Section G Reg. of Ins.: Porter: Ins. Reg. 5 Flashcards
Purpose of insurance regulation
Assure that the future performance promise, to pay a claim, will be fulfilled as needed (protects the public interest)
Briefly describe four Types of Filing Laws
- Prior Approval: insurance rates and coverages must be approved by the state insurance department before they can be used in the state
- File and Use: insurer must file insurance rates or coverages with the state insurance department but can then use them immediately
- Use and File: insurer can use the rate or coverage it wants, provided the insurer files the rate or coverage within a specified period after it’s put into use
- No File: insurer not required to make a filing of the rate or coverage
List some of the most common reasons for rate or coverage disapproval
- Not in the public interest
- Illegal
- Unfairly discriminatory
- Other- excessive, inadequate or not meeting minimum standards
Describe the basic purposes of financial examination
- Detect as early as possible those insurers in financial trouble and/or engaging in unlawful and improper activities
- Develop the information needed for timely and appropriate regulatory action
What is reviewed in the financial examination
Insurer’s statistical statements, accounting procedures, financial statements, financial controls, management practices, and investment procedures
Briefly describe a market conduct examination
Review of the ways in which insurers do business- advertising, soliciting, policy issuing, claims handling
Two reasons why only a few states have historically had fraud departments
- Restraints on budgets
- Lack of insurance fraud laws
How did the 1994 Omnibus Crime Control and Safe Streets Act address insurance fraud
- Made it illegal to defraud, loot, or plunder an insurer
- Established a multi-state approach to anti-fraud activity
Briefly describe a “Receiver”
Disinterested person/business appointed to receive, protect, and account for money or other property due
Briefly describe a “Receivership”
Type of bankruptcy an insurer enters into when a receiver is appointed to manage the insurer and its property
Briefly describe a “Rehabilitation”
Process of reorganizing an insurer’s financial affairs so it can continue to exist as a financial entity, with creditors satisfying their claims from its future earnings
Briefly describe a “Liquidation”
Bankruptcy proceeding in which a bankrupt organization does not have enough assets to pay all creditors and the creditors are prioritized and paid according to the types of their claims
List potential grounds for rehabilitation
- Liabilities exceed assets
- Insurance company refused to submit books, records, accounts or affairs to insurance department
- Insurer willfully violates its charter or any other state law