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Policies And Procedures

Ethics Committee

Atlanta Association Of Health Underwriters

  • The Atlanta Association of Health Underwriters (AAHU) has jurisdiction to review complaints of unethical practices of its own (active) members. The complaint must disclose the specific Code of Ethics (attached) violation.
  • The AAHU Board of Directors hereby assigns the task of reviewing complaints to the Ethics Committee (the Committee).
  • Complainant must submit a written report substantiating the nature and cause of the complaint, and, cite the specific violation(s) of the Ethics Code.
  • Members will be advised to submit their complaint, in writing, to the official address of AAHU. The envelope should be labeled: “Attn: Ethics Committee, Personal & Confidential.” The Executive Director of AAHU will notify the appropriate member of the Ethics Committee that a complaint has been received. This notice will be given within 24 hours if at all possible. The Ethics Committee member who receives the complaint will review the written complaint and contact the President of AAHU to reveal the content of the complaint. The identity of the parties will be kept confidential.
  • The Executive Director of AAHU will contact the Ethics Committee members in the following order to arrange for the sealed envelope to be delivered:
  • Ethics Committee Chair, if not available, then:
  • Ethics Committee Co-Chair, if not available, then:
  • Remainder of Ethics Committee members in alphabetical order, if not available, then:
  • Honorary Ethics Committee members
  • The extent of the investigation of the complaint is at the discretion of the Committee.
  • The Ethics Committee, will submit a written notice to the complainant acknowledging receipt of the Complaint. This notice will be sent within fifteen days of the Committee’s receipt of the complaint. The Committee is required to review the Complaint within thirty days from receipt of the complaint to determine whether sufficient grounds exist to conduct a hearing.
  • The Committee must maintain the confidentiality of all parties involved, throughout the review process.
  • The Committee will be prohibited from sharing the complaint via unsecured means, such as facsimile, electronic mail, etc. The Committee may elect to formally review the complaint, collectively, via teleconference, in the interest of time.
  • If the Committee determines that the complainant is not under the jurisdiction of AAHU or without merit, the Committee will advise the person filing the complaint, in writing, of such determination within thirty (30) days from the date of receipt. The Committee will provide a confidential copy of the complaint and the Committee’s’ record of review to the President within 7 days of any such determination.
  • If so determined to have merit, the accused will be notified of the complaint within 15 days of the Committee’s determination, and advised of a scheduled hearing. The hearing shall be scheduled no more than 45 days from the date the complaint is found to have merit. The accused will be notified via first class US mail to the address of record on file with the Executive Director of the Association. As a courtesy, the Ethics Committee Chair or Co-Chair will contact the accused, via phone, to advise the accused of the impending review and letter forthcoming.
  • Both parties will be advised, in writing, of the hearing date and their rights. The accused shall have the right to provide a written response and/or documentation supporting their position, within fifteen (15) days from the date of the notification. The Committee will collectively review the documentation to determine the appropriate course of action. If the information provided clearly shows that the charge has no merit, both parties will be advised of determination within seven (7) days of such determination. The Committee will provide a confidential copy of the complaint and the Committee’s record of review to the President of AAHU within seven (7) days of determination.
  • If the Committee decides that a complaint has merit after reviewing any pre-hearing documents submitted by the accused, warranting a formal review/hearing, the accused and the complainant have the following rights at such hearing:
  • Right to review the complaint and/or rebuttal documents prior to the hearing;
  • Right to rebut statements and to cross examine the other party;
  • During the hearing, which may be conducted by teleconference, the person making the charge would restate the complaint and the member being charged would present his/her account of the incident/situation. Questions may be asked by either party.
  • The Ethics Chair, or an appropriate Committee Member appointed by the Ethics Chair, will moderate the discussion and ensure that all parties are treated equitably.
  • The CommitteeBoard may restrict the scope of the hearing, including topics of discussion, corroborating witnesses, etc.
  • At the conclusion of the hearing, the Ethics Committee Members present at the hearing (including those present via teleconference) will make a written recommendation to the Board of Directors without identifying the parties., which The Board of Directors will make a final ruling on the matter. The Board of Directors will be required to provide a quorum among 8 or more voting Board Members, for there to be a valid judgment of guilt or innocence.
  • The Board’s authority for judgment can range from exoneration up to termination of membership, as follows:
  • Private reprimand;
  • Public reprimand;
  • Suspension1 of membership for more than 180 days;
  • Revocation1 of membership for life;

Should the Board find that a member has violated the Code of Ethics and impose sanctions beyond private reprimand, such findings must be reported to the state and national associations. Further, if the infraction is found to be of illegal conduct, the Board will provide the State Insurance Department with all documentation provided during the review and hearing process.

  • Under no circumstances should there be negative repercussions to anyone who files a complaint or to accused members who are exonerated under these Policies and Procedures.

1Membership dues are not eligible for refund should one’s membership be suspended or revoked.

Mission/Code of Ethics

Mission

NAHU will educate the public and decision makers about the value health insurance professionals deliver in helping consumers access the health care system and, through education and association involvement, increase members' ability to better serve consumers. We will do so in a financially prudent and responsible manner.

Code of Ethics

  • To hold the selling, service and administration of health insurance and related products and services as a professional and public trust and do all in my power to maintain its prestige.
  • To keep paramount the needs of those whom I serve.
  • To respect my clients' trust in me, and to never do anything, which would betray their trust or confidence.
  • To give all service possible when service is needed.
  • To present policies factually and accurately, providing all information necessary for the issuance of sound insurance coverage to the public I serve.
  • To use no advertising which I know may be false or misleading.
  • To consider the sale, service and administration of health insurance and related products and services as a career, to know and abide by the laws of any jurisdiction Federal and State in which I practice and seek constantly to increase my knowledge and improve my ability to meet the needs of my clients.
  • To be fair and just to my competitors, and to engage in no practices which may reflect unfavorably on myself or my industry.
  • To treat prospects, clients and companies fairly by submitting applications which reveal all available information pertinent to underwriting a policy.
  • To extend honest and professional conduct to my clients, associates, fellow agents and brokers, and the company or companies whose products I represent.