Report Recommends Changes at South Dakota Division of Insurance

A department secretary’s report on the South Dakota Division of Insurance is recommending increased oversight from supervisors and the secretary, better staff communication and a new informal settlement process, state officials said.

Gov. Dennis Daugaard earlier this month requested the report from Department of Labor and Regulation Secretary Pam Roberts reviewing the division’s investigative procedures for consumer complaints on long-term care insurance providers.

Daugaard said the division has the difficult task of balancing consumer protection and business needs.

“While perfect equilibrium will never be possible, implementing these recommendations will increase the balance between the division’s priorities,” he said in a release.

The report also recommends setting new timelines and posting completed market conduct examination reports on the department’s website.

Under existing law, the division can suspend, revoke or refuse to renew a license until fines are paid, but cannot independently fine insurers or agents without their consent.

“Once DOI has revoked a license, they no longer have leverage over a licensee to ensure future compliance with South Dakota law and regulations,” Roberts said in her report. “Consumers are then left with insurance contracts that are still in force with an insurance company DOI no longer has authority to regulate.”

Some of the proposed changes would require legislation.

Daugaard requested the report after the Argus Leader newspaper in Sioux Falls reported that the division had not publicly disciplined Ability Insurance Co. despite having evidence that the company allegedly broke state laws when it wrongfully denied claims for some long-term care policyholders.

Ability, based in Omaha, Neb., has been sued half a dozen times in federal court in South Dakota, and it also has been sued in Washington, Mississippi, Iowa and Montana. The company has said it has enacted reforms that should put an end to the lawsuits, and that only two cases – including one in South Dakota – are currently being litigated in federal court.

State laws require the division to keep confidential the details of its investigations of companies, and officials have not commented on the division’s investigation of Ability.