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AICP GULF STATES CHAPTER 2013 EDUCATION DAY Atlanta, Georgia Market Conduct & Complaint Handling June 21, 2013 2:45 PM – 3:30 PM Fred E. Karlinsky, Esq.

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Presentation on theme: "AICP GULF STATES CHAPTER 2013 EDUCATION DAY Atlanta, Georgia Market Conduct & Complaint Handling June 21, 2013 2:45 PM – 3:30 PM Fred E. Karlinsky, Esq."— Presentation transcript:

1 AICP GULF STATES CHAPTER 2013 EDUCATION DAY Atlanta, Georgia Market Conduct & Complaint Handling June 21, :45 PM – 3:30 PM Fred E. Karlinsky, Esq. Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb, P.A. Debra M. Peirce, Chief Market Conduct Examiner Georgia Insurance Department Mark Ossi, Deputy Division Director of Insurance & Financial Oversight Georgia Insurance Department Ted Hamby, Deputy Commissioner of Life & Health Division North Carolina Department of Insurance © 2013 All Rights Reserved

2 © 2013 All Rights Reserved DISCLAIMER 2 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.

3 © 2013 All Rights Reserved AGENDA 3 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

4 © 2013 All Rights Reserved 4 Market Conduct Trends

5 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 5 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. Social Media

6 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 6 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. Social Media

7 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 7 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. Social Media

8 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 8 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 sharing. Social Media

9 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 9 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 a completed report directly to themselves and their insurance agents. Social Media

10 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 10 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; Social Media

11 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 11 Outline clear delineation between static and interactive social media in order to properly apply regulatory guidelines; Insurers should train their employees/agents on the companys 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. Social Media

12 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 12 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. IT in Claims Handling

13 © 2013 All Rights Reserved MARKET CONDUCT TRENDS 13 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. IT in Claims Handling

14 © 2013 All Rights Reserved 14 The Market Conduct Annual Statement (MCAS) Update

15 © 2013 All Rights Reserved MCAS UPDATE 15 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.

16 © 2013 All Rights Reserved MCAS UPDATE 16 The data collected consists of: Claims handling – claim denials, processing times, and lawsuit activity. Underwriting – new issues, policies in force, non- renewals 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.

17 © 2013 All Rights Reserved MCAS UPDATE 17 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.

18 © 2013 All Rights Reserved 18 The Insured Perspective

19 © 2013 All Rights Reserved THE INSURED PERSPECTIVE 19 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.

20 © 2013 All Rights Reserved THE INSURED PERSPECTIVE 20 Todays consumers expect everyone at the company to share information and recognize the customers identity and history. They dont 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 dont 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.

21 © 2013 All Rights Reserved THE INSURED PERSPECTIVE 21 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 immediate- term value. Customer centricity will create a competitive advantage and market leadership.

22 © 2013 All Rights Reserved 22 The Ins & Outs from the Georgia Insurance Department Debra M. Peirce, Chief Market Conduct Examiner Mark Ossi, Deputy Division Director of Insurance & Financial Oversight

23 © 2013 All Rights Reserved THE INS & OUTS FROM GEORGIA 23

24 © 2013 All Rights Reserved THE INS & OUTS FROM GEORGIA 24

25 © 2013 All Rights Reserved THE INS & OUTS FROM GEORGIA 25

26 © 2013 All Rights Reserved THE INS & OUTS FROM GEORGIA 26

27 © 2013 All Rights Reserved THE INS & OUTS FROM GEORGIA 27

28 © 2013 All Rights Reserved THE INS & OUTS FROM GEORGIA 28

29 © 2013 All Rights Reserved 29 The Regulator Perspective Ted Hamby, Deputy Commissioner of the Life & Health Division

30 © 2013 All Rights Reserved QUESTIONS 30

31 © 2013 All Rights Reserved CONTACT INFORMATION 31 Fred Karlinsky Direct: (954) Main: (954) South Florida Office One Financial Plaza 23 rd Floor 100 SE 3 rd Avenue Ft. Lauderdale, FL Tallahassee Office 215 S. Monroe Street Suite 701 Tallahassee, FL Debra Peirce (404) Georgia Department of Insurance Two Martin Luther King Jr. Drive Atlanta, GA Mark Ossi (404) Georgia Department of Insurance Two Martin Luther King Jr. Drive Atlanta, GA Ted Hamby (919) North Carolina Department of Insurance P.O. Box Raleigh, NC 27611


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