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Around the PIA Western Alliance States

Posted By Administration, Tuesday, July 21, 2015

Arizona Insurance Fraud

This is from the Arizona Department of Insurance.

 

A Tucson man was sentenced to 60 years in prison as the result of an insurance fraud investigation by the Arizona Department of Insurance.

 

On August 7, 2013, Gabriel Christopher Morris was arrested in Tucson by agents of the Fraud Unit and the Tucson Police Department. Morris allegedly took the identity of a Tucson resident and opened up credit card accounts and financed $23,416.92 for a 2008 Dodge Durango using the victims identity. Morris also obtained an insurance policy through GEICO Insurance and was in the process of making a second accident claim on the same vehicle when it was discovered he was using the victims stolen identity.

 

GEICO contacted the Arizona Department of Insurance Investigations Division that with the help of Tucson Police Department arrested Morris when he showed up at GEICO to pick up a claim check.  Morris was found in possession of a fraudulent Arizona drivers license belonging to the victim that had Morriss photo on it.  Property was recovered during the vehicle search that was believed to be reported stolen from three Tucson residences and two vehicle burglaries in San Diego, California.  Numerous other victims identifications were found along with equipment Morris had used to make fraudulent Arizona drivers licenses.

 

On April 8, 2015, Morris went on trial in Pima County Superior Court and was convicted on five counts of forgery and one count of theft.  Morris was sentenced by Pima County Superior Court Judge Danelle Liwski to 12 years in prison on each count on the forgeries and 20 years on the theft charge to run concurrent.  In addition, Morris was sentenced to 40 years in prison on other charges brought by Tucson PD - bringing his total sentence for all charges to 60 years.  At sentencing, Judge Liwski advised Morris he would never be in a position to exploit another person again.  The case was prosecuted by the Arizona Attorney Generals Office.

 

California Wildfire

A California wildfire in the San Bernardino mountains destroyed four buildings and about 49 square miles of forest land was started by human activity. Officials have not yet been able to determine whether it was started on purpose or not. \

 

The fire burned nine-days and cost $40 million to control.

 

Source link: insurancejournal.com

 

Idaho Payment Benefit Policy

This came to us from Kenton Brine, PCI Assistant Vice President, NW Region.

 

The Idaho Industrial Commission has extended a deadline to September 1 for insurers to acknowledge receipt of their June 15 memorandum on Payment of Benefits Under Deductible Policies.

 

On June 15, the Idaho Industrial Commission issued a memorandum to insurers writing workers' compensation policies in the state, providing guidance on payment of benefits under deductible policies - including a reminder about the need to adjust and pay all claims using in-state licensed adjusters. The commission's memo required insurers to have an officer of the company acknowledge receipt of the memo and compliance with applicable statutes (an acknowledgment form is provided with the memorandum - attached) not later than July 17, 2015.

 

PCI has now been asked by Scott McDougall, Industrial Commission Manager for Claims and Benefits, to inform PCI members writing WC insurance in Idaho that the deadline for responding to the memo has been extended to September 1, 2015.

 

Members with questions regarding the content or distribution of the Industrial Commission's June 15 memo may wish to contact Mr. McDougall directly:

Scott McDougall

Manager, Claims and Benefits

Idaho Industrial Commission

scott.mcdougall@iic.idaho.gov

208-334-6063

 

Montana: Insurance for Volunteer Firefighters: The Montana Legislature is looking at a bill to provide workers compensation for volunteer firefighters. Worries are that counties are violating a law passed in 1997 that requires these volunteers be provided work comp.

 

The new proposal also says volunteers can be paid $3,000 a year and have a state retirement account. How to fund the plan hasnt been determined.

 

Source link: The Washington Times

 

Nevada Broker Contract Settlement

Nevadas Clark County School District is going to pay its former broker Business Benefits Inc. $1.65 million for prematurely ending its insurance contract. The termination came when the broker raised its commission rates.

 

Oregon Administrative Order

This from the Oregon Department of Insurance.

 

In the Matter of the Proposed Plan Approved Acquisition of Control of Trillium Community Health Plan, Inc., by Centene Corporation: Case No. 15-04-022

 

http://www.cbs.state.or.us/external/ins/admin_actions/actions_2015/other_2015/15-04-022.pdf

 

Please follow this link to the division's website for administrative orders on mergers and acquisitions:

www.cbs.state.or.us/external/ins/admin_actions/actions_2015/other_orders.html

 

For other administrative orders issued by the division, visit our website at: www.cbs.state.or.us/external/ins/admin_actions/adminact.html

 

Oregon Financial Examination Online

The Oregon Insurance Division recently published the following financial examination reports online:

 

Farmers Insurance Company of Oregon as of 12/31/13

PacificSource Health Plans as of 12/31/13

PacificSource Community Health Plans, Inc. as of 12/31/13

Valley Property and Casualty Insurance Company as of 12/31/13

To view or download the reports, please visit the Division's website:

www.oregon.gov/DCBS/insurance/insurers/regulation/Pages/examinations.aspx

 

 

Washington Sine Die

This came to us from Kenton Brine, PCI Assistant Vice President, NW Region.

 

The Washington Legislature has adjourned the 2015 Session sine die after three consecutive special sessions.

 

The Washington Legislature, which convened in Olympia on January 12, 2015, adjourned the third special session on Friday, July 10. The Legislature has now adjourned the 2015 session sine die.

 

Lawmakers on July 9 reached agreement on budget-related measures that were the key to concluding the Legislature's business without leaving any "holes" in the $38 billion two-year budget they had enacted just before the end of the 2013-15 biennium. That budget was signed into law by Gov. Jay Inslee (D) just 20 minutes before midnight on June 30 - the date on which the state would have been required to "shut down" most services, facilities and programs. Passage of the state operating, transportation and capital construction budgets were the key to adjourning sine die on July 10.

 

For P&C insurers, the 2015 session was a successful one, with enactment of industry-supported legislation establishing insurance requirements for Transportation Network Companies (Uber, Lyft, Sidecar) and their drivers. PCI also worked for the successful enactment of e-commerce legislation that includes both electronic delivery of all insurance policies, notices and documents as well as web posting of policies to a publicly available website (in lieu of mailing paper copies to insureds). PCI-supported legislation sought by Insurance Commissioner Mike Kreidler (D) that will allow the department to maintain NAIC accreditation (Model Holding Company Act) and establishing Own Risk Solvency Assessment provisions were also enacted during the Regular Session.

 

In the third special session's final days, insurers were also pleased that a proposal that would have increased user fees for obtaining motor vehicle accident reports (not driver records) appears to have not been enacted.

 

Here is a link to an article about the conclusion of the session that appeared in the Seattle Times on July 11: http://www.seattletimes.com/seattle-news/washington-legislature-adjourns-after-final-votes/

 

Washington Kriedler Issues Fines: This from the Washington Department of Insurance.

 

Insurance Commissioner Mike Kreidler disciplined and issued fines in June totaling $328,000 against insurance companies, agents, brokers and others who violated state insurance regulations.

 

The actions are linked to the disciplinary order that contains more information about each action.

Insurance companies

 

Delta Dental of Washington, Seattle; fined $10,000

 

The dental insurer changed its name in 2014 and used its old name on forms it filed with the Insurance Commissioner. The Insurance Commissioner rejected the forms and the company agreed to update them, but failed to do so for a year. In the meantime it sold plans to consumers without the Commissioners approval for the plan or the associated rates. It self-reported the error to the Commissioner.

 

Lexon Insurance Co., Louisville, Ky.; fined $3,000

 

The company canceled a consumers policy without giving the consumer at least 45 days notice and failed to tell the consumer the reason for canceling the policy.

 

National Union Fire Insurance Co., Pittsburgh; fined $300,000

 

The company issued blanket policies to 27 groups that were not eligible for blanket insurance and 53 policies before they were approved by the Insurance Commissioner. It also sold accident policies to volunteer and professional fire departments before the Commissioner approved the policies.

 

Transamerica Casualty Insurance Co., Columbus, Ohio; fined $10,000

 

Transamericas travel insurance policies incorrectly stated the timeframe within which an accidental death or accident loss must be reported for claims.

 

Agents and brokers

 

Immanuel Baah, Everett; fined $250

 

Baah failed to disclose his criminal history on his application for an insurance producers license.

 

Cristina Iglesias Francis, Fort Lauderdale, Fla.; fined $500

 

Francis negotiated and sold insurance in Washington without a license.

 

Health Plan Intermediaries Holdings LLC, Lutz, Fla.; fined $250

 

The agency sold insurance policies in Washington through its website using an unregistered trade name.

 

Jeremiah Job, Seattle; fined $1,000

 

Job, while assisting another insurance agent, signed a form for replacement life insurance that contained inaccurate information that may have misled the consumer.

 

Sabal Insurance Group, Fort Lauderdale, Fla.; fined $1,500

 

Sabal sold insurance to a Washington business without a license, falsified information on the application and forged the clients signature before submitting it to the underwriter.

Other

 

XCEL Testing Solutions, Jacksonville, Fla.; fined $1,500

 

XCEL offered pre-licensing education courses to Washington consumers without being licensed and without getting the Insurance Commissioners approval for the courses.

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