STATE OF WASHINGTON OFFICE OF THE LNSURANCE COMMISSIONER

Transcription

1 000?c2207 C^/16/15 2UiQ\^:.'s2 STATE OF WASHINGTON OFFICE OF THE LNSURANCE COMMISSIONER In the Mailer of Life of the South Insurance Company, An Authorized Insurer. Order No WAOICNo NAICNo CONSENT ORDER LEVYING A FINE This Consent Order Levying a Fine ("Order") is entered into by the Insurance Commissioner of the state of Washington ("Insurance Commissioner"), acting pursuant to the authority set forth in RCW , RCW , and RCW , and Life of the South Insurance Company. BASIS: 1. Life of the South Insurance Company ("LOTS" or "Company") is an authorized Georgia-domiciled insurer admitted to Washington in It sells life and disability insurance. 2. Benefit Marketing Solutions, LLC ("BMS") is an Oklahoma limited liabilit>' company. It administers membership programs for a separate nonprofit Illinois corporation, Benefit Ser\'ices Association ("BSA"). BSA membership is available to the public and generally entitles members to discounts in retail products and services, which vary depending on level of membership. BMS contracts with organizations who desire the right to sell BSA memberships to the organizations' customers. BMS is not registered with the Insurance Commissioner as a service contract provider. 3. Rent-A-Center of Texas, L.P., for itself and its affiliates (collectively referred to as "RAC"), contracted with BMS to provide BSA benefits in the RAC Benefits Plus program. There are multiple RAC stores in Washington that offered their customers the RAC Benefits Plus program for purchase. RAC is not licensed to conduct insurance business in Washington. SIMBA NO. i IS OlTice of ihe Insurance Commissioner 5000 Capiiol Blvd PO Box >mpia. WA 9S

2 4. In February 2012, LOTS submitted its Group Accidental Death and Dismemberment (".AD&D") Program to the Insurance Commissioner for review. The program offered accidental death, dismemberment, and loss of sight coverage to the individual members of private clubs and/or associations domiciled in the state of Oklahoma. Some of these individual members resided outside the state of Oklahoma and LOTS filed the Oklahoma program in those other states, including Washington. LOTS issued a group AD&D policy to BMS. The plan was to have this insurance be part of a BMS/BSA benefit package available to RAC customers. 5. RAC offered a membership to each consumer who rented or purchased merchandise from its retail outlets for a nominal fee. The member received a Certificate of Insurance as evidence of coverage that was contained in the membership booklet BMS provided. Consumers paid a small monthly or weekly fee to maintain membership in the association and the ADtSiD was provided at no additional cost unless the consumer failed to maintain the membership. 6. In March 2012, the Insurance Commissioner disapproved LOTS' filing and made three objections: (1) LOTS did not comply with the fraud statement requirement of RCW ; (2) LOTS did not provide an out-of-state disclosure form as required under WAC : and (3) LOTS did not explain how the membership group offering the AD&D would qualify as a discretionar\' group under RCW 48.2i.010(2)(a) and (b). The Insurance Commissioner held open LOTS' filing pending a response from LOTS as to these objections. The Insurance Commissioner gave LOTS an April 9, 2012 response deadline. On April 10, 2012, the Insurance Commissioner disapproved and closed the filing because LOTS did not respond to the Insurance Commissioner's inquir>'. Even so, LOTS did not discontinue inclusion of the AD&D coverage in benefit packages in Washington until December In 2012 and 2013, the total premium LOTS received for Washington consumers was approximately S33,215 and S33,147, respectively. BMS/BSA made the premium payments to LOTS on behalf of their Washington members. Washington consumers purchased around 13,018 memberships. LOTS paid S35,000 in AD&D claims in to Washington residents. 8. The Company violated RCW (1) by issuing, delivering, and using an insurance policy form or application form where written application is required and is to be SIMBA NO. IIS3962 OlTice or the insurance Commissioner 5000 Capitol Blvd PO Box Olympic WA 9S

3 attached to the policy, or printed life or disability rider or endorsement form without the Insurance Commissioner's approval. 9. The Company violated RCW (6) by making or issuing an insurance contract that was not in accordance with a required, effective filing. 10. The Company violated RCW (2) by offering certain group policies for which the Insurance Commissioner had not made the requisite findings, namely that: (1) The issuance of the group policy is not contrary to the best interest of the public; (2) The issuance of the group policy would result in economies of acquisition or administration; and (3) The benefits are reasonable in relation to the premium charged. 11. The Company violated WAC (3)(c) and WAC by failing to file with the Insurance Commissioner 30 days prior to solicitation of coverage a copy of the appropriately completed disclosure statement required by WAC The Company violated RCW by failing to substantively include in insurance applications and claim forms the statement: "It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment,fines,and denial of insurance benefits." 13. RCW provides that the insurance Commissioner may refuse, suspend, or revoke an insurer's certificate of authority, in addition to other grounds therefore in the Insurance Code, if the insurer fails to comply with any provision of this code other than those for violation of which refusal, suspension, or revocation is mandatory, or fails to comply with any proper order or regulation of the Insurance Commissioner. 14. RCW authorizes the Insurance Commissioner to impose a S50 penalty for each violation of the chapter, or up to $500 for each willful violation. 15. RCW provides that after hearing or with the consent of the insurer and in addition to or in lieu of the suspension, revocation, or refusal to renew any certificate of authority the Insurance Commissioner may levy a fine upon the insurer in an amount not less than S250 and not more than Si0,000. CONSENT TO ORDER: The Insurance Commissioner of the state of Washington and the Company agree that the best interest of the public will be ser\'ed by entering into this Order. NOW, THEREFORE, the Company consents to the following in consideration of its desire to resolve this matter 3 office of the insurance Commissionef,-,r.r-vr-n v i i - t\r^-r 5000 CapltOl Capitol Hlvd ORDER NO. 1?-00J6 POBox [Jo\ Olympia. WA 9S SIMBA NO. 1IS3962

4 without further administrative or judicial proceedings. The Insurance Commissioner consents to senle this maner in consideration of ihe Company's paj-ment of a fine, and upon such terms and conditions as are sei forth below: 1. The Company acknowledges its duly to comply fully vtiih the applicable laws of the state of Washington. 2. The Company consents to the entr>' of this Order,- waives any and all hearing rights, and further administrative or judicial challenges to this Order. 3. By agreement of the panics, the Insurance Commissioner will imposea fine of S20, be paid wiihin thirty (30) days of the date of this Order. 4. The Company understands and agrees that any further failure to comply with the siamies and regulations that are the subject of this Order constitutes grounds for further penalties, which may be imposed in direct response to further violations. 5. The Company's failure to pay the fine within tliirty (30) days of the date of this Order shall constitute grounds for revocation of the Company's Certificate of Authority, and shall result in the recover)' of the fine through a civil action brought on behalf of the Insurance Commissioner by the Aaomey General of the state of Washington. 6. ' This Order and the violations set forth herein constitute admissible evidence that may be considered in any future action by the Insurance Commissioner involving the Company. However, the facts of this Order, and any provision, finding or conclusion contained herein does not, and is not intended to, determine any facmal or legal issues or have any preclusive or collateral estoppel effects in any lawsuit by any party other than Insurance Commissioner. EXECUTED this dav of LIFE OF THE SOUTH INSURANCE COMPANY Printed Name: Printed Corporate Title:. SIMBA NO OfTicc of the Insurance CominiMio.tcT 5000 Capitol BM PO Bot isnsi Olvmpia. WA ;55

5 AGREED ORDER: Pursuant to the foregoing facmal Basis and Consent lo Order, the Insurance Commissioner of the state of Washington hereby Orders as follows: 1. The Company shall pay a fine in the amount of 520, The Company's failure to pay the fine within thirt>' (30) days of the daie of this Order shall result in the revocation of the Company's Certificate of Authority and in the recover)- of the fine through a civil action brought on behalf of the Insurance Commissioner by the Auomey General for the state of Washington. 3. This Order and the violations set forth herein constitute admissible evidence that may be considered in any future action by the insurance Commissioner invoking the Company. However, the fact of this Order, and any provision, finding or conclusion contained herein does not, and is not intended to, detennine any factual or legal issues or have any preclusive or collateral estoppel effects in any lawsuit by any pany other than the Insurance Commissioner. ENTERED this >0 day of l^o^o^, MIKEKLREiDLER Insurance Commissioner By and through his designee Drew Stiihnan Insurance Enforcement Specialist Leeal.Affairs Division SIMBA NO. :1S3962 OlTice of [^e Insurance Commissiooei SOOOCephol Blvd POBot *025S Ot>-mpia,WA 935<W-025S