Wolters Kluwer Financial Services’ industry research has identified top 10 common market conduct compliance criticisms found in the US insurance market conduct exams by insurance departments to help insurers minimize compliance risk exposure.
The research shows that the areas identified in the previous year’s state market conduct exam such as the property and casualty, and life and health markets still continue to dominate this year’s lists of criticisms, according to Wolters Kluwer.
The seventh year research data also identified that claims-handling, licensing and underwriting issues across the US still continue to surface.
Wolters Kluwer Financial Services senior compliance counsel, Insurance Kathy Donovan feels that a program of regulatory change management and frequent self audits can reduce the noncompliance risks.
Some of the top 10 criticisms for property and casualty insurance include failure to cancel or non-renew policies, failure to provide required disclosures in the claims process, improper documentation of claim files and failure to adhere to underwriting rules and/or provide required disclosures.
The most common criticisms for life and health insurance include improper documentation of claim and underwriting files, failure to pay claims properly in accordance with policy provisions and failure to provide required disclosures including coverage issues, fraud warnings, free-look periods, right of appeal, or guaranty fund notices.