§ 27-71-5 - Market analysis procedures.
SECTION 27-71-5
§ 27-71-5 Market analysis procedures.– (a) The commissioner shall gather information as deemed necessary from datacurrently available, as well as surveys and required reporting requirements,information collected by the NAIC and a variety of other objective sources inboth the public and private sectors including law enforcement inquires.
(2) Such information, when collected, shall be analyzed inorder to develop a baseline understanding of the marketplace and to identifyfor further review insurers and/or practices that deviate significantly fromthe norm or that may pose a potential risk to the insurance consumer. Thecommissioner shall use the NAIC Market Regulation Handbook as one resource inperforming this analysis (or procedures, adopted by regulation, that aresubstantially similar to the foregoing NAIC product).
(3) The commissioner shall perform the analysis describedunder this section by:
(i) Identifying key lines of business for systematic review;
(ii) Identifying companies for further analysis based onavailable information.
(b) If the analysis compels the commissioner to inquirefurther into a particular insurer or practice, the following continuum ofmarket conduct actions may be considered prior to conducting a targeted,on-site market conduct examination. The action selected shall be made known tothe insurer in writing if the action involves insurer participation orresponse. These actions may include, but are not limited to:
(1) Correspondence with insurer;
(2) Insurer interviews;
(3) Information gathering;
(4) Policy and procedure reviews;
(5) Interrogatories;
(6) Review of insurer self-evaluation (if not subject to aprivilege of confidentiality) and compliance programs, including membership ina best-practice organization; and
(7) Desk examinations.
(c) The commissioner shall select a market conduct actionthat is efficient for the department of business regulation and the insurer,while still protecting the insurance consumer.
(d) The commissioner shall take those steps reasonablynecessary to eliminate requests for information that duplicate informationprovided as part of an insurer's annual financial statement, the annual marketconduct statement of the National Association of Insurance Commissioners, orother required schedules, surveys, or reports that are regularly submitted tothe commissioner, or with data requests made by other states if thatinformation is available to the commissioner, unless the information is statespecific, and coordinate market conduct actions and findings with other states.
(e) Causes or conditions, if identified through marketanalysis, that may trigger a target examination, included but are not limitedto:
(1) Information obtained from a market conduct annualstatement, market survey or report of financial examination indicatingpotential fraud, that the insurer is conducting the business of insurancewithout a license or is engaged in a potential pattern of violation of thegeneral laws or law enforcement inquiry.
(2) A number of complaints against the insurer or a complaintratio sufficient to indicate potential fraud, conducting the business ofinsurance without a license, or a potential pattern of unfair trade practice inviolation of the general laws. For the purposes of this section, a complaintratio shall be determined for each line of business.
(3) Information obtained from other objective sources, suchas published advertising materials indicating potential fraud, conducting thebusiness of insurance without a license, or evidencing a potential pattern ofunfair trade practice in violation of the general laws.
(4) Patterns of violations of the general laws andadministrative regulations promulgated thereunder that cause consumer harm.