Regulator showcase: Ask the regulator

How to get attendees to show in the morning after a robust evening of networking?  The ICAE Exchange committee made the decision to have a panel of regulators, rather than a single regulator showcasing a single DOI, fielding questions from the floor.  What an opportunity—no one will forget and all took advantage in the spirit of the Exchange.

Thanks to George Lyle (Virginia), Gerard O’Sullivan (Connecticut), and Kathy Shortt (North Carolina) for agreeing to participate in this year’s “Ask the Regulator Showcase”
Thanks to George Lyle (Virginia), Gerard O’Sullivan (Connecticut), and Kathy Shortt (North Carolina) for agreeing to participate in this year’s “Ask the Regulator Showcase”

Panel participants George Lyle, Virginia Bureau of Insurance; Gerard O’Sullivan, Connecticut Insurance Department; and Kathy Shortt, North Carolina Department of Insurance, were moderated by Todd Sherman, Eccentex. Interaction between the group and regulators revealed what’s on the hot topic list for both industry professionals and regulators.

Q:  Companies are worried about confidentiality of notes or proprietary work product.  Regulator responses:

  • Pick up the phone and talk it through before sending and relying on confidential stamp.
  • Consumers have access to their file by law.

Q:  Even if timeframes are set by statute, can regulators insert a specific date?

  • Yes, we can look at doing that (and Connecticut had agreement by end of meeting).

Q:  Can regulators define a poorly managed complaint?

  • Poor communication with regulators or consumer
  • Wrong or missing information
  • Compounding error with sloppy accounting
  • Not taking the time to learn every aspect of the case
  • Too much time elapsing
  • Of these, the worst is incomplete information.

Q:  Can regulators refer complaint to company before opening investigation?

  • Most actually prefer consumer first contact the company, but that does not always happen as consumers cannot always find contact information.
  • Many DOIs ask the consumer to go to company but sometimes with a written request, DOI will begin working to resolve.

Q:  Define a well-handled complaint:

  • Good, quick, accurate communication
  • Resolution that is the right thing to do
  • Decision compliant with law, ethics and coverage contract
  • Well written consumer letters that explain in plain language the decision and a contact.

Q:  How do regulators interact with state attorney general (AG) offices?  Some companies have noticed AGs are reaching out directly to companies, not DOI?

  • Varies by state, but interaction is strong.  DOIs present suggested companies reach out to DOIs to advise of AGs query.

Q:  How do DOIs feel about electronic portals for complaints?

  • Agree electronic is best for all, but not all state DOIs have budget to accommodate electronic access.
  • Michigan still faxes complaints to companies—and that will not change any time soon due to budget constraints.
  • Arizona’s CD requirement is obsolete and an issue.

Q:  Best practices from DOIs on agents?

  • Background checks on licensing are usually a legislated function.  States that do not require licensing may have a resource constraint.
  • Agent complaints are becoming more complex, not necessarily more.
  • Agent complaints reflect the economy
  • New products breed agent creativity—not always a good thing
  • Good agents and companies do not tolerate poor behavior from other agents, so reporting is on the rise.

Q:  What do regulators view as biggest complaint issues?

  • Health care coverage under Affordable Care Act—continued confusion
  • Long-term care rate increases
  • Claim denials

Q:  If special investigation is being conducted, what should company tell DOI?

  • Pick up the phone…

Q:  Do all DOIs track the dollar amount of recoveries and is a goal set?

  • Yes, tracking occurs but a goal/benchmark is not set
  • Information is released to the media
  • All DOIs would prefer that NO assessments were made—meaning no consumer issues and the consumer has been treated fairly and well.

Q:  Regarding non-English speaking complaints

  • DOIs use bonded, expert translators to help the consumer and work to translate complaints.
  • DOIs will ask companies to provide responses in both Spanish and English to ensure consumer has complete information.

Q:  Regulators have been open and forthcoming, would they like an Ask the industry panel for2016 Exchange?  Great idea…

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