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THIS CONTINUING EDUCATION PROGRAM IS PROVIDED TO YOU BY THE: Texas Association of Health Underwriters All comments regarding this CE may be sent to the.

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Presentation on theme: "THIS CONTINUING EDUCATION PROGRAM IS PROVIDED TO YOU BY THE: Texas Association of Health Underwriters All comments regarding this CE may be sent to the."— Presentation transcript:

1 THIS CONTINUING EDUCATION PROGRAM IS PROVIDED TO YOU BY THE: Texas Association of Health Underwriters All comments regarding this CE may be sent to the above address, or to TDI Provider Course #3101 CE020

2 ETHICS: THE NAHU WAY Presented by Jackie L Spragins, RHU, LTCP

3 Ethics the NAHU Way Whatever Happened To Business Ethics? ConvenienceConvenience To WinTo Win RelativismRelativism

4 How Do You Rate Yourself? Always Ethical Always Ethical Mostly Ethical Mostly Ethical Somewhat Ethical Somewhat Ethical Seldom Ethical Seldom Ethical Never Ethical Never Ethical

5 How To Know What’s Right The Golden Rule!

6 Factors In Ethical Lapses Pressure Pressure Pleasure Pleasure Power Power Pride Pride Priorities Priorities

7 Ethics the NAHU Way 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

8 Perception of Insurance Consumer Carrier Employer Agent HealthCare Government Media

9 Keep paramount the needs of those whom I serve Ethics the NAHU Way 2

10 Sell to the Needs of the Client NOT your need for commission ASK what they need ASK what they need LISTEN to what they say LISTEN to what they say Don’t Oversell Don’t Oversell Don’t Undersell Don’t Undersell Inquire & respond appropriately Inquire & respond appropriately Stay away from Emotional selling Stay away from Emotional selling

11 Respect my clients’ trust in me, and never do anything which would betray their trust or confidence Ethics the NAHU Way 3

12 Trust & Confidence HIPAA Law HIPAA Law Security & Confidentiality Security & Confidentiality Covered Entity Covered Entity Business Associate Business Associate Employer Employer Personal Health Information Personal Health Information What do you do to secure information in your office? What do you do to secure information in your office? What about High Tech Security or Encrypting your data? What about High Tech Security or Encrypting your data?

13 Give all service possible when service is needed Ethics the NAHU Way 4

14 Service Is ‘service’ an ethical issue? Is ‘service’ an ethical issue? Speed Speed Accuracy Accuracy Friendliness Friendliness Do unto your Carriers as you would do unto your own business Do unto your Carriers as you would do unto your own business

15 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

16 Accurate Information Know the policies you sell Know the policies you sell No two policies are ever completely alike. Compare correctly! No two policies are ever completely alike. Compare correctly! Speak your client’s language Speak your client’s language

17 Prohibited Practices Rebating Rebating Churning Churning Twisting Twisting Misrepresentation Misrepresentation Fraud Fraud Failure to remit premium Failure to remit premium

18 The Uninsured The agent’s role and responsibility as current laws are changing we will become more of a resource. STAY INFORMED!!

19 Use no advertising that I know may be false or misleading Ethics the NAHU Way 6

20 Approved Advertising Advertising laws Advertising laws Approvals Needed Approvals Needed Carrier logo Carrier logo Senior products Senior products Paid print, written, internet Paid print, written, internet Beware of any new restrictions regarding Exchanges Beware of any new restrictions regarding Exchanges

21 Consider the Sale, Service and Administration of insurance and related products / services a career Ethics the NAHU Way 7

22 Career Lifetime career Lifetime career Not a part-timer Not a part-timer Surround yourself with professionals Surround yourself with professionals Are you a member of NAHU? Other association? Are you a member of NAHU? Other association?

23 Know and abide by the law of any jurisdiction, Federal and State, in which I practice Ethics the NAHU Way 8

24 Know the Laws Legislative update sources Legislative update sources If you get all your info from newspapers, then you only know as much as your clients 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 Don’t leave it all up to your Carriers

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28 Seek constantly to increase my knowledge and improve my ability to meet the needs of my clients Ethics the NAHU Way 9

29 Increase Your Knowledge Continuing Education – WHY Continuing Education – WHY TDI Requirements TDI Requirements What are they? What are they? Consider a Professional Designation Consider a Professional Designation

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32 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

33 Competition Take the High Road when confronted with unfair competitive practices. Take the High Road when confronted with unfair competitive practices. But how do we handle the ‘Bad Apples’? But how do we handle the ‘Bad Apples’?

34 Treat prospects, clients and companies fairly by submitting applications which reveal all available information pertinent to underwriting a policy Ethics the NAHU Way 11

35 Accurate Applications Proper application submission Proper application submission Learn underwriting procedures Learn underwriting procedures

36 Extend honest and professional conduct to my clients, associates, fellow agents / brokers and the companies whose products I represent Ethics the NAHU Way 12

37 Board Member & Agent Example: 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.

38 Disclosure of Info 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 com 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!

39 Year End Bonus Example: 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!

40 This program provided by: Texas Association of Health Underwriters P. O. Box Duncanville, Texas All comments regarding this CE may be sent to the above address, or to Thank you!


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