Missing claims deadlines, improper policy termination andfailure to pay claims properly top the list of reasons whyproperty-casualty insurers are out of compliance during marketconduct exam, according to the 5th annual listing by Wolters KluwerFinancial Services, a Minneapolis provider of compliance, content,and technology solutions and services. The list separatesproperty-casualty from life and health insurers.

Property-casualty insurance market conduct compliancecriticisms

1. Failure to acknowledge, pay or deny claims within specifiedtime frames

2. Failure to properly terminate a policy, including inadequatedays' notice, improper reasons and omitted required language

3. Failure to pay claims properly (sales, tax, loss of use)

4. Improper documentation of claim files

5. Using unapproved or unfiled rates and/or rating errors

6. Failure to provide required and appropriate disclosures, suchas selection/rejection or coverage notices in the underwritingprocess or notices such as statute of limitations, reasons fordenials, and bill of rights in the claims process

7. Failure to use licensed producers and provide propernotification of producer appointments or terminations, includingmaintenance of producer register

8. Failure to communicate a delay in the settlement of claims inwriting

9. Using unapproved or unfiled forms

10. Use of unlicensed claims adjusters or appraisers.

Life and health Insurance market conduct compliancecriticisms

1. Failure to adhere to advertising requirements

2. Failure to adhere to replacement requirements

3. Failure to use licensed and appointed producers, and failureto provide proper notification of producer appointments orterminations, including maintenance of producer registers

4. Failure to adhere to grievance and appeals and utilizationreview requirements

5. Improper documentation of files

6. Failure to properly terminate a policy, including conversionrequirements

7. Failure to properly acknowledge, pay, investigate or denyclaims within specified time frames

8. Using unapproved, unfiled or noncompliant forms

9. Failure to provide required disclosures, such as explanationof benefits statements, coverage issues, fraud warnings, free-lookperiods, right of appeal or guaranty fund notices

10. Failure to pay claims properly.