Wolters Kluwer performs an annual Market Conduct Issue Evaluation for Property and Casualty carriers across the country and publishes the results.

The Top 10 issues from 2010 will not surprise frequent readers of this blog:

  1. Failure to properly acknowledge, investigate, pay or deny claims within specified time frames.
  2. Failure to cancel or non-renew in accordance with requirements
  3. Using unapproved forms, unfiled rates and/or misapplication of rating factors.
  4. Failure to adhere to producer appointment, termination, and/or licensing requirements and adjuster licensing requirements.
  5. Failure to prove disclosures in the claims process
  6. Improper documentation of claim files
  7. Failure to process total loss claims properly
  8. Failure to pay the appropriate claim amount
  9. Failure to adhere to underwriting rules and/or provide required disclosures
  10.  Failure to respond to the department of insurance and/or produce records requested during the exam process

Marc Lanzkowsky, a main author on The Claims Spot blog, recently posted Insanity: Claim’s Departments Can’t Expect Different Results Without Changing Their Organizations. The post included a diagram of the Wolters Kluwer results from 2006-2010. This diagram shows that claim problems have repeatedly been market conduct issues. Take a look at Lanzkowsy’s diagram below and be sure to read the comments posted in response to his blog post for a candid look at what readers think is going on nationwide.