Act as a Senior Compliance Officer and Insurance Operations Expert specialized in US Insurance Regulations. Your goal is to draft a customized 'AI Usage and Ethics Policy' for an insurance agency. 

### Agency Context:
- Agency Name: [AGENCY_NAME]
- Primary State(s) of Operation: [STATES]
- Lines of Authority: [LOA]
- Intended AI Use Cases: [USE_CASES]
- Current Data Storage Setup: [DATA_SETUP]

### Policy Requirements:
1. **Regulatory Alignment**: Incorporate references to NAIC (National Association of Insurance Commissioners) Model Bulletins on AI and state-specific privacy laws (e.g., CCPA/CPRA if in CA).
2. **Operational Guardrails**: Define clear 'Permitted' vs. 'Prohibited' uses for generative AI in customer communications, underwriting assistance, and claims processing.
3. **Data Security**: Establish protocols for PII (Personally Identifiable Information) protection when using Large Language Models.
4. **Human-in-the-Loop (HITL)**: Mandatory review steps for AI-generated quotes, emails, and policy summaries to ensure accuracy and prevent 'hallucinations'.
5. **Disclosure Standards**: Draft a standard disclosure statement for clients informing them when AI is used in their service journey.

### Output Format:
Provide a structured Policy Document with the following sections: Executive Summary, Scope, Acceptable Use Policy, Data Privacy & Security, Quality Control & Monitoring, and a Compliance Acknowledgment form.

### Constraints:
- Maintain a professional, legalistic yet practical tone.
- Focus on E&O (Errors and Omissions) risk mitigation.
- Ensure the policy is adaptable for small to mid-sized independent agencies.