Category Archives: Regulation

Senate Panel Meets
On COVID-19 Fraud

The Senate Judiciary Committee last week held a  hearing  titled “COVID-19 Fraud: Law Enforcement’s Response to Those Exploiting the Pandemic.”   

The hearing included testimony by William Hughes, associate deputy attorney general, U.S. Department of Justice; Craig Carpenito, U.S. attorney, District of New Jersey; Calvin Shivers, assistant director, Criminal Investigative Division, Federal Bureau of Investigation; and Michael D’Ambrosio, assistant director, U.S. Secret Service, Department of Homeland Security. 

Testimony focused on the response to fraud that has resulted from the COVID-19 pandemic. Examples included sale of fraudulent personal protective equipment (PPE) and cyber-enabled fraud; price gouging and hoarding; and fraud relating to the CARES Act’s Paycheck Protection Program (PPP). 

As demand for PPE has been greater than the supply, the environment created has been “ripe for exploitation,” Shivers said.  

In addition to sales of counterfeit PPE, he cited “advance fee” schemes – in which a victim prepays for goods like ventilators, masks, or sanitizer that are never received – and business email compromise (BEC) schemes, which involve spoofing an email address or using one that’s nearly identical to one  trusted by the victim to instruct them to direct funds to bank accounts controlled by the fraudsters. 

Shivers said the FBI is working to educate “the health care industry, financial institutions, other private sector partners, and the American public of an increased potential for fraudulent activity dealing with the purchase of COVID-19-related medical equipment.”  

He added that millions of units of PPE have been recovered from price-gouging and hoarding operations and the FBI is working to determine next steps for how to redistribute or sell the PPE. 

D’Ambrosio said that although “criminals throughout history have exploited emergencies for illicit gain, the fraud associated with the current COVID-19 pandemic presents a scale and scope of risks we have not seen before.” 

He described four categories of threat: 

  1. COVID-19-related scams, including the sale of fraudulent medical equipment and nondelivery scams;  
  1. Cybercrime like BECs, exploiting increased telework; 
  1. Ransomware and other activities that could disrupt pandemic response; and 
  1. Defrauding government and financial institutions associated with response and recovery efforts. 

Thus far, the Secret Service has initiated over 100 criminal investigations, prevented approximately $1 billion in fraud losses, and disrupted hundreds of online COVID-19-related scams, D’Ambrosio said. 

CORONAVIRUS WRAP-UP: PROPERTY AND CASUALTY (4/27/2020)

Accounting Rules
NAIC Working Group Approves Flexible COVID-19 Accounting Rules
Automobile Insurance
How the Coronavirus Could Change U.S. Personal Auto Insurance
Business Interruption
Travelers, Insured Law Firm Spar Over Civil Authority Business Income Loss Claim
States Seek to Force Insurance Companies to Pay Those With Business Interruption Policies
Covid-19 Business Interruption Existential Threat, Reinsurance Capital Availability Key: Willis Re
Credit Insurance
Governments should backstop trade credit
Litigation
The Race Is on to Lead Business Interruption Insurance Litigation
What Won’t Cure Corona: Lawsuits
6 Types Of Employment Lawsuits To Expect In The Wake Of COVID-19
Editorial: Stopping a Lawsuit Epidemic
Kudlow: Businesses shouldn’t be held liable for employees and customers getting coronavirus
Corporate America Seeks Legal Protection for When Coronavirus Lockedowns Lift
Profits & Losses
Coronavirus Costs Weigh on Travelers’ Profit
Coronavirus Will Be Largest Event in Insurance History, Says Chubb CEO
Coronavirus To Be Largest Industry Loss Ever: Chubb’s Greenberg & Lloyd’s Neal
Covid-19 P&C Insurance Industry Loss Estimated $40bn – $80bn: Dowling
Chubb Classifies Covid-19 as a Catastrophe Event
Covid-19 Claims Manageable, But Reinsurers Face Formidable Challenges: Willis Re
Specialty Lines
Companies Can Expect Higher D&O Rates, Lower Limits: Experts
Lack of Adequate Insurance Puts Healthcare Workers At Risk of Malpractice Lawsuits
Workers Compensation
States Easing Path to Workers Compensation Benefits for Coronavirus Workers
Changing Virus Guidance Creates Balancing Act For Essential Employers
Employers Pushing Back as States Expand Work Comp to Cover COVID-19
Workplace Safety For COVID-19 Essential Workers
From the Triple-I Blog:
TRIPLE-I CEO AMONG PANELISTS DISCUSSING BUSINESS INTERRUPTION INSURANCE LEGISLATION
INSURERS RESPOND TO COVID-19 (4/24/2020)
CORONAVIRUS WRAP-UP: LIFE AND HEALTH INSURANCE (4/22/2020)
CORONAVIRUS WRAP-UP: DATA AND VISUALIZATIONS (4/20/2020)

CORONAVIRUS WRAP-UP: PROPERTY AND CASUALTY (4/17/2020)

Auto Insurance
Stay-at-home Pandemic Orders Reduce Auto Claims Almost by Half
As Coronavirus Empties Streets, Speeders Hit the Gas
Business Interruption
UK Watchdog Orders Insurers to Pay Small Business Claims Quickly
Cannabis Insurance
Pandemic Could Shrink Cannabis Insurers’ Premiums, Market
Cyber Insurance
Preventing Losses Due to Growing Cyber Crime During Coronavirus Crisis
As Attacks Rise, Paladin Offers Cybersecurity Platform Free to Insurance Agencies
Disaster Preparedness
‘Uncharted Territory’ as Wildfire Fighting Adapts to Pandemic
Insurance-Linked Securities
Artemis Live: Interview with Tom Johansmeyer, Head of PCS
Litigation
Nashville Bar Sues Insurer Over COVID-19 Loss Claim. Experts Say It Won’t Be the Last
Businesses Warn Fear of Liability Lawsuits Could Stall Rebooting of Economy
P/C Industry Impact
Suddenly There is Big Demand for Pandemic Cover, Says Underwriter
Chubb CEO: Forcing Insurers to Pay Pandemic Loss Claims is ‘Plainly Unconstitutional’
Allianz CEO: Pandemic Hit “Like a Metororite”
From Hacker Attacks to Shareholder Lawsuits, Insurance Industry Braces for COVID-19 Fallout
Public Health and Safety
What FDA Says About Food Safety Amid COVID-19
Travel Insurance
Travelers Consider Their Risk Tolerance
HOLIDAY HELL How to Get a Refund on Your Holiday if it’s Cancelled and How Long Should it Take to Get Cash Back
Workers Compensation
Workers Compensation in Wake of COVID-19

From the Triple-I Blog:
INSURERS RESPOND TO COVID-19 (4/17/2020)
TRIPLE-I BRIEFING: SURPLUS IS KEY TO INSURERS KEEPING POLICYHOLDER PROMISES
PUTTING CAR INSURANCE PRICES INTO PERSPECTIVE

CORONAVIRUS WRAP-UP: PROPERTY AND CASUALTY (4/16/2020)

Legislation and regulation
Democrats Plan Legislation to Force Insurance Companies to Pay Out for Pandemic Losses
Thompson Introduces the Business Interruption Insurance Coverage Act
Lawmakers Advocate Stimulus Aid to Insurers on Business Interruption
SC Proposes Bill Over Coronavirus-related Business Interruption Claims
NJ offers grace period for insurance premium expenses
Coronavirus Regulations: A State-By-State Week In Review
Litigation
COVID-19, business interruption and bad faith litigation
P/C Industry Impact
No Evidence COVID-19 Industry Loss Will Match Large Catastrophe Years: Flandro
How Insurance Claims Pros Are Adjusting to Pandemic Complications
COVID-19 Response ‘Could Bankrupt the Insurance Industry’: Insurance Defense Lawyer
Coronavirus response: Short- and long-term actions for P&C insurers
Auto Insurance
Analysts: Auto Insurance Coronavirus Rebates a Solid Move in Short Term
Will Fewer Drivers on the Road Mean Lower Auto Losses? It Depends
Auto Insurers Offer Rebates as Traffic Abates During Pandemic
Business Interruption
Neglecting Idle Facilities Amid COVID-19 Will Cost Companies, Warns FM Global
Cyber
Working From Home? Don’t Let Cyber Criminals Break In
Hospital Hackers Seize Upon Coronavirus Pandemic
Workers Compensation
COVID-19 Comp Expansions Could Have Significant Impact on Industry

I.I.I. Weighs in on Two House Bills That Would Affect Auto Insurance

Triple-I recently was asked to comment on two measures now before the House Committee on Financial Services. H.R. 1756, an amendment to the Fair Credit Reporting Act, would prohibit use of credit information in underwriting or pricing auto insurance.  H.R. 2684  would require the Treasury Department’s Federal Insurance Office (FIO) to annually study personal private auto insurance.  

Our input is summarized below. 

H.R. 1756

The insurance credit score is applied to create a rate appropriate to the customer’s riskiness. These scores help insurers avoid charging high-risk customers too little and low-risk customers too much. Every dollar of discount a person with a low score receives is offset by an extra dollar of surcharge to a person with a high score.  

Introduced in the late 1980s, the scores have been studied numerous times and found to be a powerful predictor of the likelihood a consumer will become involved in an accident. Concerns have been raised that the scores act as a proxy for income – a  variable insurers are banned from using. Recent research finds that this isn’t the case. 

Most recently, in 2019 Triple-I and the Casualty Actuarial Society produced a white paper “Insurance Rating Variables: What They Are And Why They Matter” that explains how actuaries rigorously study variables for their effectiveness and impact on the societal goal of keeping insurance available and affordable. 

H.R. 2684

Under H.R. 2684, it appears FIO would be required to annually gather premiums charged and quoted from insurers that write personal auto coverage, along with rating factors, underwriting guidelines, and any information used to compile them.  

This would be an enormous undertaking. There are more than 250 million private vehicles in the United States – 87 percent of them insured.  But the dataset would be much larger. The proposal also asks for every quote issued to policyholders and other applicants. Each renewal policy gets at least one quote – the renewal at existing terms. Anyone who shops for insurance receives more. 

Once the information is collected, the bill would require the release of each insurer’s data, rating algorithms, and underwriting guidelines to the public – including the insurer’s competitors. This would be like requiring a drug manufacturer to give up all its patents annually. Insurers would have no incentive to innovate to find, for example, variables that do a better job than the current ones because, once discovered, the variables would have to be turned over to competitors.  

Insurance Rating Variables: A Closer Look

Figuring out what the cost of an insurance premium should be is quite complicated — so complicated that insurance companies employ entire actuarial departments to do just that. Rating variables are an indispensable tool for setting the cost of insurance.

In a new paper, Insurance Rating Variables: What they are and why they matter, the Insurance Information Institute (I.I.I.) and the Casualty Actuarial Society (CAS) explain why actuaries apply variables when setting rates – for example using a driver’s age and gender, accident history and vehicle model year to calculate the premium on an auto policy.

Rating variables are basically the characteristics of individual policyholders that can help approximate the cost of their risks. Insurance companies have been using rating variables to help set rates (and thereby price their policies) for decades.

However, the use of some rating variables has recently generated discussion within the United States. Some states have even passed legislation controlling the use of certain variables, such as gender.  “Variables are designed to make insurance affordable and available to everyone,” said Ken Williams, FCAS, CAS staff actuary. “When a variable is removed from rate setting, the consumer stands to lose the most because lower-risk individuals will end up subsidizing higher-risk individuals; or, insurance companies may choose to accept fewer applications from consumers who might cause them to lose money.”

The paper explains that when regulators restrict the use of a particular variable, actuaries may replace it with another variable as a “proxy,” which might not help them price policies as well.

“Imagine that male drivers have higher accident costs and are more likely to drive pickup trucks,” Williams explained. “If gender is restricted, the proxy for gender could become pickup trucks. In this scenario, rates for pickup trucks may increase while rates for other types of vehicles may decrease.”

It is important to note that all rating variables, including proxies, are regulated in every state. For example, rating variables and proxies cannot directly or indirectly impact groups based on certain characteristics, such as race.

The paper notes that the use of rating variables has resulted in a drastic reduction in the number of consumers seeking coverage in state-supported auto risk pools. Since the increased use of rating variables, the number of consumers in assigned risk pools has decreased almost 90 percent.

James Lynch, FCAS, chief actuary and vice president of research and education at the I.I.I., added, “Rating variables are regulated by state and federal authorities and they meet a variety of important criteria: they are credible, objective, and verifiable. They are an essential tool for setting accurate prices that are lower for low risk customers, higher for high risk customers, yet sufficient to cover an insurer’s costs.”

Here are a few key points from the report:

  • Insurance companies use rating variables to develop premiums that better reflect the risks that consumers face.
    • Rating variables are characteristics of individual consumers that can help approximate the cost of their risks, like vehicle model year in auto insurance or the age of a building in homeowners insurance.
    • Rating variables help ensure that less risky consumers pay lower rates than consumers who are at greater risk.
  • Rating variables are studied rigorously by actuaries for their effectiveness and impact on the societal goal of keeping insurance available and affordable. They are also closely regulated.
    • Actuaries are very careful to make sure that each variable is effective and is subject to a wide range of criteria, including being credible, objective, verifiable, and inexpensive to administer.
    • Actuaries also make sure variables are legal. Variables are subject to regulation, and state and federal laws prohibit using rating variables that either directly or indirectly impact groups based on characteristics such as race, nationality, religion, or income.
    • Almost every state in the U.S. has the regulatory authority to reject a rating variable that it feels does not meet state requirements.
  • Widespread use of rating variables has given consumers more choice and more fairness in the insurance marketplace.
    • The ability to set accurate prices is a cornerstone to setting actuarially sound premiums that are lower for low risk customers, higher for high risk customers, yet overall sufficient to cover all the insurer’s costs.
    • Better and more available data for use in rating variables means increased ability to determine a person’s exact risk profile.
  • Restriction of rating variables that do their job well can lead to potential unintended consequences for the consumer.
    • Restrictions on some variables may result in lower-risk consumers effectively subsidizing higher-risk consumers.
    • Restricting rating variables affects consumers much more than it impacts insurance companies.

Click here to read the paper.

 

Insurance Commissioner challenges Guinness record for tallest politician

istock

On March 27, Guinness World Records named Brooklyn councilman Robert Cornegy as the tallest male politician in the world. But his title was disputed by North Dakota insurance commissioner Jon Godfread who claims that he stands an inch and 3/4 higher than Cornegy’s 6 feet, 10 inches.

Godfread, who played basketball at the University of Iowa, said he didn’t know that “being a tall politician was a thing,” and that he’d probably get in touch with Guinness. A spokeswoman from Guinness said that the organization would be “be happy to receive an application” from Godfread.

Guinness keeps track of a wide range of unusual records. Insurance related records include: The highest ever insurance valuation ($100 million) of a painting for the move of the Mona Lisa from Paris to the U.S. for a special exhibition; Pittsburgh Steelers’ Troy Polamalu highest insured hair ($1 million); and the largest ever life insurance policy ($201 million).

 

 

Impact of new TX insurance law exaggerated

A new property litigation law goes into effect in Texas on Sept. 1. Its impact has been exaggerated.  (If you read the entire story at this link, you will see that it debunks its own headline.)

If you will be filing a homeowners insurance claim, here is what you need to know:

Under the new property litigation law:

  • The claims process for filing a claim for an insurer to handle a claim has not changed.
  • Consumers still have all legal remedies available under the consumer protection laws in the event an insurer engages in bad faith conduct.
  • The Texas Department of Insurance is available to handle any complaints about insurers.
  • The new law does not take away any right to sue and does not diminish any cause of action that a person has against an insurance company. HB 1774 does, however, require notice before a lawsuit is filed.
  • The pre lawsuit notice is effective for all “actions filed on and after the effective date, which is September 1, 2017.” Any lawsuit filed after September 1, 2017, would be governed by the new law.

Texans should contact their insurance companies directly to file claims, work with your adjuster to identify all damages and coverages, and resolve your claim quickly.

Guaranty Funds: A Safety Net For Policyholders

News headlines about the failure of long-term care insurer Penn Treaty American Corp. of Allentown, Pennsylvania, underscore that while failures of U.S. insurers are rare, they are possible.

The New York Times reports that the order from state authorities calling for the liquidation of the medium-sized insurer and the closure of its operations leaves tens of thousands of Penn Treaty policyholders in limbo.

The good news is that a safety net exists to protect policyholders.

For decades, life/health (including long-term care) and annuity policyholders, as well as property/casualty insurance customers have been protected against the insolvency of an insurance company through what is known as a guaranty fund system.

So in this case, state life and health insurance guaranty funds will continue to service the policies of Penn Treaty policyholders, ensuring that they continue to receive coverage, despite the insurer’s failure.

To be eligible for guaranty fund coverage protection, it is important that policyholders continue to pay their policy premiums in full and on time.

Maximum levels and types of policies covered by state guaranty funds vary from state to state. Here is a list of the maximum amount each state’s guaranty fund will pay.

More information on the Penn Treaty Network America Insurance Company liquidation via the National Organization of Life & Health Insurance Guaranty Associations.

And here is additional background information on insolvencies and state guaranty funds, via the I.I.I.