Fillable Form 20: INSTRUCTIONS: An applicant for a life (Arizona)

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Form 20: INSTRUCTIONS: An applicant for a life (Arizona)

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Form E-LSPF (v 20201217) 1 | Page
LIFE SETTLEMENT PROVIDER
ANTIFRAUD PLAN CHECKLIST
Name of Life Settlement Provider
Contact Person Name
E-mail Address
Phone Number
INSTRUCTIONS: An applicant for a life settlement provider certificate of authority is required to provide an antifraud plan
that meets the requirements of Arizona Revised Statutes (ARS) § 20-3211 and that includes the information listed in ARS
§ 20
-3202(E)(3). The applicant shall submit its antifraud plan with a completed version of this Antifraud Plan Checklist,
identifying places within the applicant’s antifraud plan where each of the following requirements is addressed.
E
nter the page number and paragraph number within your antifraud plan where each of the following begins.
Page
Number
Paragraph
Number
Plan Part
Code*
A
B
insurance applications. ARS
C
D
E
responsible investigating and reporting possible fraudulent insurance acts, and
for investigating unresolved material inconsistencies between medical records
*You will refer to the “Plan Part Code” in the next section of this checklist.
F
or each fraudulent settlement act, enter an “X” in the Plan Part Code column(s) that correspond to the parts of
your antifraud plan (A, B, C, D and/or E) that contain measures to minimize the potential for the act. In the
“Locations” column, note the specific page/paragraph numbers for the parts of your plan that are designed to
minimize the act.
It is a fraudulent life settlement act for any person to do, allow
or assist anyone else in doing any of the following:
Plan Part Code
Locations where
addressed in
the antifraud
plan (pages and
paragraphs)
A
B
C
D
E
1. Enter into a life settlement contract if a person knows or
reasonably should have known that the life insurance policy was
obtained by means of a false, deceptive or misleading application for
the policy. ARS § 20- 3211(U)(1).
2. Engage in any transaction, practice or course of business if
a person knows or reasonably should have known that the intent
was to avoid the notice requirements of ARS § 20-3211. ARS § 20-
3211(U)(2).
3. Engage in any fraudulent act or practice in connection with
any transaction relating to any settlement involving an owner who is
a resident of this state. ARS § 20-3211(U)(3).
4. Fail to provide the disclosures or file the required reports
with the director as required by Arizona Revised Statutes, Title 20,
Chapter 22. ARS § 20- 3211(U)(4).
Reset
LIFE SETTLEMENT PROVIDER ANTIFRAUD PLAN CHECKLIST
Form E-LSPF (v 20201217) 2 | Page
It is a fraudulent life settlement act for any person to do, allow
or assist anyone else in doing any of the following:
Plan Part Code
Locations where
addressed in
the antifraud
plan (pages and
paragraphs)
A
B
C
D
E
5. Issue, solicit or market the purchase of a new life insurance
policy for the sole purpose of, or with a primary emphasis on,
settling the policy. ARS
§ 20-3211(U)(5).
6. With respect to any settlement contract or insurance policy
and a broker, knowingly solicit an offer from, effectuate a life
settlement contract with or make a sale to any provider, financing
entity or related provider trust that is controlling, controlled by or
under common control with a broker, unless the relationship has
been fully disclosed to the owner. ARS § 20- 3211(U)(6).
7. With respect to any life settlement contract or insurance
policy and a provider, knowingly enter into a life settlement contract
with an owner if, in connection with a life settlement contract,
anything of value will be paid to a broker that is controlling,
controlled by or under common control with a provider or the
financing entity or related provider trust that is involved in a
settlement contract, unless the relationship has been fully disclosed
to the owner. ARS § 20-3211(U)(7).
8. With respect to a provider, enter into a life settlement
contract unless the life settlement promotional, advertising and
marketing materials, have been filed with the Director. ARS § 20-
3211(U)(8).
9. With respect to any life insurance producer, insurance
company, broker or provider, make any statement or representation
to the applicant or policyholder in connection with the sale or
financing of a life insurance policy to the effect that the insurance is
free or without cost to the policyholder for any period of time unless
provided in the policy. ARS § 20-3211(U)(9).
10.
Present, cause to be presented or prepare with knowledge
and belief that it will be presented to or by a provider, premium
finance lender, broker, insurer, insurance producer or any other
person, false material information, or concealing material information
as part of, in support of or concerning a fact material to one or more
of the following: ARS § 20- 3211(X)(1)(a)
i)
An application for the issuance of a life settlement contract or
insurance policy.
ii)
The underwriting of a life settlement contract or insurance
policy.
iii)
A claim for payment or benefit pursuant to a life settlement
contract or insurance policy.
iv)
Premiums paid on an insurance policy.
v)
Payments and changes in ownership or beneficiary made
according to the terms of a life settlement contract or
insurance policy.
vi)
The reinstatement or conversion of an insurance policy.
vii)
The solicitation, offer to enter into or effectuation of a life
settlement contract or insurance policy.
viii)
The issuance of written evidence of life settlement contracts
or insurance and any application for or the existence of or any
payments related to a loan secured directly or indirectly by
any interest in a life insurance policy.
11. Employ any device, scheme or artifice to defraud in the
business of life settlements. ARS § 20-3211(X)(1)(b).
LIFE SETTLEMENT PROVIDER ANTIFRAUD PLAN CHECKLIST
Form E-LSPF (v 20201217) 3 | Page
It is a fraudulent life settlement act for any person to do, allow
or assist anyone else in doing any of the following:
Plan Part Code
Locations where
addressed in
the antifraud
plan (pages and
paragraphs)
A
B
C
D
E
12. Enter into any intentional practice or plan than involves
stranger originated life insurance as prescribed in ARS § 20-443.02.
ARS § 20- 3211(X)(1)(c).
13. Employ any device, scheme or artifice in violation of ARS §
20-1104. ARS § 20-3211(X)(1)(d).
14. If providing premium financing, receive any proceeds, fees
or other consideration from the policy or owner of the policy that are
in addition to the amounts required to pay principal, interest and any
costs or expenses incurred by the lender or borrower in connecti
on
w
ith the premium finance agreement, except for a default, unless t
he
def
ault on such a loan or transfer of the policy occurs pursuant to a
n
agr
eement or understanding with any other person for the purpos
e
of evading regulation under Arizona Revised Statutes, Title 20,
Chapter 22. ARS § 20-3211(X)(1)(e).
15. Remove, conceal, alter, destroy or sequester from the
director the assets or records of a licensee or other person engaged
in the business of life settlements. ARS § 20-3211(X)(2)(a).
16. Misrepresent or conceal the financial condition of a licensee,
financing entity, insurer or other person. ARS § 20-3211(X)(2)(b).
17. Transact the business of life settlements in violation of any
law requiring a license, certificate of authority or other legal authority
for the transaction of the business of life settlements. ARS § 20-
3211(X)(2)(c).
18 File with the director of Insurance and Financial Institutions
or the chief insurance regulatory official of another jurisdiction a
document containing false information or otherwise conceal
information about a material fact from the director of insurance. ARS
§ 20-3211(X)(2)(d).
19. Engage in embezzlement, theft, misappropriation or
conversion of moneys, funds, premiums, credits or other property of
a provider, insurer, insured, owner, insurance policy owner or any
other person engaged in the business of life settlements or
insurance. ARS § 20-3211(X)(2)(e).
20. Enter into, broker or otherwise deal in a life settlement
contract that was obtained by presenting false information
concerning any fact material to the policy or by concealing, for th
e
pur
pose of misleading another, information requested concernin
g
an
y fact material to the policy where the owner or the owner's agent
intended to defraud the policy's issuer. ARS § 20-3211(X)(2)(f).
21. Attempt to commit, assist, aid or abet in the commission of,
or conspiracy to commit the acts or omissions defined as a
fraudulent life settlements act. ARS § 20-3211(X)(2)(g).
22. Misrepresent the state of residence of an owner to be a
state or jurisdiction that does not have a law substantially similar to
Arizona Revised Statutes, Title 20, Chapter 22 for the purpose of
evading or avoiding the provisions of the chapter. ARS § 20-
3211(X)(2)(h).
Submit your antifraud plan and this checklist with your certificate of authority application and within 30 days of a
material change to this plan.
S
end to financialfilings@difi.az.gov
.
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Form 20: INSTRUCTIONS: An applicant for a life (Arizona)

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Completed 1 July 2022

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