Top 5 Market Conduct Criticisms for P&C, Life/Health Insurers
October 8, 2013 12:31 PM
The following are the top 5 criticisms for life/health insurers:
5. (life/health) Failure to issue correct EOBs
4. (life/health) Failure to provide required claims and underwriting disclosures including those concerning coverage issues, policy replacements and fraud warnings
3. (life/health) Failure to use licensed and/or appointed producers and to provide proper notification of producer appointments or terminations, including maintenance of producer registers
2. (life/health) Failure to properly acknowledge, pay, investigate, or deny claims within specified time frames
1. (life/health) Failure to use compliant policy forms and/or maintain compliant plans
The following are the top 5 criticisms for P&C insurers:
5. (property/casualty) Failure to maintain claims documentation
4. (property/casualty) Improper documentation of underwriting files
3. (property/casualty) Failure to provide required compliant disclosures in claims processing
2. (property/casualty) Using unapproved/unfiled forms and rates
