AD Banker Life Insurance Practice Exam

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What must an insurer do if an adverse action is taken against an insurance applicant?

The insurer must provide a detailed explanation of the adverse action.

When an insurer takes an adverse action against an insurance applicant, it is required by law to inform the applicant about this action. This obligation stems from various regulations designed to ensure transparency and fairness in the underwriting process. Providing a detailed explanation allows the applicant to understand the reasons behind the decision, which is critical for maintaining trust and giving the applicant an opportunity to address any issues or appeal if necessary.

This requirement is closely aligned with the Fair Credit Reporting Act (FCRA), which mandates that consumers must be notified when actions are taken based on information from a credit report. The detailed explanation typically includes the specific reasons for the adverse decision, such as credit history, claims history, or other pertinent factors. This empowers applicants to take informed steps regarding their insurance needs or to rectify the issues that may have led to the adverse action.

In contrast, simply denying coverage without explanation or failing to notify the applicant would not comply with these legal standards, and offering coverage despite the adverse action contradicts the nature of the action taken.

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The insurer must deny coverage without any explanation.

The insurer does not need to notify the applicant about the credit report.

The insurer must offer coverage despite the adverse action.

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