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You are here: Home / Regulation & Compliance / DOI News / A Notable Decrease In The Number of DOI Special Investigations & Enforcement Actions During 2017’s Q3

A Notable Decrease In The Number of DOI Special Investigations & Enforcement Actions During 2017’s Q3

November 14, 2017 by AC Editor

The Third Quarter includes enforcement actions during the months of July, August and September of this year.

Agency Checklists, MA Insurance News, Mass. Insurance News, Division of Insurance, Each quarter, the Division of Insurance publishes a list of the enforcement actions it has taken against licensed Resident and Non-Resident Producers. The total fines assessed often vary depending upon the circumstances and actions alleged.

The following is a review of the Third Quarter of 2017, which includes special investigations and enforcement hearings during the months of July, August and September of 2017.

What was the total amount of actions and fines during the 3rd  quarter of 2017?

The Third Quarter of 2017 saw a notable decrease in the number of administrative actions as well as fines imposed by the Division of Insurance, as compared to both the First & Second Quarters of 2017. In this most recent quarter, which ended on September 31, 2017, the Division had a total of three enforcement actions.

In comparison, during the Second Quarter of 2017, which comprises the months of April, May, and June, the Division’s Special Investigations Unit was involved in a total of 21 different administrative actions, while the First Quarter of 2017, had even more.

Only one fine imposed this quarter for $30

Bucking the trend of the first two quarters, the third quarter also included only one fine for $30 dollars. The Second Quarter, for example, had a total of $15,370 dollars in imposed fines,  while during the First Quarter, the Division imposed a total of $96,695 in fines. As a result, with the addition of the minor fine in the Third Quarter, the Division has issued fines for the first three quarters of 2017 totaling $112,095 dollars. Even with a smaller amount in the this quarter, the total fines for the entire year of 2017 still surpass the total dollar amount of fines imposed in 2016, which was $72,315. [pullquote]The DOI Special Investigations Unit only was involved in three investigations during the Third Quarter of 2017[/pullquote]

Fines involving Hearing Officer Decisions

In this quarter, there were no hearing decisions which corresponded to any of the Enforcement Actions detailed here.

A quick rundown of the three cases this quarter

Here is a list of the Administrative Actions conducted and reported during this quarter:

  1. Licensee & Type of Case: Non-Resident Producer
    • Date: July 1, 2017
      • Allegations: No Home State License
      • Disposition: Settlement Agreement
      • Fine: N/A
      • Licensing Action: Voluntary Surrender
  2. Licensee & Type of Case: Resident Producer
    • Date: Unlicensed Activity
    • Allegations: Unlicensed Activity
    • Disposition: Settlement Agreement
    • Fine: $30
    • Licensing Action: Cease & Desist
  3. Licensee & Type of Case: Non-Resident Producer
    • Date: 7/6/2017
    • Allegations: Unfair Insurance Trade Practice; Trustworthiness
    • Disposition: Settlement Agreement
    • Fine: $N/A
    • Licensing Action: Revocation; Cease & Desist

The Division’s Special Investigation Unit is in charge of investigating producers

While the primary mission of the Division of Insurance is “…to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products” a major part of that mission involves insurance enforcement. The DOI engages in a variety of administrative actions throughout the year in order to ensure that the insurance industry and its representatives maintain a just and healthy marketplace.

That said, during the course of regulating the Massachusetts insurance industry, the Division’s Special Investigation Unit will pursue allegations of misconduct against any persons licensed by the DOI including insurance producers, insurance advisers, public adjusters, reinsurance intermediaries, viatical loan brokers and providers, viatical settlement brokers and providers, insurance companies, health maintenance organizations and self-insurance groups.

As part of its investigation into a case, the Enforcement Division may interview witness, question licensees, demand and review documentary evidence supporting allegations of unfair methods of competition or unfair trade practices or any other violation of the insurance law.

If a specific investigation warrants further action, an investigation may result in a referral to the Attorney General’s office in egregious cases or in less serious cases the Division independently may negotiate settlements or request the Commissioner or his deputies to initiate an administrative proceeding before a hearing officer, agree to assist in cease and desist order and a written compliance programs.  In more egregious cases, a licensee’s conduct may warrant the sanctioning of that producer’s license including revocation or suspension along with restitution.

To learn more about avoiding enforcement issues, you may be interested in Agency Checklists’ article “One Way to Avoid Large Fines for You & Your Agency.”

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