Slideshow Top 5 Market Conduct Criticisms for P&C, Life/Health Insurers

Published
  • October 08 2013, 12:31pm EDT
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The following are the top 5 criticisms for life/health insurers:

5. (life/health) Failure to issue correct EOBs

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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

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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

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3. (property/casualty) Failure to provide required compliant disclosures in claims processing


2. (property/casualty) Using unapproved/unfiled forms and rates


1. (property/casualty) Failure to acknowledge, pay or deny claims within specified time frames