12 Hours of Study on Ethics and the California Insurance Code

课程大纲

各单元的必修学习时间按篇幅分配，合计 12 小时有效学习时间；每个单元以复习题结束。课程以英文授课，单元名称后附中文译名。

1. 第 1 单元

   必修学习 59 分钟

   The California Insurance Regulatory System and the Role of the Producer

   加州保险监管体系与从业人员的角色

   学习目标

   • Define insurance, insurer, insured, and "transact" under Cal. Ins. Code §§22, 23, and 35, and identify activities that require a license under §1631.
   • Describe how the Insurance Commissioner is selected and identify the Commissioner's principal duties and conflict-of-interest restrictions.
   • Explain the Department of Insurance's complaint-handling obligations and the producer's exposure to consumer complaints.
   • Distinguish admitted insurers, nonadmitted insurers placed through surplus line brokers, the FAIR Plan, and the guarantee associations.
   • Differentiate agent, broker, broker-agent, life, accident and health, and personal lines license capacities, including the role of appointments.
   • Identify the Commissioner's disciplinary tools, including denial, suspension, revocation, restricted licenses, and monetary penalties.

2. 第 2 单元

   必修学习 57 分钟

   Licensing, Prelicensing Education, Continuing Education and License Maintenance

   执照、考前教育、继续教育与执照维护

   学习目标

   • State the prelicensing education requirement under Cal. Ins. Code §1749 as amended by AB 943 effective January 1, 2026, including the one-hour insurance fraud component.
   • Identify the safeguards required for online prelicensing courses and the three-year validity of completion certificates.
   • Describe the examination, fingerprinting, and background review steps, and list major grounds for license denial under §§1668 and 1669.
   • Calculate a license term and explain the renewal, late renewal, and 60-day continued-operation rules.
   • Apply continuing education rules, including the 24-hour (20-hour for limited lines automobile) and three-hour ethics requirements, ethics carry-over limits, and annuity, life insurance, and long-term care training.
   • Identify ongoing reporting and display duties, including address changes, background changes, names, and license numbers on materials.

3. 第 3 单元

   必修学习 47 分钟

   Agency Law and the Producer's Ethical Duties (agent vs. broker, fiduciary duty, duty of care, disclosure)

   代理法与从业人员的职业道德义务

   学习目标

   • Explain actual and ostensible agency, imputed notice, and principal liability under Civil Code §§2295-2338 as applied to insurance producers.
   • Distinguish an insurance agent from an insurance broker under Cal. Ins. Code §§31, 33, 1621, and 1623, and identify facts that create or rebut the presumption of broker status.
   • Describe the producer's duty of care in procuring requested coverage and identify circumstances that create a greater duty under California case law.
   • Apply the duties of disclosure under §§330-332 and, for personal auto and residential property lines, the broker fee requirements of 10 CCR §§2189.1 and 2189.3 to practical scenarios.
   • Identify the statutory duty owed to prospective insureds age 65 or older and related senior protections under §§785-787.
   • Use a structured decision-making process to recognize and manage conflicts of interest.

4. 第 4 单元

   必修学习 47 分钟

   Fiduciary Handling of Premiums, Trust Accounts and Commissions

   保费、信托账户与佣金的受托管理

   学习目标

   • Define fiduciary funds under Cal. Ins. Code §1733, including premium, return premium, and financed premium, and state the consequence of diversion.
   • Identify the three lawful methods of holding fiduciary funds under §§1734 and 1734.5 and the limits on commingling.
   • List the principal recordkeeping requirements of 10 CCR §§2190.1-2190.7, including retention periods and location of records.
   • Apply the rules for handling return premium, including gross remittance to the person entitled and §481 refund provisions.
   • Explain when commissions may be retained and to whom they may lawfully be paid.
   • Describe criminal, administrative, and civil consequences of mishandling fiduciary funds and design internal controls to prevent them.

5. 第 5 单元

   必修学习 51 分钟

   Unfair Practices I: Misrepresentation, False Advertising, Defamation and Boycott

   不公平行为（一）：虚假陈述、虚假广告、诋毁与联合抵制

   学习目标

   • Identify the purpose, scope, and structure of the California Unfair Insurance Practices Act (Article 6.5 of the Insurance Code, §790 et seq.), including which persons it covers and the subjects of each subdivision of §790.03.
   • Distinguish misrepresentation of policies and misleading comparisons under §790.03(a), §780 and §781 from false or deceptive advertising under §790.03(b), and apply the 'known or should have been known' and 'reasonable care' standards to sales scenarios.
   • Apply California's life and annuity advertising regulations (10 CCR §2547.1 et seq.), the life insurance illustration law (§10509.950 et seq.), and the senior advertising rules (§§787, 787.1) to print, digital, and lead-generation marketing.
   • Determine when business cards, quotations, print advertisements, and emails must display the license number and the word 'insurance' under §1725.5, and when a true or fictitious business name may be disapproved under §1724.5.
   • Recognize prohibited disparagement of insurers, boycott/coercion/intimidation (§790.03(c)), and false financial statements and entries (§790.03(d)–(e)).
   • Explain the Commissioner's enforcement process and penalties under §§790.04–790.07 and §790.035, and the effect of Moradi-Shalal v. Fireman's Fund (1988) on private lawsuits.

6. 第 6 单元

   必修学习 52 分钟

   Unfair Practices II: Rebating, Inducements, Twisting and Replacement

   不公平行为（二）：回扣、诱导、诱导换单与保单替换

   学习目标

   • Explain how Proposition 103 (1988) and current CIC §750(d) affect commission rebating in California, and distinguish commission rebating from insurer premium rebates and from the claims-referral crime in current §750.
   • Distinguish lawful lender insurance requirements from prohibited tie-ins under CIC §770, and identify when sharing compensation with others violates CIC §§1631, 1633 and 1724.
   • Recognize twisting and churning practices and apply CIC §§780–783 and §790.03(a), including the applicable criminal and license penalties.
   • Apply the definitions, exemptions and agent and insurer duties of the replacement article, CIC §§10509–10509.7, to a proposed life insurance or annuity replacement.
   • Identify violations and penalties under CIC §§10509.8–10509.9, including unnecessary replacement annuities for consumers age 65 or older, and apply the senior 30-day free look in CIC §10127.10.
   • Evaluate a proposed replacement or §1035 exchange by weighing surrender charges, new surrender and contestability periods, insurability and lost benefits, and document a recommendation honestly.

7. 第 7 单元

   必修学习 51 分钟

   Fair Claims Practices, Unfair Discrimination and Consumer Protection

   公平理赔、不公平歧视与消费者保护

   学习目标

   • Identify the sixteen unfair claims settlement practices in Cal. Ins. Code §790.03(h) and explain the knowing-act and general-business-practice standards and the §790.035 penalties.
   • Apply the key calendar-day deadlines of 10 CCR §§2695.5 and 2695.7 (15, 21, 40, 30-day status and 30-day payment), including the weekend/holiday extension and the main exceptions, to claim scenarios.
   • Describe the producer's duties when receiving notice of a claim, including notice to an agent and the imputation rule, and when describing coverage to a claimant.
   • Explain the implied covenant of good faith and fair dealing at a high level using Gruenberg v. Aetna and Egan v. Mutual of Omaha.
   • Distinguish lawful risk classification from unfair discrimination under §790.03(f), §§679.71-679.72, §11628, §10140 et seq., §676.9 and Proposition 103 (§§1861.02-1861.03).
   • Direct consumers to the appropriate remedies, including the CDI complaint program (§12921.1), rate challenges (§1858) and Independent Medical Review.

8. 第 8 单元

   必修学习 51 分钟

   Privacy, Confidentiality and Information Security

   隐私、保密与信息安全

   学习目标

   • Identify the entities, lines of insurance and individuals covered by the Insurance Information and Privacy Protection Act (Cal. Ins. Code §§791-791.29) and explain how the act applies to producers.
   • Apply the IIPPA rules on pretext interviews, notices of information practices, disclosure authorization forms, access, correction and adverse underwriting decisions to common producer situations, including the applicable time limits.
   • Determine whether a proposed disclosure of personal or privileged information is permitted under Cal. Ins. Code §791.13, GLBA and the California Financial Information Privacy Act, and describe the enforcement consequences of improper disclosure.
   • Distinguish the roles of the CDI privacy regulations, the CCPA/CPRA exemptions, the CMIA, HIPAA, and the special HIV and genetic-information protections in insurance transactions.
   • Describe a producer's duties under California's reasonable-security, breach-notification and records-disposal laws and the status of SB 354 (2026).
   • Select appropriate information-security practices (MFA, encryption, secure transmission, call-back verification, clean desk, vendor controls) to prevent phishing, social engineering and wire fraud.

9. 第 9 单元

   必修学习 72 分钟

   Seniors, Annuities, Suitability and Best Interest

   老年人、年金、适当性与最佳利益

   学习目标

   • Identify the duties and prohibitions that apply when transacting insurance with persons age 65 or older under Cal. Ins. Code §§785–789.10, including advertising, senior designations and in-home meeting rules.
   • Apply the four obligations of California's annuity best interest standard (care, disclosure, conflict of interest and documentation) under Cal. Ins. Code §10509.9204 to a recommendation or replacement.
   • State the annuity training requirements of Cal. Ins. Code §§1749.8 and 10509.9205 and distinguish general annuity training from insurer product-specific training.
   • Explain the 30-day senior free look under Cal. Ins. Code §10127.10, including the treatment of variable products, and distinguish it from other cancellation periods.
   • Recognize prohibited Medi-Cal-related annuity sales, required written disclosures to elders, and prohibited personal dealings with clients under §§789.8, 789.9 and 1668.1.
   • Identify warning signs of elder financial abuse and diminished capacity and describe appropriate professional responses.

10. 第 10 单元

    必修学习 73 分钟

    Life, Disability and Health Insurance Provisions of the Code

    法规中关于人寿、伤残与健康保险的规定

    学习目标

    • Apply the insurable interest rules of CIC §10110.1, including timing and the prohibition on stranger-originated policies, to client situations.
    • Explain how concealment and misrepresentation rules interact with the two-year incontestable clause and the impostor rule of CIC §10113.5.
    • Identify the free-look, grace-period, lapse-notice and designee rights that apply to individual life policies and describe the producer's duties at application, delivery and service.
    • Describe the uniform required provisions of individual disability policies (CIC §§10350.1–10350.12) and state their key claim deadlines.
    • Distinguish CDI-regulated health insurance from DMHC-regulated health care service plans and summarize guaranteed issue, rescission limits, parity and claims-payment rules.
    • Summarize key Medicare supplement and long-term care protections, including the birthday rule, the LTC free look and LTC training requirements.

11. 第 11 单元

    必修学习 81 分钟

    Property, Casualty and Personal Lines Provisions of the Code

    法规中关于财产、意外责任与个人险种的规定

    学习目标

    • Explain how Proposition 103 (CIC §§1861.01–1861.05) requires prior approval of property and casualty rates and what that means for a producer's discussion of price.
    • Apply the mandatory automobile rating factors and Good Driver Discount criteria of CIC §§1861.02 and 1861.025 to a client's driving history.
    • State the current California minimum automobile liability limits under Vehicle Code §16056 and the UM offer and waiver rules of CIC §11580.2.
    • Identify the permitted grounds and notice periods for cancellation and nonrenewal of auto policies (CIC §§660–666, 1861.03(c)) and residential property policies (CIC §§675–678), including the wildfire moratorium of CIC §675.1.
    • Describe required residential disclosures and replacement-estimate standards (CIC §§10101–10103.4; 10 CCR §§2695.180–2695.183) and post-disaster claim protections (CIC §§2051.5, 2060, 2071, 10103.7).
    • Explain the mandatory earthquake offer (CIC §10081 et seq.) and the role and limits of the California FAIR Plan (CIC §10090 et seq.) when advising clients.

12. 第 12 单元

    必修学习 79 分钟

    Insurance Fraud: Recognition, Reporting, Penalties and Prevention

    保险欺诈：识别、举报、处罚与防范

    必修：保险欺诈专题 1 小时

    学习目标

    • Identify the principal California insurance fraud statutes, including Insurance Code §1871 et seq. and Penal Code §§548, 549, 550 and 551, and describe the conduct each prohibits.
    • Recognize common application, claims, workers' compensation, health, life and producer-committed fraud schemes and the red flags associated with them.
    • State the criminal, civil and licensing penalties for insurance fraud, including fines under Penal Code §550 and Insurance Code §1871.4, civil penalties under §1871.7, and license discipline under §§1668 and 1738.
    • Apply the producer reporting duty of Insurance Code §1872.41 by choosing the correct channel (Fraud Division portal before placement, insurer SIU after placement) and deadline.
    • Explain insurer obligations for special investigative units and fraud reporting (§§1872.4, 1875.20–1875.24), the §1871.2 fraud warning, and good-faith reporting immunity (§§1872.5, 1872.51, 1879.5).
    • Select fraud-prevention practices that protect clients, insurers and the producer's license in everyday application, premium-handling and claim situations.