Waves of Change: Oceans of Opportunities

Kendra Franklin, Supervisor of Customer Relations at COUNTRY Financial, and ICAE President, opened the 2014 Exchange with a welcome that equaled the warmth of the Newport Beach sun.  She shared with the group a quick walk down memory lane by noting her first-ever ICAE was at Newport Beach and this reprise in setting was her first-ever meeting while serving as the ICAE president.  She predicted the 2014 Exchange would again prove the worth-and-reward of ICAE as a long-term investment for consumer services professionals.

And then, the agenda quickly moved to business.  Discover for yourself why, with every Exchange, participants say, “You really had to be there.”

Welcome from the California Department of Insurance
Lucy Jabourian, Consumer Services Division Chief, California Department of Insurance spoke, on behalf of the department and shared a brief history of the department.  Founded in 1938, the department now has more than 1,300 professionals working with California consumers who interact with more than 1,500 insurers and 340,000 producers. Simply put, insurance is big industry in this state.

Regulation vital
Of special interest to the group present, and given the size of the department, Ms. Jabourian provided a more in-depth overview of the Consumer Services Division to help the group better understand the working of and organization for this division.  Consumer Services is a peer of the Market Conduct Division—separate but equal.  She further noted that Consumer Services works with individual complaints for 22 lines of insurance via four bureaus:
•    Consumer Communication
•    Claims services
•    Health claims
•    Rating and underwriting services

Within the Consumer Services Division (CSD), the group has enforcement responsibilities and is also responsible for consumer inquiries and complaints, education, legislative analysis, monitoring insurance trends and related consumer issues. In addition, her group is charged to work with other agencies, especially with health insurance issues (other agencies including the Inter-agency Health Forum, Medicare, Medicaid) to ensure comprehensive assistance for consumers.

Commissioner’s eyes and ears
In California, the CSD is considered to be the commissioner’s eyes and ears, which sounds omnipresence—and it almost is. The CSD’s Consumer Communications Bureau provides consumer access to the department via phone, by walking into government offices and accessing the direct red phones in lobbies; online via the department’s website, by using mobile apps, U.S. mail and more.  This department provides access to translators for more than 150 languages to help provide English-as-a-second-language consumers with the best-possible service.  Whatever the avenue, whatever the language, when the CSD receives a complaint, that complaint is processed via the CSD’s three bureaus (claims to the Claims Services Bureau,  health claim complaints to the Health Claims Bureau and investigation of consumer rating and underwriting complaints via the Rating & Underwriting Services Bureau).  Each bureau processes its complaints via a seven-step complaint handling process that helps the average consumer resolve issues.

Clearly successful…
In 2013, the CSD received more than 167,448 calls; closed more than 37,000 cases; and recovered more than $55,722,140 in consumer funds. Although these statistics drew gasps from the participants, Jabourian drew applause when she announced the number one priority on her hot list was the CSD’s number one goal was to implement electronic communication with insurance companies for complaint files—she predicts the project will be completed by summer of 2015.

…and invested in the success of others
Her best words of advice to those present?  Make sure communication with any DOI is accurate, complete and timely.  She believes accurate information from the outset goes a long way to help the consumer.  She encouraged all present—regulators and carriers—to work on common-language and soft-skills initiatives.  She noted the California DOI had done so and that investment paid off in terms of opening doors to transparent and easy communication with consumers and carriers.

The presentation was so packed with information; virtually no time was available for questions. Jabourian graciously stayed with the group through break to provide for additional one-on-one questions—proving again the extraordinary worth of ICAE’s annual Exchange.

(Please login to access this link) to view Jabourian’s presentation

Lucy Jabourian
Consumer Services Division Chief
California Department of Insurance
300 S. Spring Street
Los Angeles, CA 90013

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