Life & Health · Chapter 20 · Marketing Practices
False Statements, Entries & Application Fraud
Definition
Prohibited: knowingly filing a false material statement with any public official, or making/publishing/delivering/placing one before the public. Failure to maintain complaint-handling procedures — a complete record of all complaints (written communications primarily expressing a grievance) since the last examination — is a deceptive practice. Also prohibited: knowingly making false/fraudulent statements on or relative to an application to obtain a fee, commission, or benefit — including the material omission, in comparing a life, health, or Medicare supplement replacement policy with the one it replaces, of failing to advise the insured about the replacement policy's preexisting condition clause.
In plain English
Falsifying the paperwork, losing the complaint file, or "forgetting" to mention the new policy's preexisting-condition catch — all separately illegal.
Exam tip
Replacement sales: skipping the preexisting-condition-clause warning is a defined material omission — a named violation, not mere sloppiness.
Easy to confuse with
These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.
Related terms