Time for a Market Conduct Exam
The regulatory body that conducts market conduct exams
What is the department of insurance
"Terminating policies during a DOI-declared moratorium"
What is Underwriting and Rating
This state has a regulatory environment favorable for insurers. This state does not allow nonrenewals solely from claims arising from catastrophes, natural disasters, acts of nature, or weather related causes
What is Alabama
Connecticut DOI found that the Companies engaged in improper rating of homeowner policies. They also found that the Companies had unlicensed individuals adjusting claims.
Exam Period: Jan. 1, 2018 – Dec. 31, 2018
What is $36,500
All insurance companies are required to have a _______ ______ for complaints
What is a Complaint Log
Market conduct examinations are designed to review how insurance companies conduct business with ______ for the purpose of protecting the public.
What are consumers
"Failing to conduct business in the company's legal name"
What is Marketing/Advertising
This state has multiple activist regulators. The Attorney General acts as a consumer advocate, intervenes in rate matters, and favors strong government intervention in the market.
What is Massachusetts
Illinois DOI Comprehensive Exam with significant findings on risk selection, underwriting and rating, and claims.
Exam Period: June 1, 2020 to May 31, 2021
What is $165,000 plus restitution to policyholders
In addition to Departments of Insurance, name another organization that companies receive complaints from
What is the Better Business Bureau (BBB)
Name one of the triggers for a market conduct exam
What are: Routine Exams, a Complaint or Complaint Trending, Market Share, Market Conduct Annual Statement (MCAS) Data, Financial Exam, Information from Other States, Legal Request, Shift in Business Practices, Filing Referral, New Operation, Media Attention, Re-Examination, Request of the Director/Commissioner
"Failing to conduct an adequate investigation"
What is Claims
The Insurance Superintendent is appointed by the governor for a five-year term. On the whole, the department can be stubborn, but staff are generally available, will return calls, and typically willing to hear you out.
What is Maine
Kentucky DOI Comprehensive Exam that found significant issues in the Company’s producer terminations.
Exam Period: January 1, 2018 – December 31, 2019
What is $20,250 plus the Company agreed to implement a corrective action plan within 12 months and submit semi-annual updates on progress made to implement the correction action.
Name one of the function categories for complaints
What are: Underwriting, Marketing and Sales, Claims, Policyholder Service, and Miscellaneous
Name one type of market conduct exam
What is a: Multi-state exams, targeted exam, comprehensive exam, routine exam, and desk exam
"Accepting business from unlicensed producers and/or agencies"
What is Producer Licensing
The Department has in the past generally been balanced for insurers and welcomed feedback on issues of interest to the industry and consumers when making decisions.
What is Kentucky
Virginia examiners found significant issues in the Companies’ policy termination and claims handling. The Companies were ordered to take corrective action.
Exam Period: April 1, 2019 – March 31, 2020
What is $34,000 and restitution to policyholders of $37,358.55
Name one of the complaint disposition types
What are: No Action Required/Company Position Upheld, Complaint Withdrawn, Company Position Overturned/Corrective Action Required
Name 2 of the 7 main areas of an insurance company reviewed in a comprehensive market conduct exam
What are Operations/Management, Complaint Handling, Marketing and Sales, Producer Licensing, Policyholder Service, Underwriting and Rating, and Claims
"Failing to retain documentation and/or maintain files"
What is Record Retention
Although the marketplace is competitive and is generally viewed as a business-friendly state, the insurance regulatory environment has been challenging at times, particularly with respect to rate and form filings.
What is Georgia
Pennsylvania examiners found significant errors in the Company’s underwriting and claims practices, including failure to issue timely termination notices and retain policy documentation in the underwriting file.
What is $10,00 and the Company agreed to take corrective action, including implementing new procedures and revising internal controls.
The amount of time a company has to respond to a complaint
What is: it depends on the state!