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