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Administrative Orders - 2002

Enforcement Orders

Company - Marketplace Violations

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AIU Insurance Company
New York, New York
Violation: Failed to implement reasonable claim investigation standards. Failed to promptly acknowlege or act on claim communications.
Penalty: $10,000 fine
Date of Order: 10/01/2002
Final
American Bankers Insurance Company of Florida
Miami, Florida
Violation: Authorized unlicensed persons to transact insurance. Failed to enter into written contracts with appointed agents. Failed to notify the DCBS director of an agent appointment.
Penalty: $30,000 fine
Date of Order: 08/22/2002
Final
Equitable Life and Casualty Insurance Company
Salt Lake City, Utah
Violation: Failed to notify other insurers regarding replacement of existing long-term care policies.
Penalty: $25,000 fine
Date of Order: 01/22/2002
Final
Fortis Insurance Company
Milwaukee, Wisconsin
Violation: Used impermissible information to evaluate an applicant's health status. Refused to pay a claim without conducting a reasonable investigation. Issued health insurance polices without providing maternity coverage. Failed to promptly respond to the DCBS director.
Penalty: $42,000 fine
Date of Order: 02/04/2002
Final
Globe Life and Accident Insurance Company
Oklahoma City, Oklahoma
Violation: Failed to timely pay interest on life insurance death benefits.
Penalty: $5,000 fine
Date of Order: 11/08/2002
Final
Great American Life Insurance company
Cincinnati, OH
Violation: Failed to maintain evidence of policy summaries in life insurance replacement transactions. Failed to timely send a policy summary to replaced insurer in life insurance replacement transactions.
Penalty: $10,000 fine
Date of Order: 06/27/2002
Final
GuideOne Specialty Mutual Insurance Company
West Des Moines, Iowa
Violation: Failed to promptly settle a claim. Failed to record pertinent information about a claim. Failed to promptly communicate with a claimant about a claim.
Penalty: $10,000 fine
Date of Order: 03/12/2002
Final
IGF Insurance Company
Des Moines, IA
Violation: Failed to timely complete an investigation of a claim. Failed to promptly settle a claim. Failed to promptly acknowledge a claim communication. Failed to promptly provide necessary claim forms. Failed to timely notify a claimant of continuation of investigation of his claim. Failed to promptly pay Personal Injury Protection benefits.
Penalty: $10,000 fine
Date of Order: 07/01/2002
Final
Jackson National Life Insurance Company
Lansing, Michigan
Violation: Terminated agents without 90 days notice.
Penalty: $10,000 fine
Date of Order: 10/21/2002
Final
Kelco, Inc.
Lexington, Kentucky
Violation: The Kentucky Insurance Commissioner suspended Kelco's resident life settlement provider license after Kelco was indicted by a federal grand jury on allegations of mail fraud, wire fraud, money laundering and conspiracy to commit money laundering.
Penalty: Oregon life settlement provider and broker licenses suspended
Date of Order: 11/25/2002
Final
Life Insurance Company of Georgia and Southland Life Insurance Company
Violation: Allegedly unfair underwriting and pricing practices, including use of race-based premiums
Penalty: The companies were fined $4 million in February 2002 following a multi-state market conduct examination. The fine was allocated to each participating state based on the percentage of the total affected policies issued to the state's residents. Of the approximately 2.5 million affected policies, only 18 were issued to Oregon residents. As a result, the minimum fine of $1,000 was allocated to Oregon.
Date of Order: 05/10/2002
Final
Regulatory Settlement Agreement
Life Wise, A Premera Health Plan, Inc.
Portland, Oregon
Violation: Failed to promptly provide an insured with the proper explanation of the basis used to deny a claim.
Penalty: $5,000 fine
Date of Order: 03/26/2002
Final
Metropolitan Life Insurance Company
Tampa, Florida
Violation: Allegedly used racially discriminatory practices in the sale of life insurance policies.
Penalty: The New York Insurance Department, on behalf of other state insurance regulators, entered into a Regulatory Settlement Agreement with MetLife on August 29, 2002. The agreement requires MetLife to pay certain benefits to all those whose policies currently are in force, those whose policies have terminated by death within the past seven years, and those whose policies have otherwise terminated since January 1989. The total number of affected policies is estimated to be as many as 1.8 million, of which approximately 4,651 are issued to Oregon residents. The total settlement benefits paid for all affected policies is estimated to be as high as $160 million, of which approximately $374,851 is expected to be paid to Oregon policyholders. The minimum benefit with respect to any policy is $10.
Date of Order: 11/05/2002
Final
Regulatory Settlement Agreement
National Health Insurance Company
Dallas, Texas
Violation: Failed to conduct a reasonable investigation of claims.
Penalty: $15,000 fine
Date of Order: 10/29/2002
Final
North American Marine General Insurance Company, Ltd.
Panama City, Panama
Violation: Transacted insurance in Oregon as an unauthorized insurer.
Penalty: Ordered to cease and desist from violating the Oregon Insurance Code
Date of Order: 10/18/2002
Final
Ohio National Life Insurance Company (The)
Cincinnati, OH
Violation: Terminated agent appointments without sufficient notice.
Penalty: $10,000 fine
Date of Order: 11/18/2002
Final
Prudential Property and Casualty Insurance Company
Holmdel, NJ
Violation: Used driving record information more than three years old.
Penalty: $5,000 fine
Date of Order: 02/28/2002
Final
Puget's Sound Agricultural Society, Ltd.
Georgetown, CA
Violation: Transacted insurance as an insurer without a certificate of authority.
Penalty: Cease and desist
Date of Order: 01/11/2002
Cease & Desist
Puget's Sound Agricultural Society, Ltd.
Georgetown, CA
Violation: Transacted insurance as an insurer without a certificate of authority.
Penalty: $10,000 fine
Date of Order: 02/06/2002
Final
ServicePlan, Inc.
Glenview, Illinois
Violation: Transacted insurance as an insurer in Oregon without a license.
Penalty: Cease and Desist
Date of Order: 01/18/2002
Final
ServicePlan, Inc.
Glenview, Illinois
Violation: Transacted insurance in Oregon without a certificate of authority.
Penalty: $50,000 fine
Date of Order: 07/01/2002
Final
Star Insurance Company
Southfield, Michigan
Violation: Failed to promptly pay bond claims.
Penalty: $21,000 fine
Date of Order: 07/22/2002
Final
Union National Life Insurance Company, United Insurance Company of America, and The Reliable Life Insurance Company
Violation: Allegedly unfair underwriting and pricing practices, including use of race-based premiums.
Penalty: The companies were fined $1.25 million in May 2002 following a multi-state market conduct examination. The fine was allocated to each participating state based on the percentage of the total affected policies issued to the state's residents. Of the 391,538 affected policies, only 18 were issued to Oregon residents. As a result, the minimum fine of $1,055 was allocated to Oregon.
Date of Order: 06/11/2002
Final
Regulatory Settlement Agreement
Western Grocers Employee Benefits Trust
Portland, Oregon
Violation: Failed to comply with market conduct examination recommendations.
Penalty: $5,000 fine
Date of Order: 07/01/2002
Final