Top 5 Market Conduct Criticisms for P&C, Life/Health Insurers
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 :
1. (property/casualty) Failure to acknowledge, pay or deny claims within specified time frames:
Wolters Kluwer’s annual list of compliance issues for both P&C and life/health insurers highlight the difficulty of keeping up with regulatory changes for claims, underwriting and distribution processes.
For a news story with more top market conduct criticisms and findings, click here.
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