Annual Statements
    Ohio rule OAC 3901-1-50 addresses annual financial reports. It requires insurers over a certain size to have an audit committee, prohibits independent certified public accountants from providing certain non-accounting services to their clients, and requires auditors to report any unremediated material weakness to the Insurance Department.

    Washington state has also changed its rules for audited financial statements. The changes prohibit a person or firm from being a as a qualified independent certified public accountant if the person or firm has entered into an indemnification agreement with respect to the audit. WAC 284-07-110 and -150 also permits the agreement between an insurer and its independent accountant to include an arbitration and/or mediation provision.

Automobile Insurance
    Colorado Bulletin B-5.25 provides guidelines to insurers issuing a premium increase, reduction in coverage, cancellation or non-renewal notice as a result of weather-related, single-vehicle accidents. Existing law requires insurers to conduct a reasonable investigation based on all available information. The company has the burden of proving negligence on the part of the insured driver in any type of loss but, in particular, weather-related losses. The bulletin lists the minimal acceptable documentation that an insurer must have to support its negligence decision.

    In New Jersey, auto insurers are no longer required to insure all eligible persons. The department recently adopted changes to a number of regulations to implement this statutory change. As part of the adoption, N.J.A.C. 11 :3-34 was amended to make the subchapter inoperative unless and until the “take all eligibles” requirement is reactivated. Details are in Bulletin 08-26.

Claims
    Missouri has rescinded rule 20 CSR 300-1.100 dealing with unfair claims settlement rates.

    Florida rule FAC 69J-2.003 addresses the mediation procedures for resolving disputed personal lines insurance claims resulting from 2004 and 2005 hurricanes and tropical storms.

Health Insurance
    Missouri Bulletin 08-13 says a new credentialing form for health care providers will be required starting Jan. 30. 

Long-Term Care
    Iowa Bulletin 08-17 addresses two new reporting requirements for long-term care insurers. First, the department wants information about the contact person for independent review procedures and matters. Secondly, it also wants:
    • an explanation of how the insurer determines when an insured has qualified for independent review of the benefit trigger decision and the notice the insured receives from the insurer;
    • a copy of the notice sent to the insureds who fall within the scope of the law; and
    • an explanation of the insurer’s internal appeal process.

    Tennessee TAC 0780-1-61-.31 adds new rule language concerning the state’s long-term care insurance partnership program. The final version has not yet been posted to the state's Web site, but will be posted here later.

Producers
    Colorado Regulation 1-2-1 tells insurance producers to treat each insurance policy and premium as a separate account of the insured unless the insured has given specific authorization to commingle multiple obligations and funds.

    Maryland COMAR 31.03.04.01 requires insurance producers to place risks with authorized insurers. The rule went into effect Dec. 29, 2008.

    Texas has amended 28 TAC 1.1.D.1.501 and .503 to spell out the effect of criminal conduct on insurance licenses.

Property Casualty Insurance
    The District of Columbia has new hearing and rate filing requirements for medical malpractice liability insurance companies. Details are in DCMR Title 26, Chapter 53.

Rate and Form Filings
    Colorado Bulletin B-1.15 has guidelines for rates, rules, loss cost and form filings containing confidential information.

    Louisiana has updated and revised Directive 174, first issued in 2003, to change the certified approval process on certain mandatory and optional filings. Particularly, limited benefit health insurance plan products have been removed from the certified approval procedure. Additionally, property and casualty insurance plan products have had both removals from and additions to the certified approval procedure. Insurers should check the Insurance Department’s product filing matrix of insurance products subject to the certified approval process before submitting a policy form filing for review and approval.

(Produced with the assistance of The Clear Report)

Copyright 2009 ProBusiness Publishing LLC
January 5, 2009

Publish date Jan 05 2009
Prior Issues

Reprinted with permission from Insurance Compliance Insight.
Copyright © 2009 ProBusiness Publishing LLC
Licensed from ProBusiness Publishing LLC. All rights reserved.