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!