Annual Statements & Financial Reporting
    Missouri Proposed Rule 20 CSR 200-1.105 would set standards for property/casualty actuarial opinions.
 
 
Automobile Insurance
    Hawai’i has issued its annual data call for personal auto insurance premiums. It wants insurers to use its PDF forms and instructions and to submit data by Oct. 5. Information will be used to generate a list of motor vehicle insurers and their annual premiums that will be published in November. 
 
    Massachusetts Bulletin 2009-12 addresses premiums and factors the state will consider when determining if residual auto market rates are unfair or unreasonable.
 
    New Jersey Bulletin 09-26 deals with a court decision in litigation concerning the Ingenix database. It prevents, for the purposes of personal injury protection and motor bus medical expense coverage, the use of that database for calculating fees for services that are not on an insurer’s fee schedule until the Insurance Department reviews the reliability of the database. The department notes that the court didn’t make any part of its decision retroactive. Because of that, new rules and fee schedules will apply to bills for services or supplies provided on or after Aug. 10; the prior rules and fee schedules will apply to bills provided prior to that date. The bulletin also corrects a number of nonsubstantial errors on the Physicians’ Fee Schedule and certain changes in CPT coding as set out in a table in the bulletin.
 
 
Insurance Fraud
    The National Conference of Insurance Legislators will have a Sept. 9 conference call to discuss a proposed model law addressing airbag theft and fraud. It would require repair shops to have invoices proving they purchased a replacement airbag; criminalize the theft and purchase of stolen airbags; require police accident reports to note if an airbag was deployed; and allow manslaughter charges to be filed if someone is seriously injured or dies because of a phony airbag.
 
    Maryland Bulletin 09-24 requires third-party administrators to have fraud plans and to file them with the state by Oct. 1. The plans must detail specific procedures to prevent insurance fraud (including internal fraud, application fraud and claims fraud), to report insurance fraud, to cooperate in any investigation and prosecution of insurance fraud, and to report fraud-related data. The requirement applies even if a TPA’s insurer has filed a fraud plan.
 
 
Life Insurance
    Colorado wants to make changes to two regulations:
    • Proposed Amended Regulation 4-9-2, dealing with credit insurance, adds a new appendix of component-based rates for policies or certificates issued on or after Jan. 1, 2010. It also updates the appendix for policies issued before then.
    • Proposed Amended Regulation 4-2-15, dealing with contracts with health care providers, adds contract provisions required by recent legislation.
 
    A table in New Jersey Bulletin 09-27 shows the rates of interest to be used to determine minimum valuation standards and nonforfeiture values applicable to:
    • life insurance policies issued during 2010; and
    • annuity contracts issued or undergoing a change in fund during 2009.
 
 
Long-Term Care Insurance
Colorado Proposed Regulation 4-4-4 would establish rules for the state’s long-term care partnership program.
 
 
Medicare Supplement Insurance
    Alaska has repealed some rules and issued a new regulation, 3 AAC 28.5, dealing with health insurance marketed as Medicare supplement insurance.
 
 
Producers
    Colorado Proposed Amended Regulation 1-2-10 deals with producer licensing. It address resident producers applying for, renewing, or continuing the variable life and variable annuity products and other matters.
 
    Minnesota says in an online statement that it has mailed license renewal reminder postcards and tells agents what to do if they don’t receive one.
 
 
Property/Casualty Insurance
    Maryland Bulletin 09-22 tells insurers that the Insurance Administration interprets a new condominium insurance law to mean that each unit owner is an insured under a master condo policy. The law went into effect June 1. Regulators say that some condo associations are telling unit owners that their claims aren’t covered by the master policy, and telling insurers that there are no claims to be investigated. That essentially blocks the unit owner from making a claim under the master policy, as the state sees it. The guidance says a condominium management company can act as a conduit for claims under the master policy, essentially acting as a third-party administrator, but it cannot block unit owners from filing a claim. Further, producers who are aware of a potential claim must report it to the insurer, and an insurer that becomes aware of a claim must take reasonable actions to investigate and adjust it.
 
    Ohio has posted a reminder to property owners that they have until Sept. 14 to file claims for damage due to last year’s ice storms. State law requires property/casualty claims to be filed within a year of the loss. 
 
    Texas has adopted Emergency Rule 5.4902 to -.4908, implementing the requirements of HB 4409. The rule relates to the Texas Windstorm Insurance Association's declinations of coverage, flood insurance, minimum retained premium, continuation of coverage for persons under the pre-existing certificate of compliance approval program, a certificate of compliance transition program, and the definition of the terms alter and alteration.
 
 
Rates, Forms & Filings
    Nevada Bulletin 09-007 gives submission and review procedures for certain rates, rules and forms filed by property/casualty insurance companies. It replaces Bulletin 06-008.
 
 
Sales & Marketing
    New York Legal Opinion 09-08-06 explores sales and marketing issues related to unauthorized insurers. The guidance says an unauthorized insurer cannot provide its telephone number for purposes of engaging in telephone conversations, even if the communications are customer-initiated and devoid of any acts of solicitation by the insurer. Furthermore, such an insurer cannot sell group life insurance by phone or through an Internet Web page.
 
 
State Regulation of Insurance
    California updated its fee schedule Sept. 1. The 6-percent decrease in fees for producers and insurers was announced in March in Bulletin 2009-3.
 
    Minnesota has posted a summary of legislation of interest to insurers.
 
    These views are contained in the latest New York legal opinions:  
    • Legal Opinion 09-08-01 says insurers don’t have to obtain approval from the Insurance Department to create an in-house law firm.
    • Legal Opinion 09-08-04 looks at the electronic delivery of insurance papers. It says:
        ◊ Guidance in Legal Opinion 09-01-01 also applies to commercial lines of insurance.
        ◊ An insurer is responsible for delivery of the insurance policy to the insured or its designate, but that can be delegated to the insured’s agent or broker.
        ◊ An insurer can send an insurance policy to an insured electronically only if the insured has consented to engage in an electronic transaction. That’s true even if the insurer provides the insured with an option to insist upon receiving a paper copy of the policy.
        ◊ If the insurer sends a policy to a producer electronically, the producer must first obtain the insurer’s permission before forwarding the policy to the insured electronically.
 
    New York’s 11th Amendment to Regulation 41 changes the governing standards for excess line placements. It affects commercial excess and umbrella liability, commercial and vacant commercial property, employed attorney liability, special events and other lines.
 
    Washington Amended Rule WAC 284-02-070 requires parties to follow the civil rules of procedure for discovery for adjudicative hearings or contested administrative proceedings with the Office of the Insurance Commissioner.
 
    Wisconsin has amended a July 24 bulletin detailing legislation and regulations of interest to insurers. Section 632.835 concerning independent review of adverse insurer findings was effective July 1.
 
 
(RR&B is produced with the assistance of The CLEAR Report and the Coalition Against Insurance Fraud.)
 
Copyright 2009 ProBusiness Publishing LLC

Publish date Sep 07 2009
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Reprinted with permission from Insurance Compliance Insight.
Copyright © 2009 ProBusiness Publishing LLC
Licensed from ProBusiness Publishing LLC. All rights reserved.