W. Va. Insurance Regulator Fines 5 Based on Market Conduct Exam

January 15, 2008

Of five West Virginia market conduct examinations completed during 2007, four were routine and one was a target examination based on the findings of a consumer hearing for State Auto Property and Casualty Co.’s violation of the Unfair Trade Practices Act.

The market conduct examinations netted the state $43,500 in fines.

State Auto Property and Casualty Co., was fined $24,500 for failure to send necessary notices of delay to third party claimants and improper claims denial notices.

Municipal Mutual of West Virginia was penalized $7,000 for improper cancellation of insurance policies, failure to notify producers terminated for cause and allowing business submitted from agents not appointed by the Company.

West Virginia Insurance Co., was fined $6,000 for allowing business from un-appointed agents and for sending improper denial notices on claims.

Highmark W. Va, DBA Mountain State Blue Cross Blue Shield, was fined $5,000 for failure to timely respond to the Insurance Commissioner regarding complaints, failure to abide by small group guaranteed issue requirements and improper filing of bona fide associations plans.

Panhandle Farmers Mutual Insurance Co., of W. Va., was penalized $1,000 for failure to send notification to terminated producers.

Market conduct examinations are conducted routinely and also by referral. These examinations focus on the business practices of insurers and producers and are designed to monitor marketing, advertising, policyholder services, underwriting, rating, and claims practices. The adopted reports are public record.

Source: West Virginia Offices of the Insurance Commissioner

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