New Mexico Rio Grande Association of

Health Underwriters

Presented by:

Eva Jean Fomalont

Whatever Happened To

Business Ethics?

• Convenience

• To Win

• Relativism

Always Ethical

Mostly Ethical

Somewhat Ethical

Seldom Ethical

Never Ethical

The Golden Rule!

Pressure

Pleasure

Power

Pride

Priorities

Hold the selling, service and

administration of insurance and related products and services as a professional and public trust and do all in my power to maintain its prestige

1

Consumer

Carrier

Employer

Agent

HealthCare

Government

Media

Keep paramount the needs of those whom serve

Ethics the NAHU Way

2

NOT your need for commission

ASK what they need

LISTEN to what they say ◦Don’t Oversell

◦Don’t Undersell

◦ Inquire & respond appropriately

Respect my clients’ trust in me, and never do anything which would betray their trust or confidence

Ethics the NAHU Way

3

HIPAA Law ◦ Security & Confidentiality ◦ Covered Entity ◦Business Associate ◦Employer

Personal Health Information

What are you doing to secure information in your office?

Give all service possible when service is needed

Ethics the NAHU Way

4

Is ‘service’ an ethical issue? ◦ Speed

◦ Accuracy

◦ Friendliness

Do unto your Carriers as you would do unto your own business

Present policies factually and accurately, providing all information necessary for the issuance of sound insurance coverage to the public I serve

Ethics the NAHU Way

5

Know the policies you sell

No two policies are ever completely alike. Compare correctly!

Speak your client’s language

Rebating

Churning

Twisting

Misrepresentation

Fraud

Failure to remit premium

The agent’s role and responsibility

To provide guidance to available federal and state options to those who cannot

afford private insurance

Use no advertising that I know may be false or misleading.

Ethics the NAHU Way

6

Advertising laws

Approvals Needed

◦Carrier logo

◦Senior products

Paid print, written, internet

Consider the Sale, Service

and Administration of insurance and related products / services a career

Ethics the NAHU Way

7

Lifetime career

Not a part-timer

Surround yourself with professionals

Are you a member of NAHU? NAIFA? Other association?

Know and abide by the law of

any jurisdiction, Federal and State, in which I practice

Ethics the NAHU Way

8

Legislative update sources

If you get all your info from newspapers, then you only know as much as your clients

Don’t leave it all up to your Carriers

National Association of Health Underwriters

www.nahu.org

New Mexico Rio Grande Association of

Health Underwriters

RESOURCES

Daily Legislativ

e Updates

Front Burner Issues

28

Legislative “white” papers

Consumer Guides

29

Seek constantly to increase my

knowledge and improve my ability to meet the needs of my clients

Ethics the NAHU Way

9

Continuing Education – WHY

NMDI Requirements

◦What are they?

Consider a Professional Designation

Be fair and just to my

competitors and engage in no practices which may reflect unfavorably on myself or my industry

Ethics the NAHU Way

10

Take the High Road when confronted with unfair competitive practices.

But how do we handle the ‘Bad Apples’?

Treat prospects, clients and

companies fairly by submitting applications which reveal all available information pertinent to underwriting a policy

Ethics the NAHU Way

11

Proper application submission

Learn underwriting procedures

Extend honest and professional

conduct to my clients, associates, fellow agents / brokers and the companies whose products I represent

Ethics the NAHU Way

12

An agent serves on a board for a

friend’s company, that has the authority to make purchasing decisions for the products they sell. The accountant recommends key man insurance. You are a decision-maker and represent a life insurance company that could fill this need. Conflict of Interest!

The agent feels pressured to get a client’s case underwritten. The client indicates that he wants to move to another carrier because of increased costs. The owner says if costs don’t come, down he’ll discontinue the insurance. In reviewing the applications the agent suspects medical information has not been disclosed. The agent is caught between an obligation to provide accurate information to the carrier and the client’s desire to reduce cost. Conflict of Interest!

An agent feels pressure to sell a product even if it is not in the client’s best interest because your agency is looking for a big bonus from XYZ Company. To get that bonus, a certain number of cases have to be placed with XYZ Company. XYZ’s product does not meet the needs of the client but the agent is encouraged to sell it anyway. Conflict of Interest!