AICP GULF STATES CHAPTER 2013 EDUCATION DAY Atlanta Georgia Market Conduct amp Complaint Handling June 21 2013 245 PM 330 PM Fred E Karlinsky Esq Colodny Fass Talenfeld Karlinsky Abate amp Webb PA ID: 768892
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AICP GULF STATES CHAPTER2013 EDUCATION DAYAtlanta, Georgia Market Conduct & Complaint HandlingJune 21, 20132:45 PM – 3:30 PM Fred E. Karlinsky, Esq. Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb, P.A. Debra M. Peirce, Chief Market Conduct Examiner Georgia Insurance DepartmentMark Ossi, Deputy Division Director of Insurance & Financial Oversight Georgia Insurance DepartmentTed Hamby, Deputy Commissioner of Life & Health Division North Carolina Department of Insurance www.cftlaw.com © 2013 All Rights Reserved
DISCLAIMER2 The materials in this presentation are intended to provide a general overview of the issues contained herein and are not intended nor should they be construed to provide specific legal or regulatory guidance or advice. If you have any questions or issues of a specific nature you should consult with appropriate legal or regulatory counsel to review the specific circumstances involved. Transmission or reproduction of any of the information contained herein is prohibited without the express written consent of Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb, P.A.
AGENDA3 Market Conduct TrendsThe Market Conduct Annual Statement (MCAS) Update The Insured PerspectiveThe Ins and Outs from the Georgia Insurance DepartmentThe Regulator PerspectiveQuestions
4 Market Conduct Trends
MARKET CONDUCT TRENDS5 According to the Insurance Networking News, in April 2012, ninety-two percent of annuity and insurance providers use social media of some form; Five P&C companies offer four or more Facebook pages while the industry average is two per firm. Large insurance companies, such as Allstate, Liberty Mutual, and Hartford Financial, maintain 13 Twitter accounts according to Insurance Networking News. Social Media
MARKET CONDUCT TRENDS6 Significantly decreases marketing costs.Social media is used as a defensive maneuver. Insurers listen to what customers say online and respond to the comments.Attempt to change public perception.Used to build trust through ratings and reviews. A good tool in detecting fraud. Insurance companies are collecting information about their customers to determine if their claims are legitimate.Social Media
MARKET CONDUCT TRENDS7 Social media enables underwriters to learn more about their policyholders, which leads to better pricing and claims handling. Underwriters can learn more about their potential customers through social media. Can be used to help solve problems associated with risk assessment.Social Media
MARKET CONDUCT TRENDS8 NAIC has developed two smartphone insurance apps:myHome Inventory app lets users quickly photograph and capture images, descriptions, bar codes and serial numbers, and then stores them. The app organizes information by room, and even creates a back-up file for email sharing. Social Media
MARKET CONDUCT TRENDS9 WreckCheck mobile application outlines what to do immediately after an auto accident and helps users create their own report. The app makes it easy to capture photos and document the necessary information to file an insurance claim. Lets users email a completed report directly to themselves and their insurance agents. Social Media
MARKET CONDUCT TRENDS10 NAIC created a social media working group to develop a white paper on how insurance companies and producers use social media, identify regulatory compliance issues and provide guidance on how to address these issues. The draft was released December 2011:An insurer must develop policies and procedures that comport with existing laws and regulations;An insurer is responsible for the content of its producers’ posts;Social Media
MARKET CONDUCT TRENDS11 Outline clear delineation between static and interactive social media in order to properly apply regulatory guidelines; Insurers should train their employees/agents on the company’s social media policies; They should set up a procedure to monitor, supervise, and enforce; andThe insurer or producer is responsible for complying with the state recordkeeping laws. Social Media
MARKET CONDUCT TRENDS12 In a new era of visibility, the claims process is under intense public scrutiny and must continue to evolve.Companies are investing in their IT infrastructure and software to help streamline the claims process. Information can be gathered quickly which will enable companies to investigate and respond faster resulting in better customer support and satisfaction. IT in Claims Handling
MARKET CONDUCT TRENDS13 Mobile technology solutions are allowing customers and adjusters to share information more efficiently. Insureds prefer to receive a text from the adjustor instead of a phone call; will require more training to ensure adjusters are effectively utilizing their smart phones. Mobile technology enables field adjusters to have access to more information while they are onsite.Companies can utilize digital photography to write estimates of damages without the need for an on-inspection. IT in Claims Handling
14 The Market Conduct Annual Statement (MCAS) Update
MCAS UPDATE15 The Market Conduct Annual Statement (MCAS) was first developed with the input of state regulators and representatives from the industry to develop a tool to analyze the market. By using common data and analysis, states have a uniform method of comparing the performance of companies. MCAS was initially a pilot program among 9 jurisdictions and now has expanded to 46 states.
MCAS UPDATE16 The data collected consists of:Claims handling – claim denials, processing times, and lawsuit activity. Underwriting – new issues, policies in force, non-renewals and cancellations. On April 15, 2011 the NAIC launched a newly redesigned collection system to simplify the MCAS process.The new process will help improve state regulation by allowing all participating states to analyze the industry on a national and state level.
MCAS UPDATE17 In the next few years, MCAS will continue to expand by adding new states and new lines of business. Currently, MCAS data is only collected for private passenger automobile, homeowners and individual life and annuity products. The NAIC Market Analysis Procedures (D) Working Group was tasked in 2013 to review MCAS data elements and the "Data Call and Definitions" for all lines of business collected and to update them where necessary. In addition, the Working Group approved the addition of Long Term Care data to be collected.
18 The Insured Perspective
THE INSURED PERSPECTIVE19 Claims handling continues to be pivotal in the heated battle for market share. Market leaders view the quality of the customer experience as the means to demonstrate true customer centricity and differentiate their strength and stability of their brands. The customer experience has moved up the strategic agenda throughout the insurance industry. Policyholder expectations regarding the service and communication provided by their carriers has increased drastically.
THE INSURED PERSPECTIVE20 Today’s consumers expect everyone at the company to share information and recognize the customer’s identity and history. They don’t want to be asked the same question multiple times or have to call multiple numbers or visit multiple sites to find their answers. Younger, more digitally- oriented consumers will not tolerate companies that don’t have integrated systems where they can view date and claims status. A positive experience in claims helps eliminate reasons for policyholders to consider making a switch.
THE INSURED PERSPECTIVE21 Changes to the customer experience, should be tailored to an enterprise strategy.Insurers that gain insight into and reach a consensus on the types of customers they want to attract will be ahead of the curve on developing the optimal experience. The key is to identify changes that can deliver immediate-term value. Customer centricity will create a competitive advantage and market leadership.
22 The Ins & Outs from the Georgia Insurance Department Debra M. Peirce,Chief Market Conduct Examiner Mark Ossi,Deputy Division Director of Insurance & Financial Oversight
THE INS & OUTS FROM GEORGIA 23 http://www.oci.ga.gov/
THE INS & OUTS FROM GEORGIA24
THE INS & OUTS FROM GEORGIA25
THE INS & OUTS FROM GEORGIA26
THE INS & OUTS FROM GEORGIA27
THE INS & OUTS FROM GEORGIA28
29 The Regulator Perspective Ted Hamby,Deputy Commissioner of the Life & Health Division
QUESTIONS30
CONTACT INFORMATION31 Fred Karlinsky fkarlinsky@cftlaw.comDirect: (954) 332-1749Main: (954) 492-4010South Florida OfficeOne Financial Plaza23rd Floor100 SE 3rd AvenueFt. Lauderdale, FL 33394 Tallahassee Office215 S. Monroe StreetSuite 701Tallahassee, FL 32301Debra Peircedpeirce@oci.ga.gov (404) 657-7277Georgia Department of Insurance Two Martin Luther King Jr. DriveAtlanta, GA 30334 Mark Ossi mossi@oci.ga.gov(404) 656-0718Georgia Department of Insurance Two Martin Luther King Jr. Drive Atlanta, GA 30334 Ted Hamby Ted.hamby@ncdoi.gov (919) 733-5060 North Carolina Department of Insurance P.O. Box 26387 Raleigh, NC 27611