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Insurance Department Fines Conseco Under Pennsylvania-Led, Multi-State Agreement

ich is not actively writing new policies, will automatically review 1,112 claims that were initially denied; it will provide notices to another 18,000 policyholders covering 49,000 claims that may have been partially denied or subsequently denied after initial payment; and will set up a toll-free call center for all claimants who believe their claim settlement was not handled properly. The department's investigation found that the primary problems in most cases were delays in claim payments rather than outright claim denials.

In the case of Bankers Life and Casualty Insurance Company, which is writing new policies, the investigation uncovered inadequate marketing and sales compliance issues. The settlement requires Bankers to:

-- Enhance its producer (agent) training program;

-- Eliminate producer complaint thresholds so that a single complaint can

result in disciplinary action;

-- Regularly review experience-period results for all producers; and

-- Supervise all producers and terminate them due to non-compliance with

marketing standards.

Going forward, both companies are required to:

-- Revise claims-handling procedures to guarantee timely and accurate


-- Handle all complaints completely and in a timely fashion;

-- Create a centralized complaint data base; and

-- Establish a countrywide contact for complaints.

Regulators will conduct ongoing monitoring for appropriate compliance benchmarks for complaint and claims processing; implement quarterly reporting requirements to the department; and, ultimately, conduct a re-examination of the companies to ensure that all problems have been corrected.

This multi-state examination was coordinated with the National Association of Insurance Commissioners' (NAIC) market analysis working group and was conducted on behalf of more than 40 participating states under the leadership o

SOURCE Pennsylvania Department of Insurance
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