From Chippewa Falls to Kenosha, Wisconsin is a great place to live. With a relatively low cost of living and natural beauty, the state has plenty to offer families and singles alike.
As with other states, Wisconsin's insurance professionals will need a license to enter and stay in the profession. This applies to those who sell insurance, work as claims adjusters, or run insurance agencies. Understanding the state's requirements is essential to getting and maintaining an insurance license in the state.
The Lento Law Firm Team fully understands Wisconsin's requirements for insurance professionals, and we can help those defending their insurance licenses in the state. If your license is at risk, give us a call at 888-535-3686 or fill out our contact form.
Who Regulates Insurance Professionals in Wisconsin?
In Wisconsin, the Office of the Commissioner of Insurance (OCI) regulates insurance professionals. This includes:
- Insurance producers: Wisconsin uses this category to describe anyone who sells, solicits, or negotiates insurance.
- Adjusters: This covers both insurance and claims adjusters.
- Other: This category is for anyone else who needs licensing to practice in Wisconsin. It includes advisers, surplus lines brokers, title agents, appraisers, and third-party administrators.
The OCI exists to protect residents of the state while also making sure Wisconsin's insurance marketplace remains competitive. This includes overseeing insurance policies being issued in the state, monitoring licensed companies, and issuing and regulating licenses of all professionals doing business in the state.
Common Reasons for Disciplinary Action
The Wisconsin OCI lists its statutes on its website, and violation of those statutes can result in disciplinary action. Common reasons for disciplinary action in Wisconsin include:
- Fraudulent insurance acts
- Failure to comply with continuing education requirements
- Nonpayment of fees
- Failure to pay court-ordered child or spousal support
- Failure to comply with a subpoena or warrant
- Delinquent taxes
- Delinquent unemployment insurance contributions
- Falsifying information
- Failure to provide a Social Security number
- Changing state of residence
- Lack of qualifications to practice
- Incompetence
Requirements to Obtain an Insurance License in Wisconsin
Before you can qualify for an insurance license in Wisconsin, you'll need to satisfy the following requirements:
- Complete pre-licensing education for a pre-licensing exam, which includes 20 hours each on personal lines insurance and title insurance, as well as 20 hours per major line on life, accident and health, property, and casualty insurance
- Complete additional education specific to your license type
- Submit to a fingerprint-based criminal background check
- Apply for a license through the National Insurance Producer Registry
Requirements to Keep an Insurance License in Wisconsin
Once licensed, you're expected to respect all state and federal laws regarding insurance administration. This includes maintaining ethical standards and keeping your knowledge of the industry up to date. One of the most important things you'll do is renew your license and pay all fees in a timely manner. Failure to do so can result in temporarily losing your license.
Continuing education requirements are also an important part of retaining your Wisconsin insurance license. Insurance agents must complete 24 hours of continuing education every two years, and at least three of those hours must cover ethics in insurance.
Complaints Against Wisconsin Insurance Professionals
Anyone can file a complaint against a Wisconsin insurance professional or business by calling 1-800-236-8517 or 1-608-266-0103 for those who live outside the state. The OCI divides complaints into the following categories:
- Complaints against agents or public adjusters
- Complaints against pharmacy benefit managers
- Complaints about surprise medical bills
- Insurance fraud reports
The Investigation Process in Wisconsin
Once filed, a copy of the complaint is sent to the agent and the complainant. The OCI may contact the complainant with additional questions. The OCI acknowledges that the insurance company or agent may reach out to the complainant, offering resolution, and complainants aren't discouraged from taking measures to rectify the situation.
The OCI will initially review the complaint to determine whether any action needs to be taken. If the complaint is deemed valid, the OCI will launch an investigation. This can include requesting records, interviewing witnesses, or asking the insurance agent or company to provide written responses.
OCI's Disciplinary Process
In Wisconsin, the disciplinary process depends on the type of infraction. The following are the procedures for violations that result in revocation, suspension, or limitation of an insurance license:
- Failure to comply with continuing education requirements (CEUs): A professional's license will automatically be revoked on the day evidence of CEU completion is due. Sixty days before that date, the licensee will be notified of the due date and the repercussions if evidence isn't provided on time.
- Nonpayment of fees: As with CEU requirements, license revocation is automatic on the date the fees are due. Notice will be sent 60 days prior to the due date.
- Failure to pay court-ordered child or spousal support: If a licensee is required to pay child or spousal support, it's important to keep up with those payments. Failure to do so will result in the OCI either suspending or limiting the professional's license.
- Failure to comply with a subpoena or warrant: Ignoring court orders like subpoenas and warrants can result in a professional's license being suspended or limited.
- Delinquent taxes or unemployment insurance contributions: If the Department of Revenue reports that a licensee is late on taxes or unemployment insurance contributions, OCI will revoke the license.
- Falsifying information: If someone is suspected of falsifying information to the OCI, a hearing will be held to determine whether the suspicions are founded. If so, the license will be revoked.
- Failure to provide a Social Security number: Licenses will be suspended or limited if the licensee cannot present a Social Security number or federal employer identification number as required.
- Changing state of residence: If a licensee exits Wisconsin, the associated license will be revoked 60 days after the change of residence.
- Unqualified licensee: After a hearing, an insurance professional's license may be revoked, suspended, or limited if the OCI determines a licensee is not qualified to serve in the role.
- Fraudulent insurance acts: Fraud reports also lead to a hearing that can result in a revocation, suspension, or license limitation.
License Reinstatement in Wisconsin
If your license has been revoked for any of the following reasons, you can seek reinstatement within 12 months of the revocation date:
- CEU non-compliance
- Nonpayment of fees
- Delinquent taxes
To qualify for your license to be reinstated, you'll need to first rectify the issue that led to it being suspended. You'll also have to complete an application for reinstatement and pay a fee equal to double the cost of the standard renewal fee.
If you let the 12 months pass without applying, you'll no longer be eligible to have your license reinstated. Instead, you'll need to go through the process of applying for a license as though you're a new licensee. You'll have to fulfill the requirements that new applicants face, including possibly completing pre-licensing education and exams.
Criminal Activity and Wisconsin Licensing
If you have criminal activity in your past, you can still get an insurance license in Wisconsin. Where you put that license at risk is not fully disclosing your criminal history. The same goes for existing license holders who run afoul of the law. You're expected to report any criminal convictions to the board as soon as possible.
When deciding on licensing after a conviction, the OCI will consider the nature of the offense, the circumstances surrounding it, and how it impacts the person's ability to serve as an insurance professional. If you're convicted of a crime related to fraud, you may be permanently barred from holding an insurance license in the state.
Appealing Insurance Licensing Decisions in Wisconsin
Wisconsin insurance professionals can appeal licensing decisions through the Wisconsin Division of Hearings and Appeals. You can appeal any decision, including:
- Denial of a new license
- License suspension or revocation
- Fines or other disciplinary action
After any licensing board decision that impacts your license, you have the right to request a contested case hearing. You'll need to file a written request to the Wisconsin Division of Hearings and Appeals in Madison within 30 days of receiving the OCI's decision.
At the appeal hearing, you'll be given the opportunity to submit evidence, present witnesses, and make a closing statement. The OCI will have the same opportunity. You have the right to have legal counsel both help you prepare for the hearing and stand next to you at the hearing.
Steps to Take If You Receive a Complaint
Knowing your license is in jeopardy can be stressful, but it's important to stay calm. Whether you make your home in Green Bay, Milwaukee, or one of Wisconsin's many beautiful towns, here are some steps you can take once a complaint has been launched against you.
- Respond promptly: It's important to take every communication from the OCI seriously. Failure to respond promptly could result in disciplinary action.
- Review the complaint carefully: Your initial notice from the OCI should include details of the complaint and a deadline for your response. Review those details and compare them to Wisconsin's insurance laws to make sure you fully understand the allegations.
- Gather relevant documentation: As soon as you receive the notice of a complaint, begin collecting as much information as possible. Go through emails, phone messages, policy documents, and contracts that relate to the complaint. This will not only prepare you to support your case, but it will also help you get your thoughts together.
- Do not directly contact the complainant: Yes, the OCI acknowledges that some insurers will reach out and try to remedy the situation after a complaint. However, doing this could be seen as intimidation. It's best to let the OCI handle it.
- Draft a professional response: The response you send to the OCI is crucial. You'll need to remove emotion from the equation and craft a thorough written statement that addresses each allegation directly. Provide any supporting evidence you can, refuting any incorrect allegations and explaining any errors you might have made, along with what steps you plan to take to correct those errors.
- Contact a skilled attorney: The Lento Law Firm can review your case and help you with your response. We can also help you prepare for any in-person interviews or meetings and appeal OCI decisions.
At the conclusion of the hearing, the administrative law judge will make a decision. This decision is final. You'll either see the OCI's decision overturned, have penalties adjusted, or have your appeal denied, at which point you'll need to proceed with the original sanctions in place.
How the Lento Law Firm Can Help
Whether you live in bustling Green Bay or the beautiful Wisconsin Dells, the Lento Law Firm Team understands the challenges that come with insurance license issues. If you're facing disciplinary action in Wisconsin, the right legal counsel can make a big difference. Our team can help with the following:
- Reviewing statutes and regulations: Wisconsin's statutes are verbose and extensive. Weeding through it all can be daunting. Our experienced attorneys can take a look at the allegations against you and extract all relevant legal statutes to help you respond.
- Preparing responses: While the investigation is in progress, you'll be asked to submit written responses to the OCI. Our legal professionals have the experience necessary to put together a strong response backed by evidence.
- Negotiating penalties: In some cases, penalties are inevitable. When that's the situation, we can work with the OCI to negotiate lesser sanctions.
- Appeals: When an appeal becomes necessary, we can help request and prepare for the contested case hearing. We'll ensure the statement you present in front of the administrative law judge puts you in the best position possible for either a complete reversal or a penalty reduction.
- License reinstatement: With some infractions, a license can be reinstated within 12 months of it being revoked. We can advise you on meeting the requirements and filing for a license reinstatement.
The Lento Law Firm Team takes disciplinary action seriously, realizing the harm it can do to a career. You've worked hard to get the qualifications necessary to serve as an insurance professional, so it's important to protect and defend your license. If you're facing disciplinary action in Wisconsin, give us a call at 888-535-3686 or fill out this confidential online form.
