Date post: | 02-Jan-2016 |
Category: |
Documents |
Upload: | tasha-woods |
View: | 28 times |
Download: | 1 times |
Market Conduct Annual Statement
2
Market Conduct Process
State-based regulation• Enforcement Actions
1. Surveys2. Complaints
• Market Conduct Exams• Prior exam findings• MCAS
3
Market Regulation
Not just “market conduct” exams anymore• MCAS• Collaboration with other states• Financial exams
4
MCAS “Through the Years”
• Started in 2002• Process to collect market conduct related data• Established criteria/data requests…looking for
uniformity in data reporting• Provides data that is not otherwise collected
5
MCAS and MAP
• Market Analysis Procedures Working Group (MAP) • MAP reviews and coordinates state market analysis programs• Develops procedures • On “tap” for 2011 consideration:
1. MCAS blank to be used for the collection of data for additional lines of business
2. Best practices guide for state insurance regulators to analyze MCAS data
3. Data elements4. Making recommendations for the
enhancements/improvements to the Market Regulation Handbook
6
MAP/MARS
• MAP reports to the Market Information Systems (D) Task Force
• Market Analysis Review System (MARS)
1. Documents that reviews were performed on select insurance companies
2. Document a market analyst’s input, conclusions, and recommended next steps
7
MCAS Permits…
• State regulators to compare/contrast insurer-specific results with others in the insurance industry:1. Replacements2. Non-forfeitures3. Complaints4. Life Insurance face values5. Cancellations/Nonrenewals6. Claims timeframes7. Claims taking longer than 60 days to finalize
8
MCAS Permits…
• A review of company’s direct premium reported on a national and state basis
• Determining if premium has increased or decreased by 33% (or other %) in any single year during last 5 years
• Evaluating how the insurer is handling growth• Evaluating how claims staff is keeping pace with
growth demands• Answering the question: Are premiums down?
9
MCAS Permits…
• Statewide averages determination• View of company data to determine if there are
company ratios that exceed the statewide averages
• Identification of company outliers• Analysis and comparison of outliers with
companies through baseline analysis• Assistance in identifying which insurers may need
to have a Level 1 review conducted
10
Level 1 Analysis
• Company Action• Regulatory Action
11
Company Action
• Special Activities Database (SAD) • Market Activities• Legal Actions
12
Regulatory Action
• Substantive regulatory actions• Reasons for actions• Any patterns?• What were the magnitude of the penalties?
13
NAIC Recommended Level 1 Analysis Reviews: 2011
• Alabama 25• Alaska 15 • Arizona 20 • Arkansas 15 • California 40 • Colorado 25 • Connecticut 40 • Delaware 30 • Dist. of Col. 15 • Florida 40 • Georgia 35 • Hawaii 15
• Idaho 15• Illinois 40 • Indiana 40 • Iowa 40 • Kansas 20 • Kentucky 15 • Louisiana 25 • Maine 15 • Maryland 25 • Massachusetts 40 • Michigan 40 • Minnesota 30
14
NAIC Recommended Level 1 Analysis Reviews: 2011
• Mississippi 15• Missouri 40• Montana 15 • Nevada 15 • New Hampshire 20 • New Jersey 40 • New Mexico 15 • New York 40 • North Carolina 40 • North Dakota 15 • Ohio 40 • Oklahoma 25 • Oregon 20
• Pennsylvania 40• Rhode Island 15 • South Carolina 25 • South Dakota 15 • Tennessee 20 • Texas 40 • Utah 15 • Vermont 15 • Virginia 25 • Washington 35 • West Virginia 15 • Wisconsin 40 • Wyoming 15
15
How is MCAS Used by Regulators?
• Does a state participate?• Is the regulator concern a covered MCAS line of
business currently under review?• Was this concern/issue identified as outlier?• What data element(s)/subline(s) result in
company being an “outlier”? (PPA, HO, ILCVP, ILNCVP, IFA, IVA)
• Statewide average comparisons
16
How is MCAS Used by Insurers?
• Gather data• Evaluate data• Report Cards
17
Why MCAS?
• Permits centralized data storage• States have authority to share information with
the NAIC• States have authority to require insurers submit
information to the NAIC • Offers opportunities for trending and analytics
18
Life & AnnuitiesLife & Annuities
19
MCAS Reporting Period: Life Lines of Business1/11 through 12/11
• Individual Life Cash Value Products • Individual Life Non-Cash Value Products • Individual Fixed Annuities • Individual Variable Annuities
20
Individual Life Cash Value Products - 2011MCAS Data Elements
• Newly issued replacement policies issued during the year
• Internal replacements • External replacements • Policies replaced where age of insured at
replacement was <65• Policies replaced where age of insured at
replacement was 65 and over • Policies surrendered under 2 years from issuance• Policies surrendered between 2 and 5 years of
issuance
21
Individual Life Cash Value Products - 2011MCAS Data Elements
• Policies surrendered between 6 and 10 years of issuance
• Policies surrendered during the year• Policies issued during the year where age of
insured at issue was <65 • Policies issued during the year where age of
insured at issue was age 65 and over • New Policies issued by insurer during the year• Policies in force at the end of the year
22
Individual Life Cash Value Products - 2011MCAS Data Elements
• Direct premium during the year • Face amount ($) of insurance issued during the
year• Face amount ($) of insurance in force at the end of
the year • Direct complaints received from consumers • Number of death claims closed with payment
during the year within 60 days
23
Individual Life Cash Value Products - 2011MCAS Data Elements
• Death claims closed with payment during the year, beyond 60 days from the date of due proof of loss
• Death claims denied, resisted or compromised during the year
• Death claims received during the year
24
Individual Life Non-Cash Value Products - 2011
MCAS Data Elements • New replacement policies issued during the year • Internal replacements issued during the year• External replacements issued during the year • New policies issued during the year • Policies in force at the end of the year • Direct premium during the year • Face amount ($) of insurance issued during the year• Face amount ($) of insurance in force at end of year
25
Individual Life Non-Cash Value Products - 2011
MCAS Data Elements • Direct complaints received from consumers • Number of death claims closed with payment
during the year within 60 Days• Number of death claims closed with payment
during the year past 60 days • Number of death claims denied, resisted or
compromised during the year • Total death claims received during the year
26
Individual Fixed Annuities – 2011 MCASData Elements
• New replacement contracts issued during the year • Internal replacement contracts • External replacement contracts • Contracts replaced where annuitant’s age at replacement was < 65 • Contracts replaced where annuitant’s age at replacement was 65-
80 • Contracts replaced where annuitant’s age at replacement was > 80• New immediate contracts issued • New deferred contracts issued during the year where annuitant’s
age was < 65 • New Deferred Contracts issued during the year where annuitant’s
age was 65 to 80
27
Individual Variable Annuities - 2011 MCASData Elements
• New deferred contracts issued during the year (annuitant age >80)
• New deferred contracts issued during the year • Contracts surrendered < 2 years from issuance • Contracts surrendered between 2 and 5 years of issuance • Contracts surrendered between 6 and 10 years of issuance • Contracts surrendered during the year• Contracts in force at the end of the year • Amount ($) of annuity considerations during the year • Direct complaints received from consumers
28
Recent Life Insurer Fines
• New York: Replacement and application processes -$1,900,000 – February 2010
• New York: Life insurance and annuity client complaint handling - $2,000,000 – December 2010
29
Private Passenger AutoPrivate Passenger Auto
30
PPA Coverages in MCAS
• Collision• Comprehensive/Other Than Collision• Bodily Injury• Property Damage• Uninsured Motorists and Underinsured Motorists (UMBI)• Uninsured Motorists and Underinsured Motorists
(UMPD)• Med Pay• Combined Single Limits• Personal Injury Protection
31
PPA: Claims “at a high level” - 2011 MCASData Elements
• What was open at the beginning of the reporting year?
• How many did you open during the reporting year ?
• How many did you close through payment?• How many did you close without paying the
claim?• How many did you have open at the end of the
year?
32
PPA: It’s all about Timely Claim Handling -2011 MCAS Data Elements
• Paying the claims: How many claims were closed with payment1. 0-30 days2. 31-60 days3. 61-90 days4. 91-180 days5. 181-365 days6. > 365 days
33
It’s all about Timely Claim Handling - 2011 MCAS
Data Elements • Not paying the claims: How many claims were
closed without payment1. 0-30 days2. 31-60 days3. 61-90 days4. 91-180 days5. 181-365 days6. > 365 days
34
PPA: “Inventory of Suits”- 2011 MCAS Data Elements
What is tied up?• Open at beginning of the period• Opened during the period• Closed during the period• Open at end of period
35
PPA: Policy Data - 2011 MCAS Data Elements
• Number of autos with policies in-force at year’s end
• Number of policies in-force at year’s end• Number of new business policies written during
year• Dollar amount of direct premium written during
year
36
PPA: CNR Data - - 2011 MCAS Data Elements
• Company-Initiated non-renewals during the period• Cancellations for non-pay, NSF or insured’s
request• Company-Initiated cancellations in first 59 days• Company-Initiated cancellations 60 to 90 days out• Company-Initiated cancellations > 90 days out
37
Timely Claim Handling
• In 29 instances, the Company failed to supply the claimant with a copy of the estimate upon which the settlement was based. The Company failed to document that a copy of the estimate is provided to the insured.
• In 17 instances, the Company failed to document the basis of betterment, depreciation, or salvage. The basis for any adjustment shall be fully explained to the claimant in writing. The Company failed to tender the total loss offer in writing.
• In six instances, the Company failed to provide written notice of any statute of limitation or other time period requirement not less than 60 days prior to the expiration date. CA 10/10
38
Total Loss MCE Criticisms
• Examiners identified 21 first/third party total loss settlements, in which the Company failed to pay appropriate tax, license registration and/or air quality fees. (§ 20-461, 20-462, A.A.C. R20-6-801) AZ 11/10
• Company did not always include sales tax and fees in the actual cash value calculations on owner retained salvage claims…Companies violated WAC 284-30-3908 by deducting sales tax and fees in the actual cash value calculations in 1,788 owner retained salvage claims WA 3/11
39
Claims…it’s not just “exams”
Maryland’s MIA:
• Conducted year-long industry survey of 119 insurers
• investigated mishandling of vehicle insurance claims following changes to the taxes and fees associated with total loss
• 67 out of 119 companies were in violation• Almost $250,000 in collective fines• Almost $500,000 in restitution
40
HomeownersHomeowners
41
Homeowners Claims -2011 MCAS Data Elements
• Open at beginning of the period • Opened during the period • Closed during the period, with payment • Closed during the period, without payment
42
Homeowners: “Settling the Claims” - 2011 MCAS Data Elements
• Paying the claims1. 0-30 days2. 31-60 days3. 61-90 days4. 91-180 days5. 181-365 days6. > 365 days
43
Homeowners: “Settling the Claims” - 2011 MCAS Data Elements
• Median days to final payment • Median days to date of report
44
Homeowners: “Inventory of Suits”- 2011 MCAS Data Elements
• Open at beginning of the year• Closed during the year • Open at year’s end
45
Homeowners: Policy & CNR Data - 2011 MCAS Data Elements
• Dwellings that have policies in-force at the end of the year• Policies in-force at the end of the year • New business policies written during the year • Dollar amount of direct premium written during the year • Non-renewals during the year • Cancellations that occur 60 days or more after effective date,
(excluding those for either non-pay or at the insured’s request)• Cancellations that occur in the first 59 days after effective
date, (excluding those for either non-pay or at insured’s request)
46
Recent Property & Casualty Fines
Connecticut– $246,000 – August 2010– $177,500 – March 2010– $141,500 – February 2010– $397,000 – December 2010– $101,000 – January 2011
Missouri - $200,000 – February 2010New York - $475,000 – January 2010Texas - $221,000 – September 2010Washington - $534,000 – November 2010
47
MCAS ProcessMCAS Process
48
Overview of Process Steps
• Gather• Evaluate • Enter• Upload
49
2011 Changes
• Historical data uploaded• On-line portal (April 15th was no longer just “Tax
Day”)• Worksheets• E-Attestations
50
MCAS
• Planning• IT coordination &
understanding• Check the numbers• Forewarned is forearmed• Report card time
AICP E-Day Homework
51
MCAS
• From a company perspective
1. Are you satisfied with your “numbers”
2. Do you have outliers?
AICP E-Day Homework
52
Some E-Day Tips for MCAS
• Get ready• IT communication• Turn-around-time• Review your data• Does it make sense?• If it doesn’t make sense to you, how will the state
make sense out of it? • Learn from last year’s experience
Questions?