BILL ANALYSIS SENATE COMMITTEE ON BANKING, FINANCE, AND INSURANCE Senator Jackie Speier, Chair AB 243 (Vargas) Hearing Date: June 29, 2005 As Amended June 14, 2005 Fiscal: Yes Urgency: No VOTES: Asm. Ins. (4/27/05):8-2/ Pass Asm. Floor (6/01/05):52-24/ Pass SUMMARY Would permit consumers and others with life insurance policies to sell their in-force policies to companies that wish to buy them, rather than merely allowing the policies to lapse or to be surrendered to the insurer DIGEST Existing law 1. Regulates, through the insurance code, viatical settlements --the sale of a life insurance policy by a person with a catastrophic or life-threatening condition-to purchasers other than the insurer for anything less than the death benefits of the insurance policy, but does not separately define or regulate life settlements except insofar as life settlements may be deemed securities, thereby governed by the corporations code, under some circumstances (see #12 and #13, below); 2. Does not define catastrophic or life-threatening condition, despite relying on this term of art to identify viatical settlements; 3. Permits the purchasers of viatical settlements to collect the death benefit of the policy upon the death of the covered individual; 4. Prohibits the purchaser of the policy from paying for loans, cash surrender values or other benefits made by the insurer prior to sale; AB 243 (Vargas), PageB 5. Requires the purchaser of a viatical settlement to obtain a doctor's determination that the seller is of sound mind and under no constraint or undue influence, and a witnessed signature of the seller on an acknowledgement of complete understanding of the settlement and the related death benefits; 6. Makes it a misdemeanor to fail to obtain #5; 7. Establishes a separate license for viatical settlement sales, requirements for holding and surrendering the license, penalties for violations of the standards of sale, requirements to file a copy of each viatical settlement with the Department of Insurance (DOI), disclosures by sales representatives of alternatives to viatical sales and possible ineligibility for public programs as a result of a settlement, and broad powers of the Insurance Commissioner (IC) to regulate the affairs of viatical settlement companies; 8. Defines an insurable interest for purposes of life insurance as "?.an interest based upon a reasonable expectation of pecuniary advantage through the continued life, health or bodily safety of another person and consequent loss by reason of that person's death or disability or a substantial interest engendered by love and affection in the case of individuals closely related by blood or law"; 9. Establishes that a person has an "unlimited insurable interest" in their own life; 10. Further establishes that employers have an insurable interest in their own employees or officers and directors when the death of those persons would cause financial loss to the employer; 11. Notwithstanding #10, prohibits issuing life insurance on employees except those that are "exempt" employees pursuant to Labor Code Section 515 (generally non-hourly employees); 12. Defines viatical and life settlements as securities but exempts the offer or sale of viatical or life settlements, or fractionalized interests therein, from qualifying as a security if sold to qualified purchasers, including investment pools and, broadly speaking, other types of sophisticated investors; 13. Makes the exemption in #12 contingent upon a number of AB 243 (Vargas), PageC disclosures regarding the offering, including but not limited to the name and address of the issuer, meeting suitability standards for an investor, a description of the issuer's type of business, audit reports, notice of right to rescind the purchase of the security, etc. 14. Permits life agents to offer viatical and life settlements exempted under #12 without having to obtain a broker-dealer (securities) license. This bill 1. Would include within the definition of a viatical settlement an agreement with a seller of an insurance policy (viator) to transfer ownership or change the beneficiary designation at a later date regardless of the date that compensation is paid to the viator; 2. Would define "catastrophic or life threatening illness" to mean any of the following: a. An illness or condition that can reasonably be expected to result in death in 24 months or less; b. An inability to perform at least two activities of daily living, including eating, toileting, transferring, bathing, dressing and continence; c. Severe cognitive impairment requiring substantial supervision to protect the individual from threats to his or her health and safety; d. A level of disability similar to that described in (c), as determined by the Secretary of Health and Human Services; 3. Would establish a detailed body of law to regulate the life settlements industry, including, but not limited to, the following: a. A definition of "advertising," "business of life settlements," "financing entity," and "fraudulent life settlement act" (page 5); b. A prohibition on fraudulent acts that, generally speaking, would define as fraudulent those acts and omissions or material misrepresentations of the transaction of the sale of a life settlement contract to a buyer, and including material misrepresentations of the terms of an application of a life settlement contract, how premiums of AB 243 (Vargas), PageD the existing policy would be paid, rules regarding changes in ownership, a financing provision, etc.; (pages 5 - 6) c. A prohibition of various actions that would further a fraud or prevent the detection of fraud, such as hiding the assets of a life settlements company or person engaged in the business, destroying or moving records, filing false evidence with the IC or with another jurisdiction, recklessly brokering or otherwise dealing in a life settlement contract, facilitating the change of the state of a viator to avoid being covered by the law of California (pages 6 - 7); d. A definition of a life settlement contract, generally speaking, as a written agreement establishing the terms under which compensation or anything of value will be paid, which compensation or value is less than the expected death benefit of a policy, in return for the seller's assignment, transfer, sale, devise, or bequest of the death benefit or ownership of any portion of the policy, and an agreement to transfer ownership or change the beneficiary at a later date, but not including a viatical settlement (as defined above in "Existing law, #1) (page 7); e. A definition of "life settlement provider" as a person, other than a seller, who enters into or effectuates a life settlement contract, but not including (among others) banks, savings and loans, the act of taking assignment of a policy for a loan, financing entities, special purpose entities, accredited investor or qualified institutional buyers (page 8); f. A definition of "life settlement broker" as, generally speaking, those who earn a commission from providers for negotiating life settlement contracts between sellers and providers (page 7); g. A requirement that a person operating as a life settlement provider first obtain a license as a viatical settlement provider (page 9); h. A prohibition on a person operating as a life settlement broker unless they have been a licensed California life insurance agent for at least one year, and contingent upon the filing a notice with the DOI that they are brokering life settlements, such notice being filed AB 243 (Vargas), PageE within 30 days after they begin to broker such settlements (pages 9 bottom, 10 top); i. A grant of authority to the IC to suspend, revoke or refuse to issue a license to a provider, as specified (page 10), to impose similar restrictions on licensing of brokers (page 11), and to further impose penalties of not more than $10,000 for each violation of the law by a provider and not more than $5,000 for each violation by a broker (page 11); j. A requirement that a life settlement provider file specified information as an annual statement to the IC on or before March 1st, and a prohibition on the disclosure of medical information, financial information or the identification of the insured to any person except when the disclosure is necessary in response to an investigation by the IC or as otherwise specified (pages 12 - 13); aa.A requirement that the following disclosures be made to the seller by either the provider or broker (pages 13 - 14): i. Possible alternatives to life settlements; ii. A statement that the broker represents only the seller and owes a duty to the seller to act according to the seller's instructions and in the best interests of the seller; iii. Some of the proceeds may be taxable; iv. Receipt of proceeds may adversely impact the seller's eligibility for Medicare benefits; v. The seller has the right to rescind the sale for either 30 days after the settlement contract date or 15 days after receipt of proceeds, whichever comes first, and the seller must notify the provider and return funds and pay the fees that were otherwise paid by the provider for the transaction (right of rescission at lines 38-40 page 13 and lines 1 - 11 page 14); vi. Funds will be sent to the seller within three business days after the insurer acknowledges that the ownership of the policy has changed; vii. An explanation of other rights under the policy of life insurance that may be impacted by the life settlement; viii. A health exam may be required for the settlement; AB 243 (Vargas), PageF bb.A requirement for various other disclosures and mandatory language prior to the sale being made (pages 14 - 15); cc.A requirement that a doctor submit a written statement that the seller is of sound mind and under no constraint or undue influence (page 15); dd.A requirement that the seller consent to release of medical information if the seller acquired the life insurance within the prior three years (page 16); ee.A requirement for witnessed documents of consent to the sale of the life policy, including a requirement that terminal patients state that the condition was diagnosed after the policy was obtained (page 16); ff.A prohibition on entering into a life settlement contract within two years of the purchase of the life policy, except as specified (page 18); gg.A provision permitting a life settlement provider to resell the contract to another life settlement provider; hh. A provision prohibiting the life settlement company from paying various fees that might be incurred (doctor/lawyer/accountant) by a seller; ii.Broad language prohibiting fraudulent acts and granting the IC extensive powers to combat fraudulent acts (pages 19 - 23); jj. Language specifying that nothing in the law shall preempt or otherwise limit application of the securities laws to these transactions; aaa.Delays operation of Sections 10127.24 and 10127.34 until January 1, 2006, and of all other provisions of the bill until April 1, 2006. COMMENTS 1. Purpose of the bill . To permit life insurance policyholders to sell their policies to someone who is not the original insurer (a.k.a. a life settlement company). 2. Background . AB 243 (Vargas), PageG Life settlement vs. viatical-what's the difference? Some would argue that there is no difference because of the mathematics of viatical and life settlements. This is fair. Determining the likelihood that someone will die at a future date is the same for both types of settlements. However, this similarity also misses a major point of distinction. Viatical settlements, at least historically, have been made with people who are terminally ill. The fact that these persons are terminal makes them prey for unscrupulous buyers of their life insurance. This has necessitated a great deal of regulatory action. The market for viatical settlements flourished for a period of time and is now, according to supporters of this bill, relatively minimal because of problems with fraud in the viaticals market. Life settlements typically involve the sale of life insurance by someone who is between 65 and 70 years of age. While they may not be in perfect health, there is arguably no urgency to sell the life insurance policy. The seller therefore has more time to shop the market for buyers, and more opportunities to reject inadequate offers or, in extreme cases, to seek legal counsel if the deal sours. The lack of urgency, arguably, may give sellers many more opportunities to defend their interests in these types of transactions. Basic public policy issue. Despite the length of this bill and the apparent complexity of the topic, one basic public policy question posed by the bill is quite simple: "Should those who have life insurance policies be able to sell them or assign the benefits, beyond simply allowing the policy to lapse or surrendering the policy to the insurer for its cash surrender value?" Who is the seller? Discussions of this bill may lead one to believe that sellers will be individuals. However, it should be noted that companies may also sell life policies that they purchase. Companies often purchase "key man" life insurance policies on key senior executives who are so important to the ongoing financial health of the company that their death would severely damage the company's capacity to continue. These policies would also be regulated at time of sale under the provisions of AB 243. Recent California law bans "janitor insurance" that some companies purchased as a speculative investment on their non-exempt employees (such as janitors and other hourly workers). AB 243 (Vargas), PageH The state of current law. In the context of catastrophic or life-threatening disease, California law already permits viatical settlements to exist, and the state regulates them. California does not yet regulate life settlements, except insofar as they are securities, but they already exist. The issue of viatical settlements arose, in part, as a result of the AIDS epidemic. Those with life insurance policies and obligations to meet end-of-life care began to sell their death benefits. As noted above, these sales became fraught with problems of abuse as persons who were desperate for financial options in the midst of crippling disease were victimized. The value received by sellers, many of whom were in pain or operating under financial duress, was often minimal compared to the death benefits. Financial benefits of sales were sometimes delayed or denied as severely ill persons struggled to make ends meet, and some died before resolution of disputes with buyers. Viatical settlements were first regulated by California in 1990 and the law was last amended in 1997. Various protections were created so that sellers were able to obtain disclosure and guarantees of rescission, as well as remedies through the DOI, such as fraud investigations and licensing actions. In information provided by Coventry First to the committee, the Wall Street Journal of May 26, 2005 noted that "A controversial new life-insurance pitch promises free or low-cost coverage to wealthy people over 70. The catch: a complete stranger could benefit from their death. A financing company lends you or a family trust money so that you can buy a large insurance policy on your life. The loan lasts for at least two years. If you die during the loan period, your estate must pay back the loan, plus interest and fees. What's left goes to your heirs. If you survive, you can keep the policy and pay back the loan. Or you can transfer the policy to the lender?.This type of transaction is known as non-recourse premium financing? Critics, including some insurance companies, contend the practice alters the purpose of life insurance by treating it as an investment vehicle for outside speculators." Coventry First also provided the committee with other articles. In a May 31, 2005 article, the Wall Street Journal cited a new report (funded by MassMutual Financial Group) from Deloitte Consulting and the University of Connecticut that found that it AB 243 (Vargas), PageI is best to simply keep policies so that the wealth of an estate can be maximized. This same study found, however, that selling a life insurance policy to a life settlement company is often better than surrendering the policy to the insurer for the cash surrender value. Of 534 life settlement contracts studied in New York, the companies paid, on average, 20% of the face amount of the policy.<1> In contrast, according to the study, "?..'the intrinsic economic value of the policy'-the estimated future payout minus future premium costs-was an estimated 64% of the policy's face amount."<2> According to the Life Settlement Institute, insurers tend to discourage life settlements because 88% of all universal life insurance policies never result in a death claim.<3> 3. Support . Coventry First is a large life-settlement company. Coventry believes that life settlements permit policyholders to obtain higher payments for unneeded life insurance than would be the case if the policyholder simply surrendered the policy to the insurer and accepted the cash surrender value. The bill is "based on the Model Viatical Settlements Act developed by the National Association of Insurance Commissioners." The act regulates both viatical and life settlements under one act. [Staff notes that AB 243 defines life and viatical settlements separately and is therefore a departure from the Model Act, although the sponsors believe that this departure makes the law clearer.] 4. Neutral/Opposition . The Association of California Life & Health Insurance Companies is neutral on the bill as in print on June 14, 2005. The DOI is neutral on this bill if it is amended to deal with substantial shortcomings perceived by the DOI in the current language and approach to public policy problems. DOI generally supports statutory language in the area of life settlements because it is currently unregulated. These are excerpts from the DOI's letter. DOI personnel will be present to elaborate on these excerpts: Our main problems with AB 243 are: (1) it provides a ---------------------------- <1> Wall Street Journal, May 31, 2005, Page D2. <2> Ibid. <3> The Life Settlement Institute is an industry trade group of life settlement providers. Coventry is a member of the Life Settlement Institute. AB 243 (Vargas), PageJ definition of "catastrophic and life threatening" that is too narrow and eliminates conditions such as AIDS, coronary artery disease requiring surgery and other serious conditions; (2) it exempts third party funding entities from licensure as life settlement providers; (3) it requires a "knowingly" or intent to defraud" standard for fraudulent settlement acts, and contains other enforcement provisions that are inconsistent with the Insurance Code; (4) it allows life producers to transact life settlements without having to obtain a license which is a problem given our experience in the viatical arena; (5) the reporting requirements are too narrow; (6) the disclosure requirements are too narrow; and (7) the proposed legislation provides for something less than an unconditional right of rescission to sellers of a policy. DOI then offered amendments to deal with every perceived shortcoming in the bill. Staff is recommending at least one of those amendments, below, and the DOI will be present to explain all of its suggestions. Regarding a key definition in the bill, the DOI had these comments: Replace the definition of "catastrophic or life threatening" to comport with the Department's long-standing interpretation of what constitutes a viatical settlement. The proposed legislation's definition is too narrow, and creates a standard where one could reasonably question whether or not individuals meeting the criteria have the requisite capacity to engage in a viatical settlement transaction. Moreover, the industry's proposed definition would prevent the inclusion of many conditions that the Department currently considers "catastrophic or life threatening," the most common of which is AIDS. The DOI continued: Section 10113.209(a)(3)'s reference to persons with a "terminal or chronic illness" underscores that the effect of AB 243 weakens the Commissioner's current jurisdiction over viatical settlements. That is, under the Commissioner's existing interpretation of "catastrophic or life threatening," persons with a terminal or serious, chronic illness would typically qualify for a viatical as opposed to a life settlement. Similarly, Section 10113.208(a)(11) regulates the frequency of contacts where the insured has a life expectancy of "one year or less." Such individuals, however, clearly fall within the area of viatical, as opposed to life AB 243 (Vargas), PageK settlements. Thus, the Commissioner believes that the effect of these provisions weakens the Department of Insurance's existing jurisdiction to regulate viatical settlements. Other comments about the bill. Staff received a phone call from a viatical settlements broker who was fervently opposed to the bill, and she stated that others would soon be calling the committee. Ms. Carol Fiedler (Corte Madera) opposes the bill for many reasons. First, she believes that the persons who are selling these policies should be referred to a licensed viatical settlements broker, and she believes that life settlements should only be sold by those who hold a viatical settlements license. Life insurance agents, who could sell policies on behalf of buyers pursuant to the language in the bill, simply don't have the proper training, she believes, to best represent the interests of consumers. Furthermore, they may try to send the policy and confidential medical information to all potential buyers rather than focusing on those most likely to buy. This means that the confidential information will be spread around many businesses, all with the possibility of privacy violations. She notes that life agents won't have to even send in the minimal paperwork and fee to notify the DOI of the agent's sales until 30 days after the first sale. She strongly advises that at least these agents be required to first send in the notice and fee so that they are on record with the DOI in advance of selling to consumers. 5. No comments from the Department of Corporations . Staff has received no formal comments from the Department of Corporations (DOC). Staff is aware that a letter was sent by the DOC to Coventry in February, and that responses to that letter were only recently received by the DOC. Staff does not have the responses, but the letter generally was a wide-ranging inquiry based upon the language of the bill at that time. Since that time, the bill was amended to make clear that nothing in the bill is intended to preempt or limit the application of the California Uniform Securities Act or the authority of the Commissioner of Corporations (Proposed Section 10127.34). Staff is aware that the DOC has few, if any, investigators to conduct investigations into fraud that may occur should the market for life settlements begin to grow in dollar volume. Fraud, if it happens, would likely occur in the sale of interests in life settlement providers or in pools of life AB 243 (Vargas), PageL settlements that they offer to investors. At the present time, providers appear to be funded by relatively sophisticated investors, AIG being a noteworthy investor in life settlements originated through Coventry. However, as the market becomes regulated, supply and demand will fluctuate and at some point an investment in pools of life settlements may become relatively inexpensive. This would probably result in pool investors who are far less sophisticated than AIG. This would suggest that fraud on investors would increase unless the DOC is actively supervising the market. 6. Questions . a. The Department of Corporations has few, if any, investigators to conduct investigations into fraud that may occur should the market for life settlements investments begin to grow in dollar volume. i. Should the bill be amended to create a requirement that life settlement providers pay a specified fee to the DOC for purposes of supporting a small staff of fraud investigators, at least for a period of time such as the next five years? It may be in the interests of providers, as well as the public and investors, that this regulatory capacity be established. b. It is difficult for staff to offer informed analysis of the securities implications of this bill without the formal input of the DOC. Should the bill be amended to require the DOC to promulgate regulations about life settlements? c. How will an expanding market in life settlements influence the price of life insurance? d. Is there a standard way to compare the offers of various life settlement providers in an "apples-to-apples" fashion to evaluate the relative merits of different offers? If so, should this standard comparison technique either be required by law within this bill or developed through regulation, in order to ensure that sellers have the best available tools to evaluate offers? e. Should life settlement brokers be required to have separate licenses, as the DOI recommends? Would this result in sellers only being able to deal with brokers who have a AB 243 (Vargas), PageM specific interest in getting the policy sold, rather than dealing with brokers who could help a seller identify the broader interest in determining if a sale is even prudent? 7. Suggested Amendments . a. First, it's important to understand that the bill separates out viatical settlements and life settlements for purposes of regulation. In the process of doing so, the bill defines the concept of life-threatening and catastrophic illness, a term currently invoked but undefined in California law. California law presently requires that a viatical settlement agreement be accompanied by a doctor's statement that the person who is entering into the settlement is of sound mind (page 4, starting at line 8). This bill defines a person with a life-threatening or catastrophic illness as one who, among other things , is a person who has "severe cognitive impairment requiring substantial supervision to protect the individual from threats to his or her health and safety" (page 3, lines 22 - 24). These two provisions of the bill are logically at-odds with each other and the bill should not be passed without this problem being resolved. Staff is recommending that the DOI's definition of catastrophic or life-threatening illness or condition" be adopted (see "c," below). It is based upon the DOI's experience in trying to regulate viatical settlements and in trying to assist California consumers or their survivors, and is therefore arguably a more informed standard than the NAIC model that is supported by the proponents of the bill. At least in staff's judgment, NAIC models tend to be a compromise amongst various state regulators, a form of informed judgment but not one that necessarily reflects the history of California on any given subject. Adopting the DOI's definition would eliminate the current inconsistency in the bill's language. If the committee chooses not to adopt the DOI's definition, then staff recommends that lines 14 - 27 on page 3 be deleted. One simply cannot seriously argue that a person with severe cognitive impairment requiring substantial supervision is a person who might receive a doctor's note saying that they are mentally competent to enter into a viatical agreement. b. On page 4 at line 8, strike the term "licensed medical AB 243 (Vargas), PageN practitioner" and insert "medical doctor licensed pursuant to" and then insert the appropriate code citation for a California-licensed medical doctor. It would be bad public policy to permit a chiropractor who is a licensed medical practitioner to certify the mental competency of the seller. Staff is recommending this amendment due to past history on this issue. The mentally-deranged individual who rammed his semi-tractor-trailer truck onto the steps of the California State Capitol was licensed as a truck driver. Obtaining a license required a physical exam and the exam included a conclusion by the examining physician as to mental competency. The truck driver received his favorable physical examination from an out-of-state chiropractor. c. On page 10 at line 4, strike "after" and insert "before". On page 10 at line 12, after "article." Insert: "The life and disability insurance agents shall file with the commissioner a declaration that the person's life and disability agent license is valid and in good standing. If the commissioner determines that the agent's life and disability agent license is invalid or not in good standing, or the agent failed to submit any additional information requested by the commissioner, the commissioner may suspend the agent's ability to transact or to otherwise be involved in life settlements." The bill proposes to permit an agent to begin selling life settlements and then to notify the DOI afterwards. Staff recommends that the agent be required to notify the DOI before beginning to sell, and the DOI can then determine if the person has a troubled history and take action to prevent an agent with a troubled history from being a life settlement broker. The language of this proposed amendment is similar to that governing viatical brokers as set forth in Section 10113.1 (a) (2), although viatical brokers are also required to hold a specific license as a viatical broker. Staff's proposed amendment would not result in a separate license being required of life settlement brokers. d. Adopt the DOI's recommended definition of catastrophic or life threatening illness or condition to conform to the DOI's current interpretation of this key term, as well as to account for diseases with evolving treatment possibilities (such as AIDS or some forms of cancer): Section 10113.1(a) (3) should be amended to provide the AB 243 (Vargas), PageO following definition of "catastrophic or life threatening:" (a) an illness or condition that can reasonably be expected to result in death in twenty four (24) months or less; (b) a medical condition that has required or requires extraordinary medical intervention, such as a major organ transplant or continuous artificial life support, without which the insured person would die; (c) any condition that usually requires continuous confinement in a nursing home, convalescent center or other care facility, if the insured person is expected to remain there for the rest of his or her life; (d) a medical condition that in the absence of extensive or extraordinary medical treatment will result in a dramatically limited life span. Such medical conditions include but are not limited to the following: (i) coronary artery disease resulting in an acute infarction or requiring surgery (ii) permanent neurological deficit resulting in acute form of cerebral vascular incident (iii) end-stage renal failure; or (iv) Acquired Immune Deficiency Syndrome. e. The bill should be amended to require that a life settlement broker disclose the names of all providers to which a policy was submitted and the offers made, if any, by each provider. This is consistent with the definition of a life settlement broker that specifically states that the broker operates in the interests of the seller (see page 7 at line 34). The person operating in the interests of the seller should disclose what are, in effect, all bids for the seller's property. f. The term "financing entity" appears several times in the bill. It is defined on page 5 starting at line 13. The DOI indicated misgivings about whether there would be adequate regulation of these entities. The author should identify which body of law governs each of the types of financing entities described on page 5 at line 13 so that committee members can ask the question, "Would that body of law adequately protect an investor in this financing entity who hopes to be involved in life settlements?" If the answer is "no" then staff recommends that the committee eliminate the named financing entity from the bill. 8. Prior Legislation . AB 243 (Vargas), PageP SB 2281, Chapter 1418, Statutes of 1990: Established the law governing viatical settlements. SB 1837, Chapter 705, Statutes of 2000, Figueroa: Created exemption for specified types of viatical and life settlements from securities law and placed these transactions under provisions of the insurance code. AB 226, Chapter 328, Statutes of 2003 (Vargas): Prohibited the sale of "corporate owned" (a.k.a. "janitor policies"), as specified, in which companies purchased life insurance policies on a broad number of employees and didn't tell them that the policies existed, yet reaped the financial rewards if employees died. POSITIONS Support Coventry First (sponsor) Neutral The Association of Life & Health Insurance Companies Neutral if amended Department of Insurance Oppose Carol Fiedler, Viatical Settlements Broker, Corte Madera No position California Department of Corporations Consultant: Brian Perkins 916-651-4102