UNITED SERVICES AUTOMOBILE ASSOCIATION (NAIC# 25941) USAA CASUALTY INSURANCE COMPANY (NAIC# 25968) 9800 Fredericksburg Road San Antonio, TX 78288

Transcription

1 UNITED SERVICES AUTOMOBILE ASSOCIATION (NAIC# 25941) USAA CASUALTY INSURANCE COMPANY (NAIC# 25968) 9800 Fredericksburg Road San Antonio, TX EXAMINATION DATE: July 9, 2001 EXAMINATION PERIOD: May 1, 2000 THROUGH April 30, 2001 BY: MARKET CONDUCT EXAMINERS OF THE MARYLAND INSURANCE ADMINISTRATION

2 PARRIS N. GLENDENING GOVERNOR STEVEN B. LARSEN COMMISSIONER KATHLEEN KENNEDY TOWNSEND LIEUTENANT GOVERNOR DONNA B. IMHOFF DEPUTY COMMISSIONER STATE OF MARYLAND MARYLAND INSURANCE ADMINISTRATION 525 ST. PAUL PLACE, BALTIMORE, MARYLAND WRITER S DIRECT DIAL: Facsimile Number: dewen@mdinsurance.state.md.us ROBERT BECKER ASSOCIATE COMMISSIONER PROPERTY & CASUALTY I, Steven B. Larsen, Insurance Commissioner of the State of Maryland, do hereby certify that the annexed copy of the Market Conduct Examination United Services Automobile Association and USAA Casualty Insurance Company, as of April 30, 2001, whose home office is located at 9800 Fredericksburg Road, San Antonio, TX 78288, is a true copy of the original report, as amended, on file with the Maryland Insurance Administration and also includes a true copy of the Order/Consent Agreement issued as a result of the findings set forth therein. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the official seal of this Administration at the City of Baltimore, Maryland this 9 day of May Signatures on file with original Steven B. Larsen, Insurance Commissioner

3 TABLE OF CONTENTS PAGE SALUTATION... 1 I. EXECUTIVE SUMMARY... 2 II. SCOPE OF EXAMINATION... 3 III. COMPANY PROFILE... 4 IV. CERTIFICATE OF AUTHORITY... 5 V. SALES Agent Licensing... 6 Issue A Ins (a)(1)... 7 Issue B Ins (a)(1)... 8 Issue C Ins (b)(1)(2) VI. SUMMARY OF RECOMMENDATIONS VII. CLOSING VIII. EXAMINATION REPORT SUBMISSION Exhibits... 14

4 The Honorable Steven B. Larsen Commissioner of Insurance State of Maryland 525 St. Paul Place Baltimore, Maryland Dear Commissioner Larsen: Pursuant to your instructions and authorization, a targeted examination has been made of the market conduct affairs of the UNITED SERVICES AUTOMOBILE ASSOCIATION UNITED SERVICES CASUALTY COMPANY whose home office is located at 9800 Fredericksburg Road, San Antonio, TX The report of such Examination is being respectfully submitted. Sincerely, Signatures on file with original Dudley B. Ewen, Chief Examiner P/C Market Conduct Section der/usaa Proposed Report.doc

5 I. EXECUTIVE SUMMARY The Maryland Insurance Administration (hereinafter referred to as "MIA") previously performed Market Conduct examinations which highlighted the fact that employees, working in the Member Acquisition Center, were soliciting on behalf of United Services Automobile Association and USAA Casualty Insurance Company, hereinafter referred to as the Companies, without appropriate qualifications as an agent. The Companies, in response to the prior Market Conduct examination, sent a letter dated September 16, 1998 (Exhibit A) indicating, "...we will accept the Department's determination that its salaried representatives who engage in solicitation, negotiation or binding of coverage are subject to the requirement to obtain an agent's license." The Companies further stated, "We also agreed to propose an action plan establishing the process that USAA will utilize to accomplish the licensing of its employees." The focus of the examination was to determine whether the Companies' employees were properly licensed as Maryland agents and appointed by the Companies. The purpose of the examination was to determine if the Companies were in compliance with the MIA's licensing insurance laws and regulations. The file review was based on a review of 45% of the policies solicited during the examination period. Our review revealed that the Companies have made significant overall improvement in its compliance with Maryland's licensing laws and regulations, however, the review revealed that the Companies, in certain instances, transacted insurance business with individuals that were not properly authorized or appointed and that the Companies, therefore, are in violation of Section (a)(1) of the Maryland Insurance Code. The examination findings are detailed on the following pages.

6 II. SCOPE OF EXAMINATION A targeted Market Conduct Examination has been performed on: UNITED SERVICES AUTOMOBILE ASSOCIATION USAA CASUALTY INSURANCE COMPANY at its offices in San Antonio, Texas and a report thereon is submitted as follows: The Examination was conducted pursuant to Sections 2-205, 2-207, and of the Insurance Article and generally covered the period from May 1, 2000 through April 30, The focus of the examination was to determine whether the Companies' employees were properly licensed as Maryland agents and appointed by the Companies. The purpose of the Examination was to determine if the Companies were in compliance with the MIA's licensing insurance laws and regulations. The file review was based on a review of 45% of the policies solicited during the examination period. All unacceptable or noncomplying practices may not have been discovered and failure to identify or criticize improper company practices does not constitute acceptance of such practices. Examination report recommendations that do not reference specific insurance laws, regulations, or bulletins, are presented to improve the Companies' practices and ensure consumer protection.

7 III. COMPANY PROFILE The United Services Automobile Association began business on June 20, 1922 as the United States Army Automobile Insurance Association. The USAA Casualty Insurance Company was incorporated on September under the laws of Texas. It began business on December 1, The Company operated under the title United Services Casualty Company until December 2, 1970, when the current title was adopted. A.M. Best assigns each company a Financial Size Category. Best's Financial Size Category is based on reported policyholders' surplus plus conditional or technical reserve funds, such as mandatory securities valuation reserve, other investment and operating contingency funds and miscellaneous voluntary reserves reported as liabilities. The Financial Size Category is represented by Roman numerals ranging from Class I (the smallest) to Class XV (the largest). The Financial Size Category for the Companies is XV.

8 IV. CERTIFICATE OF AUTHORITY The Companies Certificates of Authority to transact property and casualty insurance in the State of Maryland were last issued on July 1, Both Companies are licensed to do business in DC and all states.

9 V. SALES Agent Licensing The Companies provided the MIA with listings of all policies issued by individuals employed by the Companies during the examination period. The MIA, to determine if the Companies were in compliance with the licensing requirements applicable to the Insurance Article, reviewed the lists. Due to record retention practices, the soliciting agents for all of the policies could not be identified. The listing provided by the Company contained twenty-one thousand five hundred ninety-five (21,595) policies. The soliciting agent could be identified for nine thousand seven hundred seventy-seven (9,777) policies. This represents fortyfive percent (45%) of the population. The soliciting individuals who were listed for the policies issued by the Companies for the personal automobile and homeowners new business policies or quotes issued by the Companies during the examination period were compared with the licensing records of the Maryland Insurance Administration. A total of nine thousand seven hundred seventy-seven (9,777) policies were reviewed. In addition to the above policies reviewed thirteen (13) policy transactions were reviewed that were processed by Customer Service Representatives. The review revealed a total of five (5) exceptions detailed on the following pages.

10 Issue A -- Violation of Section (a)(1) Accepting business solicited by individuals acting as an agent who did not hold an appointment with the Companies. Section (a) provides: (a) Agents - In general. - Except as otherwise provided in this article, before a person acts as an agent in the State, the person must obtain: (1) a certificate of qualification in the kind or subdivision of insurance for which the person intends to act as an agent; and (2) an appointment from an insurer. As a result, the Companies are in violation of Section (a)(1). Section (a)(1) provides: (a) In general. - (1) When an insurer doing business in the State makes or terminates an appointment, the insurer immediately shall file notice of the appointment or termination and the reasons for the termination in the manner specified by the Commissioner. Our review revealed that the Companies accepted two (2) policies from individuals that had not obtained certificates of qualification and/or an appointment as required under Section (a) of the Insurance Article detailed as follows: SECTION POPULATION NO. OF POLICIES WRITTEN BY AN INDIVIDUAL WITH NO CQ and APPT NO. OF POLICIES WRITTEN BY AN AGENT WITH NO APPT NUMBER OF INDIVIDUALS/ AGENTS WRITING THE POLICIES Homeowners B Recommendation #1 EXHIBIT Within 30 days, the Companies should demonstrate why they should not be considered in violation of the requirements set forth in Section (a)(1) of the Insurance Article. In the event the Companies are unable to provide such documentation, they should demonstrate that procedures have been put in place to assure compliance with Maryland insurance laws and regulations. Furthermore, the Companies are directed to cease doing business with individuals who do not hold an appointment with the Companies.

11 Issue B -- Violation of Section (a)(1). Customer Service Representatives soliciting and/or quoting insurance premiums and coverages, but did not hold a Maryland certificate of qualification and an appointment with the Companies. Section (a) provides: (a) Agents - In general. - Except as otherwise provided in this article, before a person acts as an agent in the State, the person must obtain: (1) a certificate of qualification in the kind or subdivision of insurance for which the person intends to act as an agent; and (2) an appointment from an insurer. As a result, the Companies are in violation of Section (a)(1). Section (a)(1) provides: (a) In general. - (1) When an insurer doing business in the State makes or terminates an appointment, the insurer immediately shall file notice of the appointment or termination and the reasons for the termination in the manner specified by the Commissioner. When reviewing the sample of new auto and homeowner business for the examination period it was found that thirteen (13) customer service representatives did not appear on the company list of licensed agents. These thirteen (13) customer service representatives discussed policy information, coverage and/or quoted premiums to the consumer. The Companies provided documentation that explained what each customer service representative discussed with the consumer during the transaction. The documentation revealed that three (3) of the thirteen (13) customer service representative acted in the capacity of an agent by quoting premiums and coverage to the consumer. These three (3) customer service representatives had not obtained certificates of qualification and an appointment. SECTION NO. OF CUSTOMER SERVICE REPRESENTATIVES NO. OF CUSTOMER SERVICE REPRESENTATIVES THAT DICUSSED QUOTING AND COVERAGE ISSUES ACTING AS AGENT WITH NO CQ AND APPOINTMENT EHXIBIT AUTO 6 2 C HOMEOWNERS 7 1 D Recommendation #2 Within 30 days, the Companies should demonstrate why they should not be considered in violation of the requirements set forth in Section (a)(1) of the Insurance Article. In the event the Companies are unable to provide such

12 documentation, they should demonstrate that procedures have been put in place to assure compliance with Maryland insurance laws and regulations. Furthermore, the Companies are directed to cease doing business with individuals who do not hold a Maryland certificate of qualification and an appointment with the Companies.

13 Issue C Inability to provide records in the MIA's requested format for review. Section 2-207(b)(1)(2) provides: (b)production of records and help with examination.- Each person that is examined and its officers, employees, agents, and representatives shall: (1) produce and make freely available to the Commissioner or an examiner the accounts, records, documents, files, information, assets, and matters that are in the possession or control of the person and relate to the subject of the examination; and (2) otherwise help the examination to the extent reasonably possible. LINE OF POPULATION NO. OF POLICIES WRITTEN BY AN UNIDENTIFIABLE BUSINESS INDIVIDUAL Auto 13,146 7,951 Homeowners ,867 Recommendation #3 The Companies indicated during the examination that they were unable to capture the employee number of the Customer Service Representatives for each new policy issued during the examination period but the information could be seen in their on-line documentation system. In a letter dated July 25, 2001(Exhibit E), the Companies stated, "...We are attempting to resolve this issue for future audits..." While the MIA is concerned that the information was unable to be captured for the electronic listings provided, the MIA will accept that the Companies are working to resolve this issue and that the information was available on the on-line documentation system. No specific findings of violation of Maryland law will be reported under this section of the report.

14 VI. SUMMARY OF RECOMMENDATIONS ISSUE RECOMMENDATION ISSUE RECOMMENDATION NUMBER PAGE NUMBER A Violation of Section (a)(1) 1 7 B Violation of Section (a)(1) 2 8 C Violation of Section 2-207(b)(1)(2) 3 10

15 VII. CLOSING A total of nine thousand seven hundred seventy-seven (9,777) policies were reviewed for the examination period. A total of five (5) exceptions are noted herein.

16 VIII. EXAMINATION REPORT SUBMISSION The courtesy and cooperation extended by the Officers and Employees of the Companies during the course of the Examination is hereby acknowledged. Signature on file with original Dudley B. Ewen, A.I.E., Chief Examiner P&C Market Conduct Section In addition, the following individuals participated in this examination and in the preparation of this Report. Dawna Ruley P&C Market Conduct Section Joan Mulligan Contractual Market Conduct Examiner

17 EXHIBITS* *Attachments and exhibits named in this file may be available with a written request addressed to the Public Information Act Coordinator.

18 IN THE MATTER OF THE * BEFORE THE STATE OF MARYLAND * INSURANCE ADMINISTRATION * INSURANCE ADMINISTRATION * v. * * UNITED SERVICES AUTOMOBILE * ASSOCIATION (NAIC # 25941) * * USAA CASUALTY INSURANCE * COMPANY (NAIC # 25968) * CASE NO. MIA-214-5/02 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ORDER - CONSENT AGREEMENT WHEREAS, the State of Maryland, Insurance Administration (hereinafter "Insurance Administration"), conducted a Market Conduct Examination of United Services Automobile Association and USAA Casualty Insurance Company (hereinafter "Respondent"), whose home office is located at 9800 Fredericksburg Road, San Antonio, TX 78288, pursuant to the Insurance Article, of the Annotated Code of Maryland; and WHEREAS, such examination disclosed violations of 2-207(b)(1)(2) and (a)(1) of the Insurance Article; and WHEREAS, the Respondent did promptly and voluntarily take corrective measures pursuant to recommendations of the Insurance Administration; and

19 WHEREAS, both parties are desirous of resolving this matter presently pending before the Insurance Administration; and WHEREAS, the Insurance Administration has considered the requirements of State Government Article and COMAR in determining the scope of the penalty imposed upon Respondent in this Order/Consent Agreement. ACCORDINGLY, by the powers vested in me under the Insurance Article of the Annotated Code of Maryland, and in view of the Consent of the Respondent herein to the terms of the Order, it is hereby ORDERED that: 1. Respondent shall immediately comply with 2-207(b)(1)(2) and (a)(1) of the Insurance Article. 2. Pursuant to 4-113(d) of the Insurance Article, the Respondent will pay an administrative penalty to the State of Maryland in the amount of one thousand seven hundred dollars ($1,700.00). 3. Respondent accepts the Market Conduct Examination Report consisting of fourteen (14) pages and five (5) exhibits submitted pursuant to the Insurance Article, of the Annotated Code of Maryland.

20 4. This Consent Order is the Final Order of the Insurance Commissioner on this matter. WITNESS the HAND and the SEAL of the Insurance Administration, this 9 day of May, Signatures on file with original Steven B. Larsen Insurance Commissioner RESPONDENT'S CONSENT Respondent hereby consents to the above Order. WITNESS the HAND and the SEAL of the Respondent this 1 day of May, ATTEST: Signatures on file with original United Services Automobile Association USAA Casualty Insurance Company Signatures on file with original