:3, IV).
Fraudulent producer representation
In New Hampshire, a person may not sell, solicit or negotiate insurance for any class of insurance unless licensed for that line of authority (N.H. Rev. Stat. Ann. § 402-J:3, I), and a producer who represents to the public a license the producer does not hold makes an untrue, deceptive or misleading statement with respect to a person in the conduct of that person’s insurance business, which is an unfair practice whatever the medium (N.H. Rev. Stat. Ann. § 417:4, III(a)).
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 New Hampshire in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked. Violating any insurance law is a ground on which the Commissioner may place an insurance producer’s license on probation, suspend it or revoke it (N.H. Rev. Stat. Ann. § 402-J:12, I(b)).
Misrepresentation
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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. Under the NAIC’s model act, any estimate, illustration or statement that misrepresents a policy’s benefits, advantages, conditions or terms is an unfair trade practice when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.
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Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.
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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. Under the model act, such a statement is an unfair trade practice when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice. Some state laws adopt this condition, and others reach a single such statement.
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 such insurer. Some states’ laws reach further, to a statement calculated to injure any person engaged in the business of insurance. 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. In New Hampshire, only a boycott needs an agreement or concerted action: an act of coercion or intimidation that results or tends to result in unreasonable restraint of, or a monopoly in, the business of insurance is an unfair practice whether committed individually or by concerted action (N.H. Rev. Stat. Ann. § 417:4, V(a)).
False financial statements
In New Hampshire, knowingly filing with a public official, or knowingly making, publishing or circulating, a false statement of an insurer’s financial condition is an unfair practice (N.H. Rev. Stat. Ann. § 417:4, VI), and so is making false or fraudulent statements on or relative to an application for insurance to obtain a fee, commission, money or benefit (N.H. Rev. Stat. Ann. § 417:4, II).
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.
New Hampshire’s rebating law expressly does not treat certain practices as rebates, among them value-added services, activities or products offered free or at a reduced fee that are available to all insureds on an objective and fair basis and directly related to servicing the policy or to risk control for the client, and contests, sweepstakes, raffles or drawings with no cost to enter that are open to consumers who are not policyholders, with no purchase required to enter or win (N.H. Rev. Stat. Ann. § 417:4, IX(b)).
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. New Hampshire allows promotional items with a fair market value of $100 or less per consumer per year (N.H. Rev. Stat. Ann. § 417:4, IX(b)(13)).
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.
New Hampshire’s own law also bars refusing to insure risks solely because of age (except in life, accident or health insurance), place or area of residence, race, color, creed, national origin, ancestry, marital status, or lawful occupation including military service (except in life, accident or health insurance), or solely because another insurer has refused to write, has canceled or has refused to renew the person’s policy; that paragraph states no exception for underwriting or actuarial principles (N.H. Rev. Stat. Ann. § 417:4, VIII(e)).
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 negligence and unintentional mistakes that cause financial harm to clients. It does not cover intentional misconduct, criminal acts, or regulatory fines.
Children covered as dependents
Under the Affordable Care Act, a plan that offers dependent coverage must make it available to an adult child until age 26, whether or not the child is married, a student or financially dependent on the parent.
In New Hampshire, every individual and group health insurance policy providing coverage on a service or expense-incurred basis covers a newly born child of the insured from the moment of birth; where a specific premium is required for the child, the policy may require notice of the birth and payment of the premium within 31 days after the birth for coverage to continue past that period, and no additional premium is collected for the first 31 days (N.H. Rev. Stat. Ann. § 415:22, I, III). A policy that covers family members pays children’s benefits for a minor from the date the minor is placed in the insured’s custody in an adoption proceeding (N.H. Rev. Stat. Ann. § 415:22-a). A covered dependent who is mentally or physically incapable of earning a living when coverage would end because of age stays covered while the incapacity continues and the dependent remains chiefly financially dependent, if proof of the incapacity reaches the insurer within 31 days (N.H. Rev. Stat. Ann. § 415:5, I(3-a)(a)).
Rebating
New Hampshire licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance. New Hampshire’s law expressly excepts some practices, among them a rebate of all or part of a producer’s commission on commercial insurance, where the insurer expressly provides for the rebate in its rate filings and the reduction is not disclosed to the insured (N.H. Rev. Stat. Ann. § 417:4, IX(b)(15)).
Sharing commission
The splitting or sharing of commissions with a licensed producer is allowed. In New Hampshire, an insurer or producer may not pay a commission, service fee, brokerage or other valuable consideration to a person for selling, soliciting or negotiating insurance in the state if that person is required to be licensed and is not, and that person may not accept it (N.H. Rev. Stat. Ann. § 402-J:13, I-II). Commissions may be paid or assigned to an insurance agency or to persons who do not sell, solicit or negotiate insurance in New Hampshire, unless the payment would violate the law’s rebates paragraph (N.H. Rev. Stat. Ann. §§ 402-J:13, IV, 417:4, IX). A person who is not licensed may be paid for referring a party to a licensed person only a nominal amount that is not based on or related to the party’s purchase of insurance (N.H. Rev. Stat. Ann. § 405:17-c).
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.
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. In New Hampshire, misrepresentation and twisting are one unfair practice, which reaches misrepresenting, directly or indirectly, in the offer or sale of any insurance or in connection with inducing or attempting to induce an insured, or a person with ownership rights under a policy, to lapse, forfeit, surrender, assign, effect a loan against, retain, exchange or convert the policy; it includes making an incomplete comparison of policies and a false or misleading representation as to the financial condition of any insurer (N.H. Rev. Stat. Ann. § 417:4, I).
Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.
Unfair marketing practices
The Insurance Department is responsible for establishing minimum standards for the full and fair disclosure of policy content. The Department also requires the standardization and simplification of the terms used to describe insurance coverage.
Advertising may not involve the following:
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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.
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Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.
In New Hampshire, such statements are reached by the unfair practices law, which makes it an unfair practice to place before the public, in any medium, an advertisement, announcement or statement about an insurer, its financial condition or the terms of its contracts, or about any person in the conduct of that person’s insurance business, that is untrue, incomplete, deceptive or misleading (N.H. Rev. Stat. Ann. § 417:4, III(a)). Accident and health advertisements must also be truthful and not misleading in fact or in implication (N.H. Code Admin. R. Ins 2601.05(d)).
Gramm-Leach Bliley Act (GLBA)
This law repealed the parts of the Glass-Steagall Act of 1933 that kept commercial banks and securities firms apart, and allowed the consolidation of commercial banks, investment institutions and insurance companies. GLBA established a framework of responsibilities for federal and state regulators for 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(c)).
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 their 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.
Under the same model act, a person told of an adverse underwriting decision may ask in writing, within 90 business days of the notice, for the specific reasons for it, which must be given within 21 business days of the request.
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 give the caller’s name, the name of the company the call is made for, and a telephone number or address at which that company can be contacted
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
Granite Advantage
Although it is all Medicaid, states use different names for their medical welfare programs. New Hampshire’s Granite Advantage Health Care Program provides coverage for the newly eligible Medicaid population (RSA 126-AA:3); it is one part of Medicaid, not another name for all of it. Medicaid is a state-administered health care program for those in financial need, funded by federal and state money.