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Consulting expert

Regulatory consulting.

Work with and before state Departments of Insurance, drawing on roughly 35 years working for and on behalf of them.

Market conduct examinations and defenseTransactions and filings (Form A / Form D)Investigations and subpoenas
About this practice area

How insurance is regulated.

Insurance in the United States is regulated primarily by the states. Each state’s Department of Insurance licenses insurers & producers, reviews rates & forms, monitors solvency, and examines how companies treat policyholders and claimants. The National Association of Insurance Commissioners (NAIC) coordinates much of that work through model laws and shared standards such as its Market Regulation Handbook.

Regulatory matters arise at several points in an insurer’s life: market conduct examinations, which can span many states at once and end in corrective action plans or regulatory settlement agreements; acquisitions and changes of control, which require Form A approval, and affiliate transactions reported on Form D; supervision and receivership when a company is troubled; and investigations and subpoenas from state and federal authorities.

Newer questions, around insurtech, data privacy & security, and non-traditional insurance products, are increasingly part of the same regulatory landscape.

An early-warning monitor: a steady compliance trace with one anomaly spike, caught and flagged the moment it appears
Sub-categories

Three kinds of regulatory work.

Market conduct examinations and defense

Examination defense and mock examinations built on the NAIC Market Regulation Handbook, with corrective action plans and regulatory settlement agreements.

View Market conduct examinations and defense →

Transactions and filings (Form A / Form D)

Filings for acquisitions, changes of control, and affiliate transactions.

View Transactions and filings (Form A / Form D) →

Investigations and subpoenas

Response to Department of Insurance and other government investigations and subpoenas.

View Investigations and subpoenas →
Engagements

Matters handled.

The regulatory work draws on roughly 35 years working for and on behalf of Departments of Insurance.

Consulting

Multi-state market conduct examination defense

50states at issue
5+years
NAICMarket Actions Working Group appearances

Market conduct

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Retained by a Property and Casualty carrier to assist in defending a multi-state Market Conduct Examination in which the client was accused of having violated rules and regulations in all 50 states. The engagement has lasted over 5 years and has required numerous appearances before the NAIC’s Market Actions Working Group (MAWG), hearings at State Departments of Insurance and on-site dealings with state Market Conduct Examiners. Other duties included writing a Corrective Action Plan (CAP) and a Regulatory Settlement Agreement (RSA). Mr. Bingham also designed and directed a mock examination based upon the tests prescribed in the NAIC’s Market Regulation Handbook.

Also listed under: Claims Handling Review

Consulting

Targeted market conduct examination of an Illinois reinsurer

Warrantsigned by the Director
Finalreport of examination

Market conduct

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Engaged by the Illinois Department of Insurance to perform a targeted Market Conduct examination of an Illinois domiciled reinsurer. Subject matter of the investigation and analyses was the ceding commission structure, other operating expense budget, price & rating program including questions of capacity and surplus requirements, and provisions of the subject company’s reinsurance agreements. The project was performed pursuant to an Examination Warrant signed by the Director of Insurance and resulted in a Final Report of Examination.

Also listed under: Reinsurance Disputes · Receivership & Insolvency Issues

Other matters

Day-to-day representative of a court-appointed supervisorConsultingSupervisionRead moreShow less

Retained by the Oklahoma Insurance Department’s Receivership Office to be the day-to-day representative of the court-appointed supervisor of an insurance company: conducting a reserve audit, analysis of the claim operation, and approval of claim payments, with responsibility for a number of other tasks including compliance, reinsurance recoveries, and financial statements, reporting to the supervisor the results of the examination of the company’s operations.

Also listed under: Defense of TPAs, Agencies, and Counsel · Carrier claims-practice reviews & audits · Claims & Reserve Auditing · Receivership & Insolvency Issues

Form A filing and regulator approval for a Medicaid behavioral health providerConsultingForm A / Form DRead moreShow less

Was engaged by a Medicaid Behavioral Health and Developmental Disability care provider to locate capital, assist the new ultimate controlling person’s Form A filing, and obtain the approval of the domiciliary regulator. Related projects included the onboarding of new staff with appropriate credentials, retention & licensing of vendors, and development of policies & procedures.

Defending a multi-state targeted claim examinationConsultingMarket conductRead moreShow less

Was engaged by a travel, short term medical, and disability insurer to defend a regulator’s multi state targeted claim examination. Mr. Bingham designed and executed a “mock exam” using the NAIC’s Market Regulation Handbook and drafted the company’s response to the examination report.

Acquisition of an Arkansas life carrier: Form A and Form DConsultingForm A / Form DRead moreShow less

Retained to consult on the acquisition of an Arkansas based life carrier for its conversion into a Medicaid Plan B provider. GIC completed the due diligence of the target and provided analysis and support for the new ownership through the Form A and Form D hearings. Mr. Bingham also oversaw the completion of both Forms A and D.

Department of Justice subpoena response for a property and casualty carrierConsultingInvestigations and subpoenasRead moreShow less

Department of Justice subpoena-response assistance for a Property and Casualty carrier: data, records, and responses to interrogatories.

Mock market conduct examinationsConsultingMarket conductRead moreShow less

Mock market-conduct exams for Accident & Health and Property & Casualty insurers.

Engage GIC

Facing an examination or a filing?

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