Around the PIA Western Alliance States – Week of January 2, 2024

California — Lara’s Update on Sustainable Insurance Strategy: Insurance Commissioner Ricardo Lara told California Assembly members at a legislative oversight hearing that “California is at an insurance crossroads and for many Californians this is an insurance emergency.” He underscored the need for marketplace reforms, with the FAIR Plan reporting 20 percent growth of policies in 2023 and restrictions by major insurance companies pushing more consumers into California’s insurer of last resort. He also outlined progress toward major regulatory and administrative reforms under his California Sustainable Insurance Strategy that he first announced in September.

The following is an excerpt of his prepared remarks to members of the Assembly Insurance Committee at an oversight hearing held at Pasadena City Hall:

“California is at an insurance crossroads and for many Californians, this is an insurance emergency. Consumers are experiencing the impact of growing climate threats, historic inflation, and outdated regulations.

“As the state’s insurance regulator, my focus is safeguarding the integrity of the insurance market, which includes protecting consumers and businesses. In September, I announced my Sustainable Insurance Strategy, which is the largest insurance reform since voters passed Proposition 103 nearly 35 years ago. There is no question that the risks that existed when voters passed Proposition 103 are not the same risks we are facing today. The insurance market we are dealing with today necessitates urgent measures that even the Governor recognizes, as set forth in his Executive Order issued on September 21st.

“My strategy is based on a thorough assessment of today’s insurance landscape with input from wildfire survivors, ranchers and farmers, supportive housing groups, REALTORS, homeowners and condo associations, new home builders, and other insurance consumers most affected.

 “We are moving with urgency and deliberately, based on the facts, and we won’t be pressured by entrenched groups seeking to defend a broken status quo that puts their interests ahead of the public’s benefit.

“It is clear that insurance reforms are long overdue and the current system does not address the insurance challenges of today. I am taking action to implement lasting changes that will make Californians safer through a stronger, sustainable insurance market.”

California — Lara Warns Auto Insurers: Insurance Commissioner Ricardo Lara took action to protect California drivers’ access to auto insurance by issuing a Bulletin to personal auto insurance companies throughout the state. The California Department of Insurance continues to receive numerous complaints from consumers who have been having issues obtaining auto insurance coverage.

“These alleged passive-aggressive tactics by insurance companies to slow down drivers’ access to coverage are unacceptable, dangerous, and will not be tolerated,” said Insurance Commissioner Ricardo Lara. “I am taking action today to ensure these insurance companies are acting according to the law and giving drivers the coverage they are paying for at the rate they qualify for. We will continue to monitor the situation and take any and all steps necessary to protect California consumers.”

The consumer complaints that the Department received were regarding waiting periods, questionnaires, and other practices instituted by auto insurance companies that the Department believes could be in violation of existing California law, including various provisions of Proposition 103, resulting in barriers for otherwise qualified drivers to secure and maintain auto insurance.

Auto insurance companies in California are required to submit complete rate applications to the Insurance Commissioner for review and prior approval before implementing any change to existing rates. These consumer complaints revealed that some insurance companies may be taking actions that are not a part of the underwriting guidelines they have previously filed with the Department. Before implementing new practices, like using questionnaires or different filing instructions, insurance companies must file those guidelines with the Department.

Auto insurance companies in California also are required to offer and sell insurance to all persons who qualify as “Good Drivers”, those who have been licensed for at least three consecutive years, have no more than one point on their driving record, and were not principally at fault as the driver in a motor vehicle accident that resulted in bodily injury or death of any person.

The complaints from consumers claim that some insurance companies may not be offering “Good Driver” discounts for all who qualify and may be imposing unreasonable application requirements that are unrelated to set eligibility factors. These requirements in many cases discourage, inhibit, and/or delay Good Drivers from completing an application for insurance and result in failure or refusal by the company to provide the deserved discount, especially in a timely manner.

Some of these requirements include having to complete unnecessarily lengthy and/or confusing questionnaires, verify employment or school information, respond to physically mailed questionnaires despite applicants electing to receive documents electronically, provide information regarding excluded drivers living at the same address, and/or submit copies of applicants’ utility bills, vehicle registrations, and/or photos of driver’s licenses or vehicles, among other examples.

Today’s action by Commissioner Lara sets the stage for future enforcement actions, if warranted. Bulletins are issued by the Department to “clear the air” on any questions that insurance companies may have regarding insurance law and regulations and their enforcement. In general, companies found to be violating insurance law and regulations after a bulletin is issued may be subject to enforcement actions such as market conduct reviews, fines, and other penalties. Once directly informed by the Department, several insurance companies have since stopped their waiting periods, questionnaires, and other practices, filed their revised underwriting guidelines with the Department for review, and reversed several previous actions made on their policyholders to restore their auto insurance coverage.

The Department urges any California driver who is looking for new auto insurance coverage or renewing their current coverage and having concerns over the information they are being asked to share or are seeing changes to their policies to contact the Department at 800-927-4357. In order to avoid cancellations or delays of coverage, the Department does advise policyholders to take the action that their insurance company requires and retain all documentation in order to file a complaint with the Department.

Washington — 2024 mandated health benefits report: Under the Affordable Care Act (ACA), each state must identify any state benefit requirements adopted under the ACA that exceed the essential health benefits package in the state. To comply with federal requirements and RCW 48.43.715, the OIC analyzed 2023 legislation to assess whether that legislation established a new benefit mandate for which the state must defray costs. We reported our findings in the 2024 mandated health benefits report.

For more information, including a copy of the report, please visit the OIC’s legislative and commissioner reports webpage.

Oregon — Registration mandatory for data brokers in Oregon starting Jan. 1, 2024: Beginning Jan. 1, 2024, data brokers operating in Oregon need to register with the Oregon Division of Financial Regulation (DFR). This requirement is in response to the recent passage of House Bill 2052, aimed at regulating the collection, sale, and licensing of personal information by data brokers.

DFR will be accepting applications for registration in early December. Data brokers intending to operate in Oregon must complete the registration process to ensure compliance with the new regulations.

Key details:

 Mandatory registration: Effective Jan. 1, 2024, data brokers must be registered in the state of Oregon to legally collect, sell, or license data from Oregon consumers.

Application period: Applications for registration will be accepted starting early December and can be found on the DFR website. Data brokers are encouraged to apply promptly once the process begins.

Purpose of registration: Data brokers engage in the sale of personal information for monetary gain, and registration is now a prerequisite for conducting such activities in Oregon. The passage of HB 2052 was intended to improve transparency and provide opportunities for Oregon consumers to take action to limit and curtail the use of their personal information. Uses of concern can include revealing people’s personal information with malicious intent, behavior, publicizing victim information, using personal information for discrimination, and targeting vulnerable people, including older adults and people with disabilities.

DFR emphasizes the importance of complying with the new regulatory requirements and failure to do so could result in fines or barring the data broker from operating in Oregon.

For information on the registration process and requirements, visit DFR’s website.

Washington — Kreidler issues $305,000 in fines for violations in November: Insurance Commissioner Mike Kreidler issued fines in November totaling $305,694 against insurance companies and insurance producers who violated state insurance laws and regulations.

Insurance companies

UnitedHealthcare of Oregon, Inc., Lake Oswego, Ore.; fined $35,000 (order 23-0179).

    UnitedHealthcare incorrectly processed telemedicine claims during the 2021 plan year, resulting in 602 reprocessed claims from 159 consumers with $31,557 in claim underpayments.

Unauthorized insurers

Towers Administrators LLC, Middletown, Del.; fined $50,000 (order 23-0211).

    Towers Administrators sold prescription discount membership plans to five Washington residents without being authorized to do so.

Geoduck Insurance Group, Salt Lake City, Utah; fined $10,000 (order 23-0180).

    Geoduck conducted insurance business in Washington state between 2014 and 2021 without being registered as a captive insurer. 

Bryn Mawr College, Bryn Mawr, Pa.; fined $25,000 (order 23-0215).

    Bryn Mawr issued charitable gift annuities to six Washington residents, totaling $81,971.29, without receiving a certificate of exemption from the OIC.

University of Wisconsin, Madison, Wis.; fined $25,000 (order 23-0221).

    The University of Wisconsin issued charitable gift annuities to four Washington residents, totaling $81,739.23, without receiving a certificate of exemption from the OIC.

GBU Financial Life, Pittsburgh, Penn.; fined $1,000 (order 23-0214).

    GBU Financial acted as a fraternal benefit society without being authorized to do so. The company was fined $1,000 and agreed to pay $18,421 in back premium taxes, penalties and interest on the $528,964 in premiums it collected on policies insuring Washington risk between 2012 and 2023.

Producers, agents & brokers

Zo Clerico, Arlington, Wash.; fined $1,000 (order 23-0660).

    Clerico’s license was revoked, in addition to the fine, for submitting insurance applications for fictitious individuals and using fraudulent practices.

Long-term care insurance

Note: Insurance agents are required to receive specific long-term care training and continuing education to ensure they have the knowledge to properly sell long-term care products. The legislature requires insurers to share in the responsibility through an annual education verification process.

Nationwide Life and Annuity Insurance Company, Columbus, Ohio; fined $140,273.87 (order 23-0148).

    Forty of Nationwide’s producers sold long-term care insurance products before the company verified that they’d received the required training.

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