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RECENT IDOI ENFORCEMENT ACTIONS RECENT IDOI ENFORCEMENT ACTIONS

RECENT IDOI ENFORCEMENT ACTIONS - PowerPoint Presentation

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Uploaded On 2017-10-20

RECENT IDOI ENFORCEMENT ACTIONS - PPT Presentation

Debra McNeil Josh Harrison Enforcement Division Enforcement Statutes Unfair Competition Unfair or Deceptive Acts and Practices IC 27411 Producers Statute IC 27115612 IC 27413 No ID: 597639

failure unfair practice deceptive unfair failure deceptive practice charges jones state license competition denial settlement enforcement bail action provide

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Presentation Transcript

Slide1

RECENT IDOI ENFORCEMENT ACTIONS

Debra McNeil

Josh HarrisonSlide2

Enforcement DivisionSlide3

Enforcement StatutesUnfair Competition, Unfair or Deceptive Acts and PracticesIC 27-4-1-1

Producer’s Statute

IC 27-1-15.6-12Slide4

IC 27-4-1-3No person shall engage in this state in any trade practice which is defined in this chapter or determined pursuant to this chapter as an

unfair method of competition

or as an

unfair or deceptive act or practice

in the business of insurance.Slide5

PersonIndividualAgentBroker

Adjuster

Navigator

Third Party Adjuster

Independent Adjuster

Company

Agency

UnderwriterSlide6

Unfair Method of CompetitionIC 27-4-1-4Misrepresenting terms

Untrue, deceptive, or misleading statements

Supplying false information to regulator

Unfairly discriminating

Excessive or inadequate chargesSlide7

Unfair or Deceptive Act or PracticeIC 27-4-1-4.5Misrepresenting facts or policy terms

Failing to respond

Not attempting prompt, fair, and equitable settlement of a claim

Failing to provide reasonable explanation for a denialSlide8

Catch-AllIC 27-4-1-8Any

method of competition or any practice not otherwise defined but deemed unfair or deceptiveSlide9

Statement of ChargesIC 27-4-1-5The Commissioner shall issue and cause to be served a statement of charges and notice in writing of a hearing under IC 4-21.5-3.Slide10

ProcedureHearingsPreliminaryMotions

Adjudicatory

SettlementSlide11

PenaltiesIC 27-4-1-6Civil penalty

$25,000 per violation

$50,000 per violation if the person knew or reasonably should have known in violation

Suspension or RevocationSlide12

Producer’s StatuteProviding incorrect information on license applicationViolating an insurance lawMisappropriating funds

Convicted of a felony

Having license revoked in another state

Failing to pay state income taxSlide13

Additional CausesAppointments listChild support order

Failure to notify of administrative action in another jurisdiction

Failure to notify of a criminal prosecutionSlide14

HearingsDenial or Non-renewalIC 27-1-15.6-12(d)Applicant must request within 63 days

Burden on Applicant to show denial unreasonable

Active License

IC 4-21.5 (AOPA)

Department must give Notice and Hearing

Burden on the DepartmentSlide15

PenaltiesIC 27-1-15.6-12(b)Civil penalty

Probation

Suspension

RevocationSlide16

BailQualificationsIC 27-10-3-3

Good Moral Character

Disqualifying Offense

Misdemeanor 5 years

Felony 10 yearsSlide17

Bail27-10-3-8Violating any laws under license

Misstatement or fraud in application

Fraudulent or dishonest practice

Incompetence or untrustworthiness

Rebating

Tax WarrantSlide18

Bail RevocationDisqualifying OffenseImmediately upon plea or convictionBefore sentencing

Is not stayed on appeal

Other cause

Serve a copy of charges

Agent must request hearing within 10 daysSlide19

Alvino Jones3 separate complaints about Jones

On December 15, complainants came in after being shot during one attempted recovery

Investigator Herndon relayed investigation to Indiana State Police Det. Logsdon

March 6, 2015, Jones arrested during attempted apprehension

Jones was charged with Burglary and Possession of Firearm by a Serious Violent FelonSlide20

Unique Insurance CompanyInitial Consumer complaints and Prior Enforcement actionMarket Conduct Examination

Evidence of Major Claims handling issues

Failure to communicate

Failure to pay claim

Failure to provide prompt and fair settlement

Failure to provide explanation of denialSlide21

UniqueIC 27-1-3.1-9(e)Prima facie evidence in any legal or regulatory action

Statement of Charges

269 separate violations

Regulatory Settlement Agreement Reached