Insurer Complaints

It’s no surprise that claims handling ranks in the top 10 when it comes to insurer complaints, but producer licensing issues also appear to be a top grievance.

According to a new report by Waltham, Mass.-based Wolters Kluwer Financial Services, the failure to handle claims within specified time frames is the number one criticism found on U.S. property/casualty insurer market conduct exams. And using unapproved forms and rates ranks number two.

The data from the company’s ninth annual report show that claims-handling, licensing and underwriting issues continue to dominate regulators’ complaints against insurers.

“The regulatory landscape is getting more complex as industry requirements, laws and regulations change constantly under the direction of government and industry oversight, making it extremely challenging to embed regulatory requirements into claims, underwriting and distribution processes,” said Kathy Donovan, senior compliance counsel, Insurance, at Wolters Kluwer Financial Services. “Strong regulatory change management processes and frequent self-audits are extremely effective in helping stay on top of these changes.”

In addition to those criticisms on the Top 10 list, insurers were also frequently criticized for the manner in which they maintained complaint handling, their failure to provide requested data to market conduct examiners, as well as the failure to conduct business in their “own name.”

To develop its list, the company said its regulatory experts reviewed last year’s state market conduct exams to identify areas with the most criticisms. The company provides compliance and risk management services for banking, insurance and other financial firms. The firm says its report can serve as a checklist to help insurers minimize compliance risk exposure.

According to Wolters Kluwer Financial Services, the top 10 most common market conduct compliance criticisms for property and casualty insurance are: