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Administrative Orders - 2007
Enforcement Orders
Company - Marketplace Violations

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ACE American Insurance Company
Philadelphia, Pennsylvania
Violation: Issued a group health insurance policy to unapproved associations.
Penalty: $15,000 fine
Date of Order: 04/30/2007; Amended:
Final
AIU Insurance Company
American Home Assurance Company
AIG Casualty Company
Commerce and Industry Insurance Company
Granite State Insurance Company
Illinois National Insurance Company
National Union Fire Insurance Company of Pittsburgh PA
New Hampshire Insurance Company
The Insurance Company of the State of Pennsylvania
Violation: Failed to comply with Oregon laws for processing claims of injured workers and reporting proof of insurance coverage. Used unapproved policy forms. Failed to accurately report workers' compensation premiums and claims data.
Penalty: $5 million fine, with $4 million suspended. The companies must comply with corrective actions contained in the order to avoid paying the suspended fine.
Date of Order: 07/05/2007; Amended: 01/28/2008
Stipulation and Final Order
Amendment of Stipulation and Final Order
Amended Exhibit A
Exhibit B
Farmers Insurance Company of Oregon
Tigard, Oregon
Violation: A market conduct examination of Farmers as of December 31, 2004, found that the company did not comply with Oregon insurance credit scoring laws. Farmers also did not handle automobile total loss settlements in accordance with policy provisions and statues and rules.
Penalty: $20,000 fine
Date of Order: 04/03/2007; Amended:
Final
Market Conduct Examination
Fidelity National Title Insurance Company
Jacksonville, Florida
Violation: Issued a title insurance policy not in compliance with its approved rate filing.
Penalty: $10,000 fine
Date of Order: 03/19/2007; Amended:
Final
GEICO General Insurance Company
Washington, D.C.
Violation: Failed to promptly and equitably settle a claim.
Penalty: $5,000 fine
Date of Order: 03/14/2007; Amended:
Final
Guarantee Trust Life Insurance Company
Glenview, Illinois
Violation: Issued a group health insurance policy to an unapproved association.
Penalty: $5,000 fine
Date of Order: 05/21/2007; Amended:
Final
Healthy Alliance Life Insurance Company
St. Louis, Missouri
Violation: Issued a group life insurance policy to an unapproved association.
Penalty: $5,000 fine
Date of Order: 02/06/2007; Amended:
Final
John Alden Life Insurance Company
Milwaukee, Wisconsin
Violation: Failed to apply creditable coverage from prior health insurance policies. Used impermissible information to evaluate the health status of applicants.
Penalty: $10,000 fine
Date of Order: 02/13/2007; Amended:
Final
Kaiser Foundation Health Plan of the Northwest dba Kaiser Permanente
Portland, Oregon
Violation: Failed to timely pay or deny clean health insurance claims.
Penalty: $10,000 fine
Date of Order: 10/12/2007; Amended:
Final
Kaiser Foundation Health Plan of the Northwest dba Kaiser Permanente
Portland, Oregon
Violation: Evaluated the health status of applicants for group health insurance.
Penalty: $10,000 fine
Date of Order: 11/08/2007; Amended:
Final
Mid-Century Insurance Company
Los Angeles, California
Violation: A market conduct examination of Mid-Century as of December 31, 2004, found that the company did not comply with Oregon insurance credit scoring laws. Mid-Century also did not comply with claims handling laws and did not handle total loss settlements in accordance with policy provisions and statues and rules.
Penalty: $20,000 fine
Date of Order: 04/03/2007; Amended:
Final
Market Conduct Examination
Nationwide Mutual Insurance Company
Columbus, Ohio
Violation: Failed to acknowledge and act promptly on claim communications.
Penalty: $10,000 fine
Date of Order: 11/08/2007; Amended:
Final
Northland Insurance Company
St. Paul, Minnesota
Violation: Failed to promptly and equitably settle a claim.
Penalty: $5,000 fine
Date of Order: 05/30/2007; Amended:
Final
PacifiCare of Oregon, Inc.
Lake Oswego, Oregon
Violation: Denied claims without conducting a reasonable investigation. Failed to acknowledge and act promptly on claim communications. Failed to timely respond to an inquiry from the DCBS director.
Penalty: $34,000 fine
Date of Order: 09/20/2007; Amended:
Final
Presidential Life Insurance Company
Nyak, New York
Violation: Issued a group health insurance policy to an unapproved association.
Penalty: $5,000 fine
Date of Order: 12/26/2007; Amended:
Final
Presidential Life Insurance Company
Dallas, Texas
Violation: Issued a group health insurance policy to unapproved associations.
Penalty: $15,000 fine
Date of Order: 05/30/2007; Amended:
Final
Reliance Standard Life Insurance Company
Philadelphia, Pennsylvania
Violation: Issued a group life insurance policy and a group health insurance policy to an unapproved association.
Penalty: $10,000 fine
Date of Order: 04/16/2007; Amended:
Final
Reliance Standard Life Insurance Company
Philadelphia, Pennsylvania
Violation: Issued a group health insurance policy to an unapproved association.
Penalty: $5,000 fine
Date of Order: 11/13/2007; Amended:
Final
Stonebridge Life Insurance Company
Plano, Texas
Violation: Issued a group health insurance policy to an unapproved association.
Penalty: $5,000 fine
Date of Order: 04/30/2007; Amended:
Final
The MEGA Life and Health Insurance Company
North Richland Hills, Texas
Violation: Violations included failing to: 1) notify insureds about potential creditable coverage, 2) refer to policy provisions in notices of claim denial, 3) provide information to insureds about its grievance and appeal procedures, 4) provide information to insureds about how to access the DCBS complaint line, 5) acknowledge grievances, 6) timely acknowledge grievances, 7) timely decide a grievance, 8) timely file with DCBS summaries of grievances and appeals, and external reviews, 9) timely acknowledge or pay claims, 10) acknowledge and act promptly on claim communications, 11) provide an explanation of portability coverage to insureds, 12) give the required notice to insurance producers before termination.
Penalty: $50,000 fine
Date of Order: 10/11/2007; Amended:
Final
Ticor Title Insurance Company
Jacksonville, Florida
Violation: Gave a thing of value to an intermediary.
Penalty: $6,000 fine
Date of Order: 10/17/2007; Amended:
Final
Time Insurance Company (Formerly known as Fortis Insurance Company)
Milwaukee, Wisconsin
Violation: Failed to apply creditable coverage from prior health insurance policies. Refused to pay claims without conducting a reasonable investigation. Used impermissible information to evaluate the health status of applicants. Issued policies using an unapproved form. Failed to timely notify claimants that it needed more time to accept or deny claims.
Penalty: $60,000 fine
Date of Order: 02/13/2007; Amended:
Final
United Healthcare Insurance Company
Hartford, Connecticut
Violation: United Healthcare Insurance Company and 25 of its subsidiaries and affiliates entered into a regulatory settlement agreement (RSA) to resolve "areas of concern" identified in a multi-state analysis of the companies. Areas of concern included claims processing; coordination of benefits; complaints, grievances, and appeals; responses to regulatory and consumer inquiries; and oversight of contracted entities.
Penalty: Among provisions of the RSA, the companies agreed to pay up to a $20 million fine, make corrective actions, and pay any claims that should have been paid. Oregon's share of the fine is estimated to be $42,346.03.
Date of Order: 08/23/2007; Amended:
Final
Regulatory Settlement Agreement