AICP GULF STATES CHAPTER
2013 EDUCATION DAY
Atlanta, Georgia
Market Conduct & Complaint Handling
June 21, 2013
2:45 PM – 3:30 PM
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Fred E. Karlinsky, Esq.
Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb, P.A.
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Debra M. Peirce, Chief Market Conduct Examiner
Georgia Insurance Department
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Mark Ossi, Deputy Division Director of Insurance & Financial Oversight
Georgia Insurance Department
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Ted Hamby, Deputy Commissioner of Life & Health Division
North Carolina Department of Insurance
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DISCLAIMER
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.
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AGENDA
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Market Conduct Trends
The Market Conduct Annual Statement (MCAS) Update
The Insured Perspective
The Ins and Outs from the Georgia Insurance Department
The Regulator Perspective
Questions
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Market Conduct Trends
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MARKET CONDUCT TRENDS
Social Media
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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.
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MARKET CONDUCT TRENDS
Social Media
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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.
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MARKET CONDUCT TRENDS
Social Media
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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.
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MARKET CONDUCT TRENDS
Social Media
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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.
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MARKET CONDUCT TRENDS
Social Media
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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.
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MARKET CONDUCT TRENDS
Social Media
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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;
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MARKET CONDUCT TRENDS
Social Media
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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; and
The insurer or producer is responsible for complying with
the state recordkeeping laws.
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MARKET CONDUCT TRENDS
IT in Claims Handling
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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.
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MARKET CONDUCT TRENDS
IT in Claims Handling
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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.
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The Market Conduct Annual
Statement (MCAS) Update
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MCAS UPDATE
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.
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MCAS UPDATE
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The data collected consists of:
 Claims handling – claim denials, processing times, and
lawsuit activity.
 Underwriting – new issues, policies in force, nonrenewals 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.
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MCAS UPDATE
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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.
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The Insured Perspective
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THE INSURED PERSPECTIVE
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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.
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THE INSURED PERSPECTIVE
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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.
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THE INSURED PERSPECTIVE
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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 immediateterm value.
Customer centricity will create a competitive advantage and
market leadership.
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The Ins & Outs from the Georgia
Insurance Department
Debra M. Peirce,
Chief Market Conduct Examiner
Mark Ossi,
Deputy Division Director of
Insurance & Financial Oversight
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THE INS & OUTS FROM GEORGIA
http://www.oci.ga.gov/
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THE INS & OUTS FROM GEORGIA
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THE INS & OUTS FROM GEORGIA
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THE INS & OUTS FROM GEORGIA
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THE INS & OUTS FROM GEORGIA
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THE INS & OUTS FROM GEORGIA
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The Regulator Perspective
Ted Hamby,
Deputy Commissioner of the
Life & Health Division
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QUESTIONS
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CONTACT INFORMATION
Fred Karlinsky
Debra Peirce
Mark Ossi
Ted Hamby
fkarlinsky@cftlaw.com
Direct: (954) 332-1749
Main: (954) 492-4010
dpeirce@oci.ga.gov
(404) 657-7277
mossi@oci.ga.gov
(404) 656-0718
Ted.hamby@ncdoi.gov
(919) 733-5060
South Florida Office
One Financial Plaza
23rd Floor
100 SE 3rd Avenue
Ft. Lauderdale, FL 33394
Georgia Department of
Insurance
Two Martin Luther King
Jr. Drive
Atlanta, GA 30334
Georgia Department of
Insurance
Two Martin Luther King
Jr. Drive
Atlanta, GA 30334
North Carolina
Department of Insurance
P.O. Box 26387
Raleigh, NC 27611
Tallahassee Office
215 S. Monroe Street
Suite 701
Tallahassee, FL 32301
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