Connecticut Insurance Department

Transcription

1 Market Conduct Report Great Northern Insurance Company May 29, 2018 Connecticut Insurance Department

2 TABLE OF CONTENTS Page I. Introduction A. Statutory Authority B. Scope of Examination C. Company Profile D. Market Conduct Reports E. Privacy of Consumer Financial Information 2 n. Items Examined 3 A. Operations and Management 3 B. Complaint Handling 5 C. Marketing and Sales 5 D. Producer Licensing 6 B.* Policyholder Service ; 7 F. Underwriting and Rating 7 G. Claims 12 ni. Summary of Recommendations 16 IV. Acknowledgment..18

3 1. INTRODUCTION A. Statutory Authority By authority granted under Section 38a-15 of the Connecticut General Statutes, this examination was conducted by Market Conduct examiners of the State of Connecticut Insurance Department at the companies' office located in New Haven, Connecticut. B. Scope of Examination From May 4, 2017 to on or about September 1, 2017, the Market Conduct Division of the Connecticut Insurance Department examined the market conduct practices of the companies using a sample period of July 1, 2015 through June 30,2016. The examination was limited to Connecticut business. C. Companv Profile Companv Commenced Business State of Domicile Great Northern Insurance Company Indemnity Insurance Company North America June 26, 1952 July 17,1939 November 1, 1945 September 27,1977 Indiana New York Pennsylvania Pennsylvania Direct premiums written as of December 31, 2016 are as follows; Connecticut Great Northern Insurance Company 110,406,489 63,728,294 58,924,945 Indemnity Insurance Company North America 15,343,710 Total 1,335,467, ,517,373 4,345,819, ,383,860 D. Market Conduct Reports The examiners generated a listing of market conduct examination reports using National Association of Insurance Commissioners' I-Site. This information was used to request market conduct examination reports from the companies. -1-

4 ACE American hisurance Company The examiners obtained copies of all relevant market conduct examination reports which had been issued to the companies during the three (3) years preceding the examination. The reports were reviewed to identify any recommendations that have been made by the respective Insurance Departments and to determine whether the companies had taken appropriate corrective action in response to those recommendations. E, Privacv of Consumer Financial Information : Standard 1: The companies have adequate procedures in place for the protection of consumer financial information. Standard 2: The companies provide each consumer with an initial privacy notice in accordance with statutes, rules and regulations. Standard 3: The companies provide each consumer with an annual privacy notice in accordance with statutes, rules and regulations but at a minimum annually. Hie companies appear to be in compliance. Standard 4: The companies provide each consumer with an opt out notice in accordance with statutes, rules and regulations. Standard 5: The companies provide each consumer with a revised privacy notice in accordance with statutes, rules and regulations. Standard 6: All notices are provided in the required timeframe so as to minimize any improper intrusion into the privacy of consumers. -2-

5 Standard 7: The companies comply with au requirements for the disclosure of nonpublic personal financial information to nonaffiliated third parties so as to minimize any improper intrusion into the privacy of consumers. Standard 8: The companies comply with all requirements for the disclosure and redisclosure of nonpublic personal financial information so as to minimize any improper intrusion into the privacy of consumers. Standard 9: The companies have procedures for the sharing of consumer account numbers so as to minimize any improper intrusion into the privacy of consumers. n. ITEMS EXAMINED A. Operations and Management Standard 1: The companies have an up-to-date, valid internal or external audit program. The companies provided the examiners with ACE North America Corporate Audit procedures and Chubb Program Audit procedures. There are more than adequate processes and standards in place with regard to underwriting, financial and claims audits. Standard 2: The companies have appropriate controls, safeguards and procedures for protecting the integrity of computer information. The companies have adequate controls in place with regard to computer information protection. Adequate measures include appropriate clearances for employees and vendors. Firewall protection, encryption of certain data along with appropriate password and authority protocols. -3-

6 Standard 3: The companies have an antifraud plan in place. During the period of examination, there were a total of seventy-seven (77) referrals to the S.LU. unit. There were no prosecutions or convictions during the examination period. Standard 4: The companies have a valid disaster recovery plan. The company's Business[DMl] Continuity Plan was reviewed. The plan included Recovery Strategy, Resumption Activities and Process and Workaround Procedures. The plan was well detailed with adequate references, documents and notes. Standard 5: The companies adequately monitor the activities of the managing general agents. Standard 6: The companies' contract with managing general agents comply with applicable statutes, rules and regulations. Standard 7: Records are adequate, accessible, consistent and orderly, and comply with State record retention requirements. Standard 8: The companies are licensed for the lines of business that are being written. Standard 9; The companies cooperate on a timely basis with examiners performing the examination. -4-

7 B. Complaint Handling Standard 1: All complaints are recorded in the required format on the companies' complaint register. The examiners reviewed a total of five (5) complaints filed with the Department. In addition, the examiners also reviewed non-dq)artment complaints. The companies appear to be in compliance. Standard 2: The companies have adequate complaint handling procedures in place and communicate such procedures to policyholders. Standard 3: The companies take adequate steps to finalize and dispose of the complaint in accordance with applicable statutes, rules and regulations, and contract language. Standard 4: The time frame within which the companies respond is in accordance with applicable statutes, rules and regulations. C. Marketing and Sales Standard 1: All advertising and sales materials are in compliance with applicable statutes, rules and regulations. Standard 2: The companies' internal producer training materials are in compliance with applicable statutes, rules and regulations. The companies appear to be in compliance, -5-

8 Standard 3: The companies' communications to producers are in compliance with applicable statutes, rules and regulations. Standard 4: The companies' mass marketing of property and casualty insurance is in compliance with applicable statutes, rules and regulations. The companies do not mass market property and casualty insurance. D. Producer Licensing Standard 1: The companies' records of licensed and appointed producers agree with Insurance Department's records. Standard 2: The producers are properly licensed and appointed in the jurisdiction where the application was taken. The companies were not in compliance with Connecticut General Statutes. Standard 3: Termination of producers complies with statutes regarding notification to the producer and notification to the State, if applicable. Standard 4: The companies' policy of producer appointments and terminations does not result in unfair discrimination against policyholders. Standard 5: Records of terminated producers adequately document the reasons for termination. -6-

9 E. Policvholder Service Standard 1: Premium notices and billing notices are sent out with an adequate amount of advance notice. The Companies appear to be in compliance. Standard 2: Policy issuance and insured requested cancellations are timely. Standard 3: All correspondence directed to the companies is answered in a timely and responsive manner by the appropriate department. F. Underwriting and Rating Standard 1: The rates charged for the policy coverage are in accordance with filed rates or the companies' rating plan. Homeowners Great Northern Insurance Company In a sample of Homeowners new business policies, the examiner noted the following: In nine (9) instances, Rounding Rules were not followed. One (1) policy received a Superior Protection Credit without any documentation to support the credit. In a sample of Homeowner new business policies manually rated, the examiner noted the following: In five (5) instances, the company Rounding Rule was not followed. One (1) Superior Protection Credit was not applied with the new business effective date. During the manual rating review, the examiner noted the following recommendation the companies should take: The companies should file an update with the Property Casualty Division how it handles the use of Credit that has been frozen by an insured and how it applies that in its rating methodology. It is also recommended, as a matter of clarity, the companies file their Unprotected Risk Assessment Model (URAM). -7-

10 Indemnity Insxarance Company of North America Standard 2: Disclosures to insureds concerning rates and coverages are accurate and timely. Private Passenger Automobile During the rating review, the company was not able to provide in some instances documentation that would reference some coverage selections and options available to the insureds. The company advised that in these instances the agent is responsible for documenting and advising its insureds regarding these issues. It is recommended the company ensure that its agents are retaining necessary documentation. Standard 3: The companies do not permit illegal rebating, commission cutting or inducements. Standard 4: Credits and deviations are consistently applied on a non-discriminatory basis. Standard 5: Schedule rating or individual risk premium modification plans, where permitted, are based on objective criteria with usage supported by appropriate documentation. Standard 6: The companies' underwriting practices are not unfairly discriminatory. The companies adhere to applicable statutes, rules, regulations and companies' guidelines in the selection of risks. See Standard 15. Standard 7: All forms and endorsements forming a part of the contract are listed on the declarations page and should be filed with the Department of Insurance. -8-

11 Standard 8: The producers are properly licensed and appointed in the jurisdiction where the application was taken. Private Passenger Automobile Great Northern Insurance Company It was determined in a sample of new business policies that in twenty-three (23) instances, producers did not hold the necessary appointments as required by Connecticut General Statutes, Section 38a-702m. Homeowners In a sample of new business policies, in six (6) instances producers did not hold the necessary appointments as required by Connecticut General Statutes, Section 38a-702m. In three (3) instances, the producer did not hold necessary license as required by Connecticut General Statutes, Section 38a-702b. Homeowners In a sample of new business policies, in five (5) instances producers did not hold the necessary appointments as required by Connecticut General Statutes, Section 38a-702m. In one (1) instance, the producer did not hold necessary license as required by Connecticut General Statutes, Section 3 8a-702b. Commercial Lines Ace American Insurance Company In a sample of new business polices, in one (1) instance it was determined that a producer did not hold the necessary license in accordance with Connecticut General Statutes, Section 38a-702b. It was also determined in fourteen (14) instances, the producers were not appointed as required by Connecticut General Statutes, Section 38a-702m. Indemnity Company of North America In a sample of new business polices, in one (1) instance it was determined that a producer did not hold the necessary license in accordance with Connecticut General Statutes, Section 38a-702b. It was also determined in two (2) instances, the producers were not appointed as required by Connecticut General Statutes, Section 38a-702m. Standard 9: Underwriting, rating and classifications are based on adequate information developed at or near inception of the coverage rather than near expiration or following a claim. -9-

12 Standard 10; File documentation adequately supports decisions made. Standard 11: Policies and endorsements are issued or renewed accurately, timely and completely. Standard 12: Audits, when required, are conducted accurately and timely. Standard 13: The companies verify that VIN number submitted with application is valid and that the correct symbol is utilized. Standard 14: The companies do not engage in collusive or anti-competitive underwriting practices. Standard 15: Rejections and declinations are not unfairly discriminatory. The company was asked to provide a listing of private passenger automobile and homeowner declinations that occurred during the examination period. The company advised that dxzring the examination period, it did not have procedures in place to capture declinations and rejections of applicants seeking insurance coverage with the company. During the finalization of the report, the company then advised it was able to retrieve the documentation for the declinations. The company stated the lack of providing the declination documentation in a timely manner was caused by its recent merger with ACE. The company was found to be in non-compliance with the providing of documentation in a timely manner for review of automobile and homeowner declinations. -10-

13 Standard 16: Cancellation/non-renewal notices comply with policy provisions and State laws, and companies' guidelines. Homeowners Cancellations In a sample of homeowner cancellations, it was determined that in eight (8) instances the risk should have been non-renewed and not cancelled mid-term. Great Northern Insurance Company Cancellations In a sample of homeowner cancellations, it was determined in twelve (12) instances the risk should have been non-renewed and not mid-term cancelled. One (1) cancellation was found to be non-specific and one (1) cancellation was outside the company's guidelines. Non-Renewals One non-renewal was sent for two CAT losses which does not comply with Connecticut General Statutes, Section 3 8a-316d. Commercial Lines Cancellations One (1) cancellation was found to be a short notice. Standard 17: Cancellation/non-renewal notices comply with policy provisions and State laws, including the amount of advance notice provided to the insured and other parties to the contract. See Standard 16. Standard 18: Unearned premiums are correctly calculated and returned to appropriate party in a timely manner, and in accordance with applicable statutes, rules and regulations. Standard 19: Rescissions are not made for non-material misrepresentation. -11-

14 Great Northern Insiirance Company Standard 20: All policies are correctly coded. G. Claims The companies provided a listing of claims paid and denied during the period of examination. The claim files were reviewed to determine if they were handled in accordance with policy provisions, and applicable statutes and regulations. Standard 1: The initial contact by the companies with the claimant is within the required time frame. Standard 2: Timely investigations are conducted. Standard 3: Claims are resolved in a timely manner. Standard 4: The companies respond to claim correspondence in a timely manner. Standard 5: Claim files are adequately documented. 12-

15 Standard 6: Claim files are handled in accordance with policy provisions and applicable statutes, rules and regulations. Private Passenger Automobile Great Northern Insurance Company In a sample of property damage liability claims, in three (3) instances the company did not consider loss of use in the settlement of the claim. The company agreed and refunded these claimants a total of $ In addition, in five (5) instances the company advised the claimant that repairs had to begin on a Monday and would not allow claimant any other option. Homeowners In a sample of homeowner paid elaims, four (4) condominium claims were not settled per statute. Two (2) claims had instances in which the deductible should have been waived. There were two (2) claims in which partial denial letters were not sent and one (1) claim in which a partial payment was owed. In a sample of subrogated homeowner claims, one (1) claim settlement should have waived the deductible. One (1) subrogation demand sent was ineorrect and one (1) condominium claim was not settled per statute. Great Northern Insurance Company In a sample of homeowner paid claims, four (4) condominium elaims were per statute. There were two (2) claims with coverage denial errors. One (1) claim had a partial denial in which the denial letter was not sent. One (1) claim had an undue delay and one (1) claim should have absorbed the deductible. In a sample of homeowner subrogated claims, one (1) claim was not settled per condominium statute. Commercial Lines One (1) closed without payment claim advised claimant to contact the New York Department of Insurance and not Connecticut if it disagreed with the denial. The policy was a Connecticut insured policy and location and should have not referenced New York.. Standard 7: The companies use the reservation of rights and excess of loss letters when appropriate. -13-

16 Standard 8: Deductible reimbursement to insureds upon subrogation recovery is made in a timely and accurate manner.!. 1 Standard 9: The companies' claim forms are appropriate for the type of product. ) I Standard 10: Claim files are reserved in accordance with the companies' established procedures. Standard 11: Denied and closed without payment claims are handled in accordance with policy provisions and State law. See Standard 6. Standard 12: Cancelled benefit checks and drafts reflect appropriate claim handling procedures. Standard 13: Claim handling practices do not compel claimants to institute litigation, in cases of clear liability and coverage, to recover amoimts due under policies by offering substantially less than is due under the policy. The companies appear to be incompliance. Standard 14: The companies use licensed adjusters and (Connecticut) appraisers in the handling of casualty claims. Private Passenger Automobile Great Northern Insurance Company One (1) adjuster was not licensed in accordance with Connecticut General Statutes, Section 38a

17 Homeowners Two (2) individuals were not licensed in accordance with Connecticut General Statutes, Section 38a-792. Great Northern Insurance Company Two (2) individuals were not licensed in accordance with Connecticut General Statutes, Section 38a-792. ^ Commercial Lines Five (5) individuals were not licensed in accordance with Connecticut General Statutes, Section 3 8a-792. Standard 15: Loss statistical coding is complete and accurate. Standard 16: Release by injured person voidable if obtained within fifteen days, (Connecticut) 15-

18 m. SUMMARY OF RECOMMENDATIONS Report Section n. D. Producer Licensing: New Business I It is required that Great Northern Insurance Company, ACE American Insurance Company and Indemnity Company of North America comply with Connecticut General Statutes, Section 38a-702m with regard to agent appointments. n. D. Producer Licensing: New Business It is required that Great Northern Insurance Company, ACE American Insurance Company and Indemnity Company of North America comply with Connecticut General Statutes, Section 38a-702b with regard to agent licensing. n. F. Underwriting and Rating: Personal Lines - Homeowner Rating It is required that Great Northern Insurance Company and Vigilant Insurance Company comply with Connecticut General Statutes, Section 38a-686 with regard to homeowner rating. n. F. Underwriting and Rating: Homeowner - Cancellations It is required that Great Northern Insurance Company and Vigilant Insurance Company comply with Connecticut General Statutes, Section 38a-307 with regard to homeowner cancellations. II. F. Underwriting and Rating: Commercial - Cancellations It is required that Ace American Insurance Company comply with Connecticut General Statutes, Section 38a-343 with regard to commercial cancellations. n. F. Underwriting and Rating: Automobile - Declinations Homeowner - Declinations It is required that Great Northern Insurance Company and Vigilant Insurance comply with Connecticut General Statutes, Section 38a-15 with regard to providing timely information to the examiners regarding automobile and homeowner declinations. 16-

19 n. F. Underwriting and Rating: Homeowner - Non-Renewals It is required that the Great Northern Insurance Company comply with Connecticut General Statutes, Section 38a-323 and Bulletin PC-66 with regard to the non-renewal of homeowner policies. n. G. Claims: Automobile It is required that Great Northern Insurance Company comply with Connecticut Regulations 38a-334-(2)(c) and 38a-334-(5)(a) with regard to loss of use in the settlement of private passenger automobile property damage liability claims. n. G. Claims: Automobile It is required that Great Northern Insurance Company comply with Connecticut General Statutes, Section 38a-816 with regard to the settlement of automobile claims. H: G. Claims: Homeowner It is required that Great Northern Insurance Company and Vigilant Insurance Company comply with Connecticut General Statutes, Section 38a-816 with regard to the settlement of homeowner claims. n. G. Claims: Commercial It is required that Ace American Insurance Company comply with Connecticut General Statutes, Section 38a-816 with regard to the settlement of commercial claims. n. G. Claims: Casualty Claims Adiusters It is required that Great Northern Insurance Company, and Ace American Insurance Company comply with Connecticut General Statutes, Section 38a-792 with regard to licensing of casualty adjusters. 17-

20 IV. ACBCNOWLEDGMENT The courtesy and cooperation of Chubb Group during the course of this examination is acknowledged. Mark J. Duffy, Karen A. Romero and James Stowe participated in the examination and preparation of this report. 18-

21 STATE OF CONNECTICUT INSURANCE DEPARTMENT m THE MATTER OF; DOCKET MC INDEMNITY INSURANCE COMPANY OF NORTH AMERICA: X STIPULATION AND CONSENT ORDER It is hereby stipulated and agreed between Indemnity Insurance Company of North America and the State of Connecticut Insurance Department by and through Katharine L. Wade, Insurance Commissioner, to wit: I WHEREAS, pursuant to a Market Conduct examination, the Commissioner alleges the following with respect to : 1., hereinafter referred to as Respondent, is domiciled in the State of Pennsylvania and is licensed to transact property and casualty insurance in the State of Connecticut. The NAIC company code number is From May 4, 2017 through September 1, 2017, the Department conducted an examination of Respondent's market conduct practices in the State of Connecticut covering the period from July 1,2015 through June 30, During the period under examination. Respondent failed to follow established practices and procedures to ensure compliance with statutory requirements resulting in instances of: a) unlicensed individuals or entities acting as producers b) unappointed individuals or entities acting as producers 4. The conduct described in paragraph three is in violation of Sections 38a-702b, and 38a-702m of the Connecticut General Statutes, and constitutes cause for the imposition of a fine or other administrative penalty under Sections 38a-2, and 38a-41 of the Connecticut General Statutes. P.O. Box 816 Hartford, CT An Equal Opportunity Employer

22 II 1. WHEREAS, Respondent admits the allegations in paragraphs three and four of Article 1 of this Stipulation and Consent Order; and 2. WHEREAS, Respondent agrees to undertake a complete review of its practices and procedures, Avith respect to those areas of concern, as described in the Market Conduct Report and this Stipulation, so that those areas of concern are compliant with Connecticut Statutes; and 3. WHEREAS, Respondent agrees to provide the Insurance Commissioner with a full report of findings and a summary of actions taken to comply with the requirements of paragraph two of this Section within ninety (90) days of the date of this document; and 4. WHEREAS, Respondent agrees to pay a fine in the amount of $8,000 for the violations described herein; and 5. WHEREAS, Respondent, being desirous of terminating administrative action without the necessity of a formal hearing or further litigation, does consent to the making of this Consent Order and voluntarily waives; a. any right to notice and a hearing; and b. any requirements that the Insurance Commissioner's decision contain a statement of findings of fact and conclusions of law; and c. any and all rights to object to or challenge before the Insurance Commissioner or in any judicial proceeding any aspect, provision or requirement of this Stipulation NOW THEREFORE, upon the consent of the parties, it is hereby ordered and adjudged: 1. That the Insurance Department has jurisdiction of the subject matter of this administrative proceeding. 2. That is ordered to pay a fine in the amount of Eight Thousand Dollars ($8,000). INDEMNITY INSURANCE COMPANY OF NORTH AMERICA By: Kevin M. Rampe (Representative of Insurance Company) -2-

23 CERTIFICATION The undersigned deposes and says that she/he has duly executed this Stipulation and Consent Order on this day of 2018, for and on behalf of that she/he is the General Counsel - North America of such company, and she/he has authority to execute and file such instrument.y STATE OF PENNSYLVANIA SS COUNTY OF PHILADELPHIA On the A3F day of 2018, before me personally appeared /ffiv'/aj M, sealer of the foregoing Stipulation and Consent Order, acknowledged same to be her/his act and deed. COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL MARIE C. MORRILL. Notary Public City of Philadelphia, Phila. County My Commission Expires July 14,2018 Notary Public/Commissioner of The Superior Court Section Below To Be Completed by State of Connecticut Insurance Department Dated at Hartford, Connecticut this day of Ujiv Katharine L. Wade Insurance Commissioner -3-