COMMISSIONER OF INSURANCE
Commissioner of Insurance - Records Maintenance/Inspection
All companies, agents, or brokers doing any kind of insurance business in North Carolina must make and keep a full and correct record of the business done by them. This includes: -The policy/certificate of renewal number, date, term, amount insured, premiums -The person(s) to whom it was issued Information from these records must be provided to the Commissioner on demand, and the original books of record shall be open to the Commissioner's inspection whenever they so request.
Commissioner of Insurance - Embezzlement
An insurance agent, broker, or administrator who does any of the following with money or consideration received based on their performance will be guilty of a felony: -Embezzles -Fraudulently converts for their own use or withholds -Disposes of -Appropriates -Lends -Invests *Amount of $100,000 or more is a Class C felony *Amount less than $100,000 is a Class H felony
Contract of Insurance
an agreement that obligates an insurer to compensate an insured when there is destruction, loss, or injury to something in which the insured has an interest.
Commissioner of Insurance - Examinations, Hearings, and Investigations
-May be conducted by the Commissioner personally or by one or more deputies, investigators, actuaries, examiners, or employees designated for the purpose. -If the Commissioner or designee is of the opinion that there is evidence to charge any person or persons with a criminal violation, the Commissioner may arrest them with warrant or cause. -The Commissioner must notify all interested parties of a hearing's time, place, and subject.
Commissioner of Insurance - License Surrenders
-When a licensee is accused of any act, omission, or misconduct that would subject the license to suspension or revocation of the license, the licensee may surrender the license for a period of time established by the Commissioner. -Commissioner must consent and approve of the surrender. -A person or entity who surrenders a license is not eligible for a license and cannot submit a licensing application during the period of time the license is surrendered.
Commissioner of Insurance - Investigations of Complaints
-A citizen of this state may file a complaint that a company authorized to do business in this state has violated any provisions of these laws. -Commissioner must investigate the citizen's complaint against an insurer and may examine the insurer's books, records, and documents. -Commissioner may request information for an investigation from any person. -Any person, employee, or agent acting without malice, is not subject to civil liability for libel or slander by providing to the Commissioner reports or other information relating to any known or suspected fraudulent insurance claims or transactions. -If the complaint is justified, the insurer must pay investigation expenses and any appropriate fines.
Commissioner of Insurance - General Duties and Broad Powers
-Advises the Governor on insurance matters. -Primary duties involve: -Administering and executing the applicable laws in North Carolina and adopting rules to enforce and carry out the provisions of those laws -Receiving and examining each financial statement required by law -Conducting examinations, investigations, and hearings as necessary to administer state insurance laws -Reporting to the Attorney General any violations of laws relative to insurance companies and the overall business of insurance -Compiling and making available to the public a list of rates charged and explanations of coverages provided by insurers in connection with residential property and private passenger insurance -Approving or disapproving rates, forms, classification plans, rating plans, plans of operation, and Safe Driver Incentive Plans -Providing a statement of the provisions of any insurance contract offered or issued, upon request by any citizen of North Carolina -Seeking restraining orders, from the appropriate superior courts, against persons who are violating insurance laws
Commissioner of Insurance - Report to the Commissioner
-Any insurance company, employee, representative, or licensee who has reason to believe that any other person has violated the law or that any entity licensed by the Commissioner is financially impaired must inform the Commissioner and provide a complete statement of all relevant facts. -Commissioner may suspend, revoke, or refuse to renew the license of any licensee who fails to comply.
Commissioner of Insurance - Judicial Review
-Any order or decision made, issued, or executed by the Commissioner will be subject to a judicial review in the Superior Court if a petition is filed within 30 days from the date of delivery of the order or decision. -Does not apply to an order regarding financial impairment or a decision that the premium rates charged or filed on any class of risk are excessive, inadequate, or unfairly discriminatory.
Commissioner of Insurance - False Statements to Procure or Deny Benefits
-Any person who presents a written or oral statement that contains false or misleading information material to a claim to procure or deny benefits is guilty of a Class H felony. -The person must have the intent to injure, defraud, or deceive an insurer or insurance claimant. -Each claim is considered a separate count. -Upon conviction the court may impose probation and order the defendant to pay restitution, including compensatory damages, attorney's fees, costs, and reasonable investigation costs.
Commissioner of Insurance - Restraining Orders
-Commissioner may apply to the superior court of the county where the violation is occurring or suspected, for a restraining order and injunction whenever it appears that any person has violated, is violating, or threatens to violate any provision of state insurance law. -May be issued regardless of whether criminal prosecution is instituted. -Conviction of any licensee for any criminal violation of state statutes results in automatic suspension of the producer's license, until the Commissioner reinstates it.
Commissioner of Insurance - Election
-Elected by North Carolina residents as the chief officer to head the North Carolina Department of Insurance. -4-year term or until a successor is elected and qualified. -If office becomes vacant, the Governor must act as Commissioner for the remaining portion of the term.
Commissioner of Insurance - Notifications to the Commissioner
-Every applicant for a license must provide the Commissioner with a residential address and email address. -Must notify the Commissioner in writing or by using an online service approved by the Commissioner within 10 days of a change in residential address or email address. -Violation of this requirement is subject to a $50 administrative fee. -If a licensee is convicted in a court of competent jurisdiction for any crime, other than a minor traffic infraction, the licensee must notify the Commissioner in writing within 10 days after the conviction. -If the Commissioner is required to give notice to a licensee, the notice may be given personally or by first-class mail to the licensee's last known address.
Commissioner of Insurance - Producer of Record
-Every insurance agency transacting insurance business in North Carolina shall appoint a producer of record. -This person shall have the responsibility of seeing that all records are maintained as required and provided to the Commissioner as requested. -Any person who is subject to and violates the record-keeping regulations may be subject to the following disciplines after a notice and hearing: -For the first offense, the person may have their license suspended or revoked for 1-6 months -For the second offense, the person may have their license suspended or revoked for 1 year -Any person who refuses to provide records required by the Commissioner or who makes any false statements about records is guilty of a Class 1 misdemeanor and subject to license suspension or revocation.
Commissioner of Insurance - Complaint Records
-Every insurer or its agents must maintain a record of all written complaints for at least 5 years after the complaint's final disposition. -Domestic companies: the complaint must be kept until the Commissioner has adopted a final report of a general examination that contains a review of those records for that calendar year, or for 5 years, whichever is later. -These records may be subject to inspection and should contain at a minimum the: -Insured's name -Nature of the complaint -Policy/claim number of the insured -Final disposition of the complaint
Commissioner of Insurance - Punishment for Misstatements
-Making willful misstatements of information in financial or other required statements is a Class I felony. -Punishable by a fine of not less than $2,000 and not more than $10,000.
