Insurers can and must improve theirclaims-handling and underwriting practices in several key areas.That's the message market conduct regulators are sending toboth life and health and property and casualty (p&c)insurers.

When the regulatory experts at Wolters Kluwer FinancialServices reviewed and analyzed the results of last year'sstate market conduct exams, two criticisms were cited mostfrequently: p&c insurers' failure to handleclaims within specified time frames and their use ofunapproved forms and rates.

The Waltham, Mass.-based compliance and risk managementservices provider condensed the findings of its annualreport to a “top 10″ list in order to create an easyreference to assist insurers seeking to minimize theircompliance risk exposure. When asked to explain what maybe preventing insurers from staying compliant, Kathy Donovan,senior compliance counsel of insurance at Wolters Kluwer FinancialServices, had this to say:

“The regulatory landscape is getting more complex as industryrequirements and laws change constantly under the direction ofgovernment and industry oversight,” she explained. “[This makes] itextremely challenging to embed regulatory requirements into claims,underwriting, and distribution processes. [However] strongregulatory change management processes and frequent self-audits areextremely effective in helping [insurers] stay on top of thesechanges.”

In addition to the complaints notedbelow, regulators criticized insurers for the manner inwhich they maintain complaint handling; their failure to providerequested data to market conduct examiners; and a failure toconduct business in their “own name.”

This marks the ninth year that Wolters Kluwer hascompiled the report. The 10 most common compliance criticismsfor p&c insurers are:

1. Failure to acknowledge, to pay, or to denyclaims within specified time frames.

2. Using unapproved/unfiled forms andrates.

3. Failure to provide required compliantdisclosures in claims processing.

4. Improper documentation of underwritingfiles.

5. Failure to maintain claimsdocumentation.

6. Failure to process/pay total loss claimsproperly.

7. Failure to provide required compliantdisclosures in underwriting processing.

8. Failure to adhere to producer appointment,termination and/or licensing requirements and adjuster licensingrequirements.

9. Failure to issue compliant adverse actionunderwriting notices.

10. Failure to apply rates, rules andguidelines correctly.