NAIC Uniform Use of Coding
Bob Lisson (North Carolina DOI) updates Exchange attendees on NAIC’s efforts on uniformity in complaint handling and reporting.
Robert Lisson, deputy commissioner, North Carolina DOI, returned after a three-year hiatus to update Exchange participants on the status of the NAIC complaint coding project. This update is of vital importance to all attendees because the actions accomplished by this NAIC working group are impressive, significant, and will have a long-range, extremely positive, impact on the industry and the insurance-buying consumer.
Responsibilities defined
Lisson noted the Complaint Handling and Reporting Standards (D) Working Group was given the task to create and promote uniformity in complaint handling and reporting. Specifically, this group was given the responsibility to:
- Clarify and edit the existing reason and disposition codes within NAIC’s existing coding structure
- Modify the structure of the CDS coding scheme, grouping reason codes and creating new fields
- Establish guidelines for consistent complaint handling, starting with the definition of a complaint
- Develop and/or enhance training materials for regulators who work with complaints
- Establish guidelines for the consistent reporting of complaint-related statistics
- Examine best practices and technology applications and models to help states promote uniformity
Ever forward
Lisson observed that given the intricacy of the tasks, the complexity of the NAIC, and the sheer amount of data involved, significant strides have been made.
Currently, many elements of this work group’s recommendations have been approved including a revised complaint database system manual; standardized definitions for complaint, confirmed and inquiry; consolidation and mapping of NAIC reason and disposition codes; and the creation of confirmed, not confirmed, and subject fields.
Lisson acknowledges that NAIC’s efforts were initiated by ICAE’s initial position paper suggesting the need for uniformity.
Lisson shared with the group that the revised complaint code scheme is slated to phase in over a five-year period. Why the phase-in schedule? Because complaint data is used by so many different entities: consumers, regulators, policymakers, industry, media and others, uniform coding is complex and important—especially important for companies to make sure items are compared accurately. The phase-in was designed to give each state DOI time to perform data testing to ensure smooth implementation so that companies and DOIs ultimately could distill meaningful and accurate information.
As sweeping as progress has been, this committee is moving ever forward. Currently, the committee is still reviewing additional topics—including complaint reconciliation and the code change/update process.
Forward movement on databases
Lisson noted the NAIC maintains two complaint databases: CDS—a regulator-only database that holds all complaints, and CIS—a consumer information source that is available to anyone and lists only confirmed complaints.
Recommendations to enhance and improve the usability for both databases have been put forward, especially around the use of confirmed and unconfirmed. Lisson explained that to foster a spirit of fairness to companies, regulators and consumers, the CIS database will continue to use the disposition code to determine confirmed status until all states fully implement use of the proposed confirmed definitions.
Acknowledging the work
Lisson stated that a wealth of data is available via the NAIC website, where all working groups’ activities are detailed. He encouraged all attending to access the NAIC website to remain current with the many important initiatives undertaken by the NAIC—and to keep current with this Working Group’s initiatives.
CONTACT INFO
Robert Lisson
Deputy Commissioner
North Carolina Department of Insurance
817 Richmond St.
Raleigh, NC 27609
919.807.6751
bob.lisson@ncdoi.gov
www.ncdoi.com
PRESENTATION
Click here to view Lisson’s presentation
