RECENT IDOI ENFORCEMENT ACTIONS Debra McNeil Josh Harrison.
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Transcript of RECENT IDOI ENFORCEMENT ACTIONS Debra McNeil Josh Harrison.
RECENT IDOI ENFORCEMENT
ACTIONS
Debra McNeilJosh Harrison
Enforcement Division
Market Regulation
InvestigationsTitle
Enforcement Statutes
• Unfair Competition, Unfair or Deceptive Acts and Practices– IC 27-4-1-1
• Producer’s Statute– IC 27-1-15.6-12
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.
Person
• Individual–Agent–Broker–Adjuster–Navigator–Third Party
Adjuster– Independent
Adjuster
• Company–Agency–Underwriter
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
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
Catch-All
• IC 27-4-1-8
– Any method of competition or any practice not otherwise defined but deemed unfair or deceptive
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.
Procedure
• Hearings– Preliminary– Motions– Adjudicatory
• Settlement
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
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
Additional Causes
• Appointments list
• Child support order
• Failure to notify of administrative action in
another jurisdiction
• Failure to notify of a criminal prosecution
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
Penalties
• IC 27-1-15.6-12(b)
– Civil penalty
– Probation
– Suspension
– Revocation
Bail
• Qualifications
– IC 27-10-3-3
• Good Moral Character
• Disqualifying Offense
– Misdemeanor 5 years
– Felony 10 years
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
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
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
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
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