Section § 10509

Explanation

This section aims to oversee how insurers and agents handle replacing existing life insurance and annuities. It sets standards to protect buyers by ensuring they get the necessary information to make the best decision for themselves. It also seeks to prevent false or incomplete information being given and establishes penalties for not following these rules.

The purpose of this article is the following:
(a)CA Insurance Code § 10509(a) To regulate the activities of insurers and agents with respect to the replacement of existing life insurance and annuities.
(b)CA Insurance Code § 10509(b) To protect the interests of life insurance and annuity purchasers by establishing minimum standards of conduct to be observed in replacement transactions by the following:
(1)CA Insurance Code § 10509(b)(1) Assuring that the purchaser receives information with which a decision can be made in his or her own best interest.
(2)CA Insurance Code § 10509(b)(2) Reducing the opportunity for misrepresentation and incomplete disclosures.
(3)CA Insurance Code § 10509(b)(3) Establishing penalties for failure to comply with the requirements of this article.

Section § 10509.1

Explanation

This section means that the rules and requirements outlined in this article apply to every individual life insurance policy and annuity contract.

This article is applicable to all individual life insurance and annuity policies.

Section § 10509.2

Explanation

This section defines key terms related to purchasing new life insurance or annuities when existing policies are affected. Replacement occurs when a new policy results in changes like termination or modification of an existing policy. Conservation is when an insurer tries to stop a policyholder from replacing their existing policy, excluding routine admin tasks. Direct-response sales happen when policies are sold without an agent. The existing insurer is the one whose policy is being changed or terminated, while the replacing insurer issues the new policy. Existing life insurance or annuity refers to current policies, including those with temporary coverage or refunds. A registered contract involves policies with death benefits and cash values that change based on investment performance.

(a)CA Insurance Code § 10509.2(a) “Replacement” means any transaction in which new life insurance or a new annuity is to be purchased, and it is known or should be known to the proposing agent, or to the proposing insurer if there is no agent, that by reason of that transaction, the existing life insurance or annuity has been or is to be any of the following:
(1)CA Insurance Code § 10509.2(a)(1) Lapsed, forfeited, surrendered, or otherwise terminated.
(2)CA Insurance Code § 10509.2(a)(2) Converted to reduced paid-up insurance, continued as extended term insurance, or otherwise reduced in value by the use of nonforfeiture benefits or other policy values.
(3)CA Insurance Code § 10509.2(a)(3) Amended so as to effect either a reduction in benefits or in the term for which coverage would otherwise remain in force or for which benefits would be paid.
(4)CA Insurance Code § 10509.2(a)(4) Reissued with any reduction in cash value.
(5)CA Insurance Code § 10509.2(a)(5) Pledged as collateral or subjected to borrowing, whether in a single loan or under a schedule of borrowing over a period of time for amounts in the aggregate exceeding 25 percent of the loan value set forth in the policy.
(b)CA Insurance Code § 10509.2(b) “Conservation” means any attempt by the existing insurer or its agent to dissuade a policyowner from the replacement of existing life insurance or annuity. Conservation does not include routine administrative procedures such as late payment reminders, late payment offers, or reinstatement offers.
(c)CA Insurance Code § 10509.2(c) “Direct-response sales” means any sale of life insurance or annuity where the insurer does not utilize an agent in the sale or delivery of the policy.
(d)CA Insurance Code § 10509.2(d) “Existing insurer” means the insurer whose policy is or will be changed or terminated in such a manner as described within the definition of “replacement.”
(e)CA Insurance Code § 10509.2(e) “Existing life insurance or annuity” means any life insurance or annuity in force including life insurance under a binding or conditional receipt or a life insurance policy that is within an unconditional refund period.
(f)CA Insurance Code § 10509.2(f) “Replacing insurer” means the insurer that issues a new policy which is a replacement of existing life insurance or annuity.
(g)CA Insurance Code § 10509.2(g) “Registered contract” means variable annuities, investment annuities, variable life insurance under which the death benefits and cash values vary in accordance with unit values of investments held in a separate account, or any other contracts issued by life insurers which are registered with the Federal Securities and Exchange Commission.

Section § 10509.3

Explanation

This section outlines situations where certain life insurance rules don't apply. It excludes credit life insurance, group life insurance or annuities, and cases involving changes with the same insurer, or when term conversion is happening among affiliates. If an insurer is replacing its own policy, they must provide clear written details on premiums, cash values, and benefits before and after the change. Registered contracts have different information requirements. The term conversion privilege lets people convert term policies to permanent ones without health checks, using the same premium class. 'Corporate affiliate' refers to certain related companies.

(a)CA Insurance Code § 10509.3(a) Unless otherwise specifically included, this article does not apply to the following:
(1)CA Insurance Code § 10509.3(a)(1) Credit life insurance.
(2)CA Insurance Code § 10509.3(a)(2) Group life insurance or group annuities.
(3)CA Insurance Code § 10509.3(a)(3) An application to the existing insurer that issued the existing life insurance when a contractual change or a conversion privilege is being exercised, or when a term conversion privilege is exercised among corporate affiliates.
(4)CA Insurance Code § 10509.3(a)(4) Proposed life insurance that is to replace life insurance under a binding or conditional receipt issued by the same insurer.
(5)CA Insurance Code § 10509.3(a)(5) Transactions where the replacing insurer and the existing insurer are the same; provided, however, that agents proposing replacement shall:
(A)CA Insurance Code § 10509.3(a)(5)(A) Comply with the requirements of subdivisions (a) and (d) of Section 10509.4.
(B)CA Insurance Code § 10509.3(a)(5)(B) Provide and leave with the applicant a written statement containing information relating to premiums, cash values, death benefits, and outstanding indebtedness, and dividends and dividend accumulations, if any, for the existing policy, both immediately before and after replacement, and for the proposed life insurance or annuity.
(b)CA Insurance Code § 10509.3(b) Registered contracts shall be exempt from the requirements of paragraphs (2) and (3) of subdivision (b) of Section 10509.6 requiring provision of policy summary or ledger statement information; however, premium or contract contribution amounts and identification of the appropriate prospectus or offering circular shall be required in lieu thereof.
(c)CA Insurance Code § 10509.3(c) “Term conversion privilege” means an option afforded by contract to certain holders of term life insurance policies that permits the policy to be converted into permanent insurance, including whole life insurance, universal life insurance, or variable life insurance, regardless of the insured’s physical condition and without a medical examination. The holder of a term life insurance policy with a term conversion privilege shall not be denied coverage or charged an additional premium for any health problems and premiums for the permanent policy shall be based on the same underwriting class as the term policy, regardless of any changes of health since the term policy was issued.
(d)CA Insurance Code § 10509.3(d) “Corporate affiliate” means the same as “affiliate” as defined in Section 1215.

Section § 10509.4

Explanation

If you're an insurance agent handling a life insurance or annuity application, you must include statements from both yourself and the applicant about whether the new policy will replace an existing one. If a replacement is involved, you need to provide the client with a 'Notice Regarding Replacement of Life Insurance,' listing all current policies or annuities being replaced. The client should also keep copies of all presentation materials. A copy of the replacement notice must accompany the application to the new insurer. Any written or printed conservation materials used must also be left with the client, ensuring transparency and informed decision-making.

(a)CA Insurance Code § 10509.4(a) Each agent who accepts an application shall submit to the insurer with which an application for life insurance or annuity is presented, or as part of each application, both of the following:
(1)CA Insurance Code § 10509.4(a)(1) A statement signed by the applicant as to whether replacement of existing life insurance or annuity is involved in the transaction.
(2)CA Insurance Code § 10509.4(a)(2) A signed statement as to whether or not the agent knows replacement is or may be involved in the transaction.
(b)CA Insurance Code § 10509.4(b) Where a replacement is involved, the agent shall do all of the following:
(1)CA Insurance Code § 10509.4(b)(1) Present to the applicant, not later than at the time of taking the application, a “Notice Regarding Replacement of Life Insurance” in the form as described in subdivision (d). The notice shall be signed by both the applicant and the agent and left with the applicant. Obtain with or as part of each application a list of all existing life insurance or annuities to be replaced and properly identified by name of insurer, the insured and contract number. If a contract number has not been assigned by the existing insurer, alternative identification, such as an application or receipt number, shall be listed.
(2)CA Insurance Code § 10509.4(b)(2) Leave with the applicant the original or a copy of all printed communications used for presentation to the applicant.
(3)CA Insurance Code § 10509.4(b)(3) Submit to the replacing insurer with the application a copy of the replacement notice.
(c)CA Insurance Code § 10509.4(c) Every agent who uses written or printed communications in conservation shall leave with the applicant the originals of any materials used.
(d)CA Insurance Code § 10509.4(d) Each agent or broker shall present to an applicant the following notice:
NOTICE REGARDING REPLACEMENT
Are you thinking about buying a new life insurance policy or annuity and discontinuing or changing an existing one? If you are, your decision could be a good one—or a mistake. You will not know for sure unless you make a careful comparison of your existing benefits and the proposed benefits.
Make sure you understand the facts. You should ask the company or agent that sold you your existing policy to give you information about it.
Hear both sides before you decide. This way you can be sure you are making a decision that is in your best interest.
We are required by law to notify your existing company that you may be replacing their policy.
(applicant)
(agent)
(date)
_____ _____

Section § 10509.5

Explanation

Life insurance companies in California are required to inform their field representatives and other relevant staff about the rules outlined in this section. Additionally, they must ask people applying for life insurance or annuities to sign a statement indicating if the new policy or annuity will replace an existing one.

Every life insurer shall do the following:
(a)CA Insurance Code § 10509.5(a) Inform its field representatives or other personnel responsible for compliance with this article of the requirements of this article.
(b)CA Insurance Code § 10509.5(b) Require with, or as part of, each completed application for life insurance or annuity a statement signed by the applicant as to whether such proposed insurance or annuity will replace existing life insurance or annuity.

Section § 10509.6

Explanation

This California law mandates procedures for life insurers when using agents in the sale of life insurance or annuities. First, agents must disclose if a policy replacement might occur. If a replacement is involved, specific steps are required, including listing all policies to be replaced, notifying existing insurers, and providing policy summaries.

Insurers must act quickly, notifying within three days of application receipt and responding to requests within five days. Policy summaries must be kept for three years. Furthermore, policyholders have a 30-day window from policy receipt to get a full refund if they cancel.

These requirements took effect on July 1, 2015.

Every life insurer that uses an agent in a life insurance or annuity sale shall do the following:
(a)CA Insurance Code § 10509.6(a) Require with or as part of each completed application for life insurance or annuity, a statement signed by the agent as to whether he or she knows a replacement is or may be involved in the transaction.
(b)CA Insurance Code § 10509.6(b) Where a replacement is involved:
(1)CA Insurance Code § 10509.6(b)(1) Require from the agent with the application for life insurance or annuity: (i) a list of all of the applicant’s existing life insurance or annuity to be replaced, and (ii) a copy of the replacement notice provided the applicant pursuant to Section 10509.4. The existing life insurance or annuity shall be identified by name of insurer, insured, and contract number. If a number has not been assigned by the existing insurer, alternative identification, such as an application or receipt number, shall be listed.
(2)CA Insurance Code § 10509.6(b)(2) Send to each existing life insurer a written communication advising of the replacement or proposed replacement and the identification information obtained pursuant to this section and a policy summary, contract summary, or ledger statement containing policy data on the proposed life insurance or annuity. Cost indices and equivalent level annual dividend figures need not be included in the policy summary or ledger statement. This written communication shall be made within three working days of the date the application is received in the replacing insurer’s home or regional office, or the date the proposed policy or contract is issued, whichever is sooner.
(3)CA Insurance Code § 10509.6(b)(3) Every existing life insurer or the insurer’s agent that undertakes a conservation shall, within 20 days from the date the written communication plus the materials required in subdivisions (1) and (2) are received by the existing insurer, furnish the policyowner with a policy summary for the existing life insurance or ledger statement containing policy data on the existing policy or annuity. Information relating to premiums, cash values, death benefits, and dividends, if any, shall be computed from the current policy year of the existing life insurance. The policy summary or ledger statement shall include the amount of any outstanding indebtedness, the sum of any dividend accumulations or additions, and may include any other information that is not in violation of any regulation or statute. Cost indices and equivalent level annual dividend figures need not be included. When annuities are involved, the disclosure information shall be that in the contract summary.
The replacing insurer may request the existing insurer to furnish it with a copy of the summaries or ledger statement, which shall be within five working days of the receipt of the request.
(c)CA Insurance Code § 10509.6(c) The replacing insurer shall maintain evidence of the “notice regarding replacement,” the policy summary, the contract summary, and any ledger statements used, and a replacement register, cross-indexed by replacing agent and existing insurer to be replaced. The existing insurer shall maintain evidence of policy summaries, contract summaries, or ledger statements used in any conservation. Evidence that all requirements were met shall be maintained for at least three years.
(d)CA Insurance Code § 10509.6(d) The replacing insurer shall provide on the front of the policy jacket or on the cover page of its life insurance policy or annuity contract or, alternatively, as a separate written document which is delivered with the life insurance policy or annuity contract, a notice stating that the owner has a right to an unconditional refund of all premiums paid which right may be exercised within a period of 30 days commencing from the date of delivery of the contract. In the case of variable annuities, and variable life insurance, return of the contract during the cancellation period shall entitle the owner to a refund of the account value and any policy fee paid. The account value and policy fee shall be refunded by the insurer to the owner within 30 days from the date that the insurer is notified that the owner has canceled the contract.
(e)CA Insurance Code § 10509.6(e) This section shall become operative on July 1, 2015.

Section § 10509.7

Explanation

This law section outlines what an insurance company must do when replacing a life insurance policy or annuity in a direct response sale. If the insurance company does not suggest the replacement, they still need to send a warning about the replacement to the applicant with the new policy, using a specific notice form. They can slightly modify the form without approval. If the company does suggest replacing a policy, they need to give the applicant the notice with the application. They also need to ask for a list of the policies being replaced and follow certain procedures if they receive other insurers' names from the applicant, but they don't have to keep a replacement register.

(a)CA Insurance Code § 10509.7(a) If in the solicitation of a direct response sale, an insurer does not propose the replacement, and a replacement is involved, the insurer shall send to the applicant with the policy a replacement notice as described in subdivision (d) of Section 10509.4 or other substantially similar form approved by the commissioner. In those instances the insurer may delete the last sentence and the reference to signatures from the form without having to obtain approval of the form from the commissioner.
(b)CA Insurance Code § 10509.7(b) If the insurer proposed the replacement it shall do the following:
(1)CA Insurance Code § 10509.7(b)(1) Provide to applicants or prospective applicants with or as part of the application a replacement notice as described in subdivision (d) of Section 10509.4.
(2)CA Insurance Code § 10509.7(b)(2) Request from the applicant with or as part of the application, a list of all existing life insurance or annuities to be replaced and properly identified by name of insurer and insured.
(3)CA Insurance Code § 10509.7(b)(3) Comply with the requirements of paragraph (2) of subdivision (b) of Section 10509.6, if the applicant furnishes the names of the existing insurers, and the requirements of subdivision (c) of Section 10509.6, except that it need not maintain a replacement register.

Section § 10509.8

Explanation

This law prohibits agents or insurers from suggesting clients replace or maintain their insurance policies using misleading information, especially targeting those 65 and older to buy unnecessary replacement annuities. "Unnecessary replacement" means selling an annuity that costs the customer more in surrender charges without offering significant financial benefits compared to the old one.

If many clients buy replacement policies from the same agent, despite stating replacements weren't involved, it suggests that the agent knowingly intended such replacements. Finally, the law allows using extra materials in presentations, as long as they don't break any rules or laws.

(a)CA Insurance Code § 10509.8(a) A violation of this article shall occur if an agent or insurer recommends the replacement or conservation of an existing policy by use of a materially inaccurate presentation or comparison of an existing contract’s premiums and benefits or dividends and values, if any, or recommends that an insured 65 years of age or older purchase an unnecessary replacement annuity.
(b)CA Insurance Code § 10509.8(b) For purposes of this section, “unnecessary replacement” means the sale of an annuity to replace an existing annuity that requires that the insured will pay a surrender charge for the annuity that is being replaced and that does not confer a substantial financial benefit over the life of the policy to the purchaser so that a reasonable person would believe that the purchase is unnecessary.
(c)CA Insurance Code § 10509.8(c) Patterns of action by policyowners who purchase replacement policies from the same agent after indicating on applications that replacement is not involved, shall constitute a rebuttable presumption of the agent’s knowledge that replacement was intended in connection with the sale of those policies, and such patterns of action shall constitute a rebuttable presumption of the agent’s intent to violate this article.
(d)CA Insurance Code § 10509.8(d) This article does not prohibit the use of additional material other than that which is required that is not in violation of this article or any other statute or regulation.

Section § 10509.9

Explanation

This law section lays out penalties for insurance agents, other insurance-related entities, and insurers who violate specific rules. If an insurance agent or entity breaks the rules for the first time, they face at least a $1,000 fine. Repeat offenders or those knowingly violating the rules face higher fines between $5,000 and $50,000. For insurers, the penalty starts at $10,000 for a first offense. However, if insurance companies regularly break rules or knowingly do so, they face penalties from $30,000 to $300,000 per violation.

A hearing must occur to determine if someone loses their license due to violations. This law doesn't limit other legal powers the commissioner might have.

(a)CA Insurance Code § 10509.9(a) Any agent or other person or entity engaged in the business of insurance, other than an insurer, who violates this article is liable for an administrative penalty of no less than one thousand dollars ($1,000) for the first violation.
(b)CA Insurance Code § 10509.9(b) Any agent or other person or entity engaged in the business of insurance, other than an insurer, who engages in practices prohibited by this chapter a second or subsequent time or who commits a knowing violation of this article, is liable for an administrative penalty of no less than five thousand dollars ($5,000) and no more than fifty thousand dollars ($50,000) for each violation.
(c)CA Insurance Code § 10509.9(c) Any insurer who violates this article is liable for an administrative penalty of ten thousand dollars ($10,000) for the first violation.
(d)CA Insurance Code § 10509.9(d) Any insurer who violates this article with a frequency as to indicate a general business practice or commits a knowing violation of this article, is liable for an administrative penalty of no less than thirty thousand dollars ($30,000) and no more than three hundred thousand dollars ($300,000) for each violation.
(e)CA Insurance Code § 10509.9(e) After a hearing conducted in accordance with Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, the commissioner may suspend or revoke the license of any person or entity that violates this article.
(f)CA Insurance Code § 10509.9(f) Nothing in this section shall be deemed to affect any other authority provided by law to the commissioner.