Breakout Sessions: Life and Health

This group was fortunate to have Martin Mitchell, who presented earlier on the Affordable Care Act, attend the first session.  This group was able to further mine Mitchell’s expertise through interactive discussion, which took the majority of the first breakout session.

Not surprisingly, the group focused on health care reform but narrowed the discussion to specific questions regarding:

• The importance of and how to conduct consumer education
• Dialogue on the grandfathered status
• Detailed review of essential benefits
• Discussion of the penalties and anti-selection provisions of the health care act

It was noted www.healthcare.gov is an excellent site for information, updates and education for consumers and professionals.

Life-specific topics
The professionals representing life products were able to have interactive time with regulators for discussion of life-specific topics.  More precisely, the group steered the discussion to:

• Issues involving unclaimed property/ unpaid insurance benefits
• Privacy issues
• Life searches

Discussion centered on the increase in the number of states conducting audits of unclaimed property relating to unpaid life insurance and annuity benefits.   The history of these audits and the experiences that companies have had were discussed in great detail—the sharing of experiences provided important insights for all companies and regulators represented.

Once focused on the topic, the group spent a significant amount of time discussing what triggers claims activities and claims investigations relating to unclaimed property/unpaid insurance benefit audits.  To that end, the group discussed extensively the resources required (both cost and time) to investigate claims and what the contract vs. statutory issues were.

Also noted, the concerns about fraudulent calls by agents impersonating customer.

Mirroring the property and casualty sessions, companies present were deeply interested in getting the regulators’ perspectives on what triggers market conduct exams.  As has become the ICAE tradition, the regulators present engaged in candid discussion for the purpose of enhancing the consumer insurance experience.   Regulators are especially concerned with suitability issues regarding annuity products.

Additional topics discussed included:

• Privacy
• Explanation of benefit
• The issue of unlicensed or not appointed producer, further defined as the problem of a producer signing a life application not actually being the soliciting producer
• Unclaimed property

Missing policy searches
The group showed strong interest in, and therefore centered much discussion around, missing policy searches.  Together, regulators and company representatives spent a substantial portion of the session discussing policies, procedures and best practices established by those states that actively assist consumers with locating missing policies.  Companies were able to discuss with regulators present what was needed to better assist any state DOI in locating policies.  Company representatives advised it would be beneficial if provided full name, maiden name, date of birth, Social Security number, address for insured, and data on the individual requesting information including relationship to insured. It was noted that some states require a life-verification contact.

In the limited time remaining, many life company representatives sought to explore the idea that DOI requests could be sent at regular intervals—such as monthly—rather than one big request.

Yet again, the open dialogue between companies and regulators during this breakout session proved the ICAE platform is one where both companies and DOIs can engage in candid discussion, for the mutual benefit of each other and the ultimate benefit of the consumer.