Podcast
Questions and Answers
Aflac's Understanding Insurance Fraud and Prohibited Practices guide includes _______________.
Aflac's Understanding Insurance Fraud and Prohibited Practices guide includes _______________.
Policy administration and claims administration prohibited practices and Corrective actions and FAQs
Fraud is an intentional act, omission or violation of trust designed to _____ others.
Fraud is an intentional act, omission or violation of trust designed to _____ others.
deceive
Prohibited Practices include acts that _______ the procedures, industry codes, branding or security as outlined in the Prohibited Practices document.
Prohibited Practices include acts that _______ the procedures, industry codes, branding or security as outlined in the Prohibited Practices document.
violate
One way Susan, an insurance sales producer, keeps her enrollments up and increases her sales is to encourage her customers to replace existing coverage every two years. This is ________.
One way Susan, an insurance sales producer, keeps her enrollments up and increases her sales is to encourage her customers to replace existing coverage every two years. This is ________.
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Bob, a new insurance sales producer, provides a customer misleading information to get the customer to surrender a current policy with another carrier. This is ___________.
Bob, a new insurance sales producer, provides a customer misleading information to get the customer to surrender a current policy with another carrier. This is ___________.
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Alicia, an Aflac producer, is unsure if she is allowed to write business while on disability. She should ____________.
Alicia, an Aflac producer, is unsure if she is allowed to write business while on disability. She should ____________.
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Jaron, an Aflac producer, is concerned his customers may not be able to sign applications. He should ___________.
Jaron, an Aflac producer, is concerned his customers may not be able to sign applications. He should ___________.
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We create environments that are free from discrimination and harassment. This means ______________________ toward other people.
We create environments that are free from discrimination and harassment. This means ______________________ toward other people.
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Contacting any of the businesses, accounts or brokers on the Do Not Contact List for which you are not the servicing agent is a prohibited practice.
Contacting any of the businesses, accounts or brokers on the Do Not Contact List for which you are not the servicing agent is a prohibited practice.
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A situation that arises in which a producer's self-interest interferes with their obligation to act in the best interests of a customer is called a ______________.
A situation that arises in which a producer's self-interest interferes with their obligation to act in the best interests of a customer is called a ______________.
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Individuals representing Aflac cannot participate in any portion of the sales process, _________________, until they're appropriately licensed and appointed.
Individuals representing Aflac cannot participate in any portion of the sales process, _________________, until they're appropriately licensed and appointed.
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Aflac has a ________ policy regarding contest manipulation.
Aflac has a ________ policy regarding contest manipulation.
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Splitting commissions or using SIT codes for contest qualification is _____________.
Splitting commissions or using SIT codes for contest qualification is _____________.
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Contest manipulation will result in ____
Contest manipulation will result in ____
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Incentive programs include __________.
Incentive programs include __________.
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If Aflac discovers a producer or coordinator won a contest or reward based on invalid business, Aflac will charge the producer for the amount of the contest winnings, as well as ____________.
If Aflac discovers a producer or coordinator won a contest or reward based on invalid business, Aflac will charge the producer for the amount of the contest winnings, as well as ____________.
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As an Aflac producer, you are relieved of the responsibility for continuing education that is required by some jurisdictions.
As an Aflac producer, you are relieved of the responsibility for continuing education that is required by some jurisdictions.
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You ______________ a Suitability Notice to potential policyholders in all U.S. states and territories.
You ______________ a Suitability Notice to potential policyholders in all U.S. states and territories.
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___ is NOT a valid reason for replacing a policy.
___ is NOT a valid reason for replacing a policy.
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Examples of need-based selling are ____________.
Examples of need-based selling are ____________.
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Fraud is defined as __________.
Fraud is defined as __________.
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What is a prohibited practice?
What is a prohibited practice?
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Study Notes
Understanding Insurance Fraud and Prohibited Practices
- Aflac's guide includes policies on administration, claims, prohibited practices, corrective actions, and FAQs regarding insurance fraud.
Definition of Fraud
- Fraud is an intentional act intended to deceive others, leading to losses for victims or gains for perpetrators.
Violations of Prohibited Practices
- Prohibited practices encompass actions that violate outlined procedures, industry codes, branding, or security measures.
Churning
- Churning occurs when a producer misleads customers into replacing existing insurance coverage every two years, prioritizing sales over suitability.
Twisting
- Twisting involves providing misleading information to persuade customers to abandon a current policy for a new one, aimed at generating commissions.
Guidelines for Producers on Disability
- Producers receiving benefits should review guidelines on fraud and prohibited practices before engaging in business activities while on disability.
Virtual Enrollment Procedures
- Producers conducting virtual enrollments should consult fraud guidelines regarding customer signatures and initial entries.
Non-Discrimination Policy
- Aflac promotes an environment free from discrimination and harassment, necessitating respectful conduct towards all individuals.
Do Not Contact List
- Contacting entities on the Do Not Contact List without being the servicing agent is strictly prohibited.
Conflict of Interest
- A conflict of interest arises when a producer's self-interest conflicts with their duty to act in the customer's best interests.
Licensing and Sales Participation
- Individuals must be properly licensed and appointed before participating in any sales activities, including solicitation and negotiation.
Contest Manipulation Policy
- Aflac has a zero-tolerance policy regarding contest manipulation among producers, emphasizing fairness in rewards.
Commission Splitting and Contest Qualification
- Splitting commissions or misusing SIT codes for contest qualification is not permitted and is subject to scrutiny.
Consequences of Contest Manipulation
- Contest manipulation can lead to chargebacks and disciplinary actions, potentially resulting in termination.
Incentive Programs
- Aflac's incentive programs include various promotions, contests, and sweepstakes aimed at enhancing producer performance.
Discovery of Invalid Contest Winnings
- If Aflac finds that a producer won a contest based on invalid business, they will charge back the winnings and their hierarchy.
Continuing Education Responsibility
- Aflac producers are not exempt from the continuing education requirements mandated by some jurisdictions.
Suitability Notice Requirement
- Producers must explain the Suitability Notice to potential policyholders across all U.S. states and territories.
Invalid Reasons for Policy Replacement
- Declining health status is not considered a valid reason for replacing an insurance policy.
Need-Based Selling Examples
- Effective need-based selling includes inquiries about customers' current coverage and salary illustrations to demonstrate premium impacts on take-home pay.
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Description
This quiz explores key concepts related to insurance fraud, including definitions, prohibited practices, and specific tactics like churning and twisting. It provides insights into guidelines for producers and the importance of adhering to ethical practices in the industry.
