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Flashcards in Porter Ch 5 Deck (13)
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Purpose of insurance regulation:

Assure that the future performance promise, to pay a claim,will be fulfilled as needed (Protects the public interest)


Briefly describe 4 Types of Filing Laws:

1. Prior approval - Insurance rates and coverages must be approved by the state insurance department before they can
be used in the state
2. File and use - Insurer must file insurance rates or coverages with the state insurance department but can then use them
3. Use and file - Insurer can use the rate or coverage it wants, provided the insurer files the rate or coverage within a specied period after it is put into use
4. No file - Insurer not required to make a filing of the rate or coverage


List some of the most common reasons for rate or coverage disapproval:

-Not in the public interest
-Unfairly discriminatory
-Other - excessive, inadequate or not meeting minimum


Describe the basic purposes of a financial examination:

-Detect as early as possible those insurers in financial trouble and/or engaging in unlawful and improper activities
-Develop the information needed for timely, appropriate
regulatory action


What is reviewed in the financial examination:

Insurer's statistical statements, accounting procedures,
financial statements, financial controls, management practices, and investment procedures


Briefly describe a market conduct examination.

Review of the ways in which insurers do business - advertising, soliciting, policy issuing, claims handling


2 reasons why only a few states have historically had fraud departments:

1. Restraints on budgets
2. Lack of insurance fraud laws


How did the 1994 Omnibus Crime Control and Safe
Streets Act address insurance fraud:

-Made it illegal to defraud, loot, or plunder an insurer
-Established a multi-state approach to anti fraud activity


Briefly describe a "Receiver"

Disinterested person/business appointed to receive, protect,
and account for money or other property due


Briefly describe a "Receivership"

Type of bankruptcy an insurer enters into when a receiver is
appointed to manage the insurer and its property


Briefly describe a "Rehabilitation"

Process of reorganizing an insurer's financial affairs so it can continue to exist as a financial entity, with creditors satisfying their claims from its future earnings


Briefly describe a "Liquidation"

Bankruptcy proceeding in which a bankrupt organization does not have enough assets to pay all creditors, and the creditors are prioritized and paid according to the types of their claims


List potential grounds for rehabilitation:

-Liabilities exceed assets
-Insurance company refused to submit books, records,
accounts or affairs to insurance department
-Insurer willfully violates its charter or any other state law