Congress Could Set Insurance Oversight Of States

By Steven Brostoff, Washington Editor

NU Online News Service, May 8, 2:53 p.m. EDT, Washington?Congress may have to act unless the states take immediate steps to upgrade and rationalize oversight of market conduct in the insurance industry, the chairman of the House Financial Services Committee warned.

"We will be discussing a number of short-term legislative proposals to fix the state system later this year, and hope that the states can act quickly and effectively in this case to protect consumers on their own before Congress needs to step in and provide additional impetus," Rep. Mike Oxley, R-Ohio, said.

Rep. Oxley delivered his comments at a Tuesday hearing called by the Financial Services Subcommittee on Oversight and Investigations, which is chaired by Rep. Sue Kelly, R-N.Y.

Rep. Oxley said that the current system lacks "both strategic design and uniformity, with the rules of the game too uncertain and limited state resources wasted on inefficient and often duplicative regulation."

Rep. Kelly added that consumers are harmed by the current "patchwork" of state systems that involve too much duplication, with too few standards and no systematic approach to detect patterns of improper conduct.

"We need to develop a systematic, comprehensive approach with clear standards that will target resources more efficiently," she said.

This does not mean that states should enact more regulations that would create more unnecessary burdens on the entire insurance industry, she said. "Put simply, we do not need to pursue more regulation, but more effective regulation."

Richard J. Hillman, director of financial markets and community investment for the United States General Accounting Office, said a GAO investigation reveals that while all states do some level of market analysis, few have established formal programs to maintain a systematic and rigorous overview of company behavior that would effectively identify problem companies for detailed review.

Moreover, Mr. Hillman said, the number of market conduct examiners differs widely among states and there are no generally accepted standards for training and certification of examiners.

Most states try to regulate the behavior of all companies selling insurance within their borders, he said, which is an overwhelming burden given that anywhere from 900 to 2,000 companies operate within each state. And because many states do not coordinate market conduct exams, some companies are examined frequently, while others not at all, he said.

The National Association of Insurance Commissioners in Kansas City, Mo., has taken steps to improve the consistency and quality of market conduct exams, he said, but progress has been slow.

"If NAIC cannot convince the various states to adopt and implement common standards for market analysis and examinations, current efforts to strengthen these consumer protection tools are unlikely to result in any fundamental improvement," Mr. Hillman said.

Terry Parke, a member of the Illinois State legislature and former president of the National Conference of Insurance Legislators, said that state legislators understand the problem.

Indeed, he said, NCOIL sponsored a study by PricewaterhouseCoopers and Georgia State University which identified wide disagreements regarding the purpose of market conduct examinations and little coordination among states, leading to widespread and wasteful redundancies.

He said the report, which will be considered at an upcoming NCOIL meeting, recommends a comprehensive self-policing market conduct program.

The proposal includes standards for a compliance program, including CEO certification of compliance, incentives for self-assessment activities and a comprehensive system for filing consumer complaint information.

It would give insurers' states of domicile responsibility for surveillance with coordinated targeted multistate examinations and the development of model legislation.

The concept of a self-policing system in not unique to the insurance industry, Mr. Parke said. He cited the recent anti-money laundering requirements promulgated by the Securities and Exchange Commission as an example of a self-policing program that allows companies to design systems tailored to their specific business environments.

"Insurers should be accountable for their own monitoring and compliance with uniform state standards," he said.

"Regulators should pursue abuses and take actions that will result in the mitigation of the greatest harm and restoration of the greatest benefit to consumers and the public," he said.

But J. Robert Hunter, director of insurance for the Washington-based Consumer Federation of America, said that the market conduct record by the industry is "abysmal."

He also said that consumers strongly oppose self-certification proposals developed by NCOIL and by some in the industry. In a post-Enron environment, reliance on self-certification is problematic at best, he said.

Minimum standards for market conduct examinations would be good for consumers only if the standards are high and they are enforced, he said. "We agree that consistency in market standards is a good approach, but we are very concerned about weak uniform standards."

In addition, he said, a strong, consumer-oriented market conduct program must contain other elements, including private causes of action that provide restitution to consumers who have been harmed, consumer feedback and data collection. In particular, Mr. Hunter said, NAIC should be collecting data to determine whether redlining is taking place and how insurers use credit scores.

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