Operational gaps and regulatory compliance violations are a constant threat to agents, insurers, InsurTechs, managing general agents (“MGAs”), third-party administrators (“TPAs”), and others operating in the U.S. property and casualty insurance market.
Compliance penalties are serious and can include cease and desist orders, consent orders, fines, license suspensions, or the loss of the company’s certificate of authority. Internal inefficiencies, lack of proper controls, insufficient analysis or testing of processes, and/or unfamiliarity with regulatory requirements are often the cause of the violations resulting in penalties.
However, those operating in the insurance market are not sitting ducks for regulatory action. Avoiding these risks – and mitigating their consequences – is possible through mock market conduct exams.
Here are seven reasons why you should undergo this valuable self-assessment as soon as possible.
1. Identify risks before regulators do
Regulators expect you to understand insurance regulatory requirements and be able to demonstrate compliance. Mock market conduct exams compare your processes, procedures and output, such as premium and claim files, to requirements to validate compliance or to identify gaps and provide recommendations for remediation.
2. Protect your reputation
Beyond the lost time and high costs of state Department of Insurance (“DOI”) penalties, negative findings from regulatory bodies can jeopardize your reputation with policyholders, shareholders, your current and potential customer base, and the industry at large. Operational gaps and compliance violations may also bring damages in possibly the most impactful form, that of long-term reputational risk and negative financial impact, such as devaluation of stock or a downgrade in AM Best rating. Conducting regular mock market conduct exams enables you to move forward with confidence that your company will stand up to regulatory scrutiny in the event you undergo an examination.
3. Be proactive with DOIs
Most states encourage you to report issues you surface internally and often allow you to do so in a confidential manner. By conducting self-assessments, and reporting as appropriate, there is often a longer runway for completing the remediation process which allows you to take a more deliberate and planned approach instead of disrupting workflow by shifting your teams’ attention to responding to regulatory requests, which are most often more time sensitive.
4. Reveal “what you don’t know”
Mock market conduct exams are particularly useful for InsurTech companies or companies that are new to the insurance space. The insurance industry contains many regulatory requirements (both obvious and obscure) that can require comprehensive operational protocols and controls. Working with an experienced insurance compliance services partner fast-tracks the awareness and correction of compliance and operational issues that may have otherwise remained hidden until identified through the hands of regulators.
5. Remove blind spots
Compliance is a top consideration for most who operate in the insurance market, but it’s often difficult for internal business units to conduct detailed reviews of processes in which they are already deeply immersed. “Business as usual” is great for achieving day-to-day efficiency, but internal teams may be unaware of their own blind spots. Working with an outside insurance compliance services provider on a mock market conduct exam brings an independent perspective that can reveal previously unseen procedural weaknesses and/or compliance gaps.
6. Correct issues before they become problems
Small issues tend to quietly compound until they become complex, costly problems. Mock market conduct exams can identify if you have correct, efficient processes in place to address regulatory requirements and/or inquiries from regulators or alert companies to ineffective processes that could lead to violations down the road.
For example, a review of policy files may identify that the rates and rules loaded into the policy admin system and/or forms issued to the policyholder are different than those on file with the regulatory authority.
Identifying gaps and/or non-compliance ahead of a DOI inquiry or action enables you to correct these issues before they cause widespread non-compliance.
7. Prevent costs from spiraling
Mock market conduct exams are controlled investments that protect you against expensive DOI examinations. When examiners from regulatory authorities perform a desk exam or arrive on-site to administer an exam, your company will be on the hook for their time and travel expenses. DOI exams can be more than three times more expensive than conducting a mock market conduct exam with an experienced insurance compliance services partner. Time, fines and reputational harm impact your bottom line; mock market conduct exams improve the likelihood of shorter exams, less business interruption and fewer regulatory actions.
Partner with experts
At Perr&Knight, our depth of operational and compliance knowledge enables us to conduct thorough mock market conduct exams that are relevant to today’s regulatory landscape. We also offer related services including Operational Process and Documentation Reviews and DOI Exam Preparation / Response Training and Guidance.
Performing a mock market conduct exam allows you to proactively obtain an understanding of your operations before gaps and compliance violations result in regulatory action.