Regulation Framework in U.S. Insurance Market: Overview and Guidelines
Explore the comprehensive framework for market conduct regulation in the U.S. insurance industry, covering core principles, producer licensing, rate and form review, consumer assistance, monitoring processes, on-site examinations, and corrective measures.
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Presentation Transcript
Market Regulation The U.S. Framework MARKET CONDUCT ICP 19 CONDUCT OF BUSINESS APRIL 20, 2016 TED NICKEL WISCONSIN INSURANCE COMMISSIONER NAIC PRESIDENT-ELECT
Presentation Overview Insurance Core Principle 19: The supervisor sets requirements for the conduct of the business of insurance to ensure customers are treated fairly, both before a contract is entered into and through to the point at which all obligations under a contract have been satisfied. Core market regulation framework in the United States Producer licensing process Rate and form review options General consumer assistance functions Off-site monitoring tools On-site examination process Corrective measures a state may impose
Producer Licensing Application and Background Check Examination by Line of Authority Company Appointment Continuing Education License Renewal Broad Enforcement Authority
Rate and Form Review Rates Must not be inadequate, excessive or unfairly discriminatory Review Options Prior Approval File and Use Use and File Open Competition
Consumer Assistance Consumer Inquiries Consumer Complaints Education and Outreach Investigations Antifraud
Off-Site Monitoring Market Conduct Annual Statement Level 1 and Level 2 Analysis Consumer Inquiries and Complaints Not all market data is the same Local monitoring is essential
On-Site Risk Focused Examinations Performed as needed on any company operating in jurisdiction Examination may cover one or more of the following areas: operations/management, complaint handling, marketing and sales, producer licensing, policyholder service, underwriting and rating, claims Examination report provides company a summary of findings and violations of state laws, regulations, contract provisions
Corrective Measures Remediation Fines Implementation of policies and procedures Self-audits and reporting Follow-up examinations Cease and desist
Questions/Comments THANK YOU FOR YOUR PARTICIPATION.
