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Published byAmos Mills Modified over 9 years ago
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RECENT IDOI ENFORCEMENT ACTIONS Debra McNeil Josh Harrison
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Enforcement Division Market Regulation InvestigationsTitle
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Enforcement Statutes Unfair Competition, Unfair or Deceptive Acts and Practices –IC 27-4-1-1 Producer’s Statute –IC 27-1-15.6-12
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IC 27-4-1-3 No person shall engage in this state in any trade practice which is defined in this chapter or determined pursuant to this chapter as an unfair method of competition or as an unfair or deceptive act or practice in the business of insurance.
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Person Individual –Agent –Broker –Adjuster –Navigator –Third Party Adjuster –Independent Adjuster Company –Agency –Underwriter
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Unfair Method of Competition IC 27-4-1-4 –Misrepresenting terms –Untrue, deceptive, or misleading statements –Supplying false information to regulator –Unfairly discriminating –Excessive or inadequate charges
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Unfair or Deceptive Act or Practice IC 27-4-1-4.5 –Misrepresenting facts or policy terms –Failing to respond –Not attempting prompt, fair, and equitable settlement of a claim –Failing to provide reasonable explanation for a denial
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Catch-All IC 27-4-1-8 –Any method of competition or any practice not otherwise defined but deemed unfair or deceptive
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Statement of Charges IC 27-4-1-5 –The Commissioner shall issue and cause to be served a statement of charges and notice in writing of a hearing under IC 4-21.5-3.
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Procedure Hearings –Preliminary –Motions –Adjudicatory Settlement
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Penalties IC 27-4-1-6 –Civil penalty $25,000 per violation $50,000 per violation if the person knew or reasonably should have known in violation –Suspension or Revocation
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Producer’s Statute Providing incorrect information on license application Violating an insurance law Misappropriating funds Convicted of a felony Having license revoked in another state Failing to pay state income tax
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Additional Causes Appointments list Child support order Failure to notify of administrative action in another jurisdiction Failure to notify of a criminal prosecution
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Hearings Denial or Non-renewal –IC 27-1-15.6-12(d) Applicant must request within 63 days Burden on Applicant to show denial unreasonable Active License –IC 4-21.5 (AOPA) Department must give Notice and Hearing Burden on the Department
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Penalties IC 27-1-15.6-12(b) –Civil penalty –Probation –Suspension –Revocation
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Bail Qualifications –IC 27-10-3-3 Good Moral Character Disqualifying Offense –Misdemeanor 5 years –Felony 10 years
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Bail 27-10-3-8 –Violating any laws under license –Misstatement or fraud in application –Fraudulent or dishonest practice –Incompetence or untrustworthiness –Rebating –Tax Warrant
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Bail Revocation Disqualifying Offense –Immediately upon plea or conviction Before sentencing Is not stayed on appeal Other cause –Serve a copy of charges –Agent must request hearing within 10 days
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Alvino Jones 3 separate complaints about Jones –On December 15, complainants came in after being shot during one attempted recovery Investigator Herndon relayed investigation to Indiana State Police Det. Logsdon March 6, 2015, Jones arrested during attempted apprehension Jones was charged with Burglary and Possession of Firearm by a Serious Violent Felon
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Unique Insurance Company Initial Consumer complaints and Prior Enforcement action Market Conduct Examination –Evidence of Major Claims handling issues Failure to communicate Failure to pay claim Failure to provide prompt and fair settlement Failure to provide explanation of denial
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Unique IC 27-1-3.1-9(e) –Prima facie evidence in any legal or regulatory action Statement of Charges –269 separate violations Regulatory Settlement Agreement Reached
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