State RegulationsFL specificDifficulty 2/5
A Florida agent presents a health insurance policy to a prospect using the insurer's outline of coverage. Which practice is proper?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
The proper use of an outline of coverage is to give the applicant an accurate, insurer-approved summary of the policy's benefits and principal exclusions and limitations, enabling informed comparison before purchase. Under Chapter 627, Florida Statutes, disclosure documents must not be altered or used in a misleading way, and the Department of Financial Services treats misrepresentations in policy presentations as unfair trade practices. Altering or withholding the outline defeats its consumer-protection purpose.
Why the other options are wrong
- A) Deleting the exclusions section misrepresents the coverage and is an improper use of the disclosure document.
- B) Rewriting benefit figures to overstate the plan is misrepresentation, an unfair trade practice subject to DFS discipline.
- D) Withholding the outline until after a claim denial defeats the disclosure purpose, which is informed choice at purchase.
Memory hook
Present the outline whole and honest.