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Bureau of Insurance

Bureau Responsibilities

The Bureau of Insurance is organized into four divisions:

Each area has unique responsibilities.

Financial Regulation

The Financial Regulation Division of the Bureau of Insurance is divided into three sections: Company Licensing and Regulatory Compliance, Financial Analysis, and Financial Condition Examination.

The Company Licensing and Regulatory Compliance section is primarily responsible for administering the initial license, approval, and registration process for insurers and insurance related entities desiring to do the business of insurance in Virginia. The section also has the responsibility for monitoring health maintenance organizations, premium finance companies, automobile clubs, multiple employer welfare arrangements, viatical settlement providers and continuing care retirement communities. In addition, the section is responsible for ensuring regulatory compliance with licensing requirements for companies transacting business in Virginia.

The Financial Analysis section is charged with the on-going monitoring and solvency assessment of insurance companies. The section also has the responsibility for approving purchasing groups, risk retention groups, surplus lines carriers, and qualified reinsurers. In addition, the section is responsible for notification of any insolvency to the Insurance Guaranty Fund Associations.

The Financial Condition Examination section is responsible for conducting periodic on-site examinations of domestic insurers’ accounts, records, books, and operations. The section also has the responsibility for publishing Examination Reports on the financial condition of insurance companies and any material findings.

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Life and Health Market Regulation

The Life and Health Market Regulation Division monitors the market activities of companies and agents within the Life and Health classes of insurance. There are seven functional sections, whose responsibilities are described below:

Consumer Services: This section logs, investigates and works toward resolution of complaints about agents, agencies and companies. They make recommendations for disciplinary action where necessary. Consumer Services representatives also provide consumers with information and answer insurance-related questions.

Market Conduct: This section performs field examinations of insurance companies to ensure their business practices are in compliance with Virginia’s insurance laws and regulations.

Forms and Rates: This section reviews policies and contracts to ensure they are in compliance with statutory and regulatory requirements. They also review and, for certain lines, may approve premium rates.

Research: This section assesses the impact of major issues affecting the insurance industry, develops regulations and proposes legislation relative to the issues. They participate in legislative studies, undertake consumer research projects and develop guidebooks to promote awareness of insurance issues and standards.

Office of the Managed Care Ombudsman: This section helps consumers who have Managed Care Health Insurance Plan (MCHIPs) products understand their rights of appeal of adverse decisions by MCHIPs.

Outreach Coordinator: Insurance Consumer Outreach serves and protects by providing education, information, and assistance to consumers. This section accomplishes this mission by coordinating all life and health consumer outreach programs, including special programs for senior citizens.

External Appeals: In addition to the traditional services provided by this division, Life and Health Market Regulation also has a section dedicated to the external review of final adverse decisions rendered by managed care health insurance plans.

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Property and Casualty Market Regulation

The Property and Casualty Market Regulation Division monitors the market activities of companies and agents within the Property and Casualty classes of insurance. There are five functional sections, whose responsibilities are described below:

Consumer Services: This section logs, investigates and works toward resolution of complaints about agents, agencies and companies. Consumer Services representatives also provide consumers with information and answer insurance-related questions.

Market Conduct: This section performs field examinations of insurance companies to ensure their business practices are in compliance with Virginia’s insurance laws and regulations. Available for download: Common Problems Found During Property and Casualty Market Conduct Examinations.

Personal & Commercial Lines Rules, Rates and Forms: This section reviews policies and contracts to ensure they are in compliance with statutory and regulatory requirements. They also review and, for certain lines, may approve premium rates.

Research: This section assesses the impact of major issues affecting the insurance industry, develops regulations and proposes legislation relative to the issues. They participate in legislative studies, undertake consumer research projects and develop guidebooks to promote awareness of insurance issues and standards.

Outreach Coordinator: Property and Casualty Insurance Consumer Outreach provides education, information, and assistance to consumers and members of the insurance industry. This section accomplishes this mission by coordinating all property and casualty consumer outreach programs.

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Agent Regulation and Administration

Agent Regulation and Administration provides the primary financial and personnel support for all operational departments in the Bureau of Insurance. This includes preparing the Bureau of Insurance biennial budget, collecting and recording fees and taxes, and overseeing Bureau of Insurance personnel transactions.

Agents Licensing: This section performs licensing for all lines of insurance and tracking functions for the entire Bureau of Insurance. They screen applications, issue agent/agency and public adjuster licenses, track appointments, register navigators and monitor regulatory requirements for licensing. They respond to all informational requests about agents. There are approximately 208,000 insurance agents, 1,500 insurance companies, and 14,000 insurance agencies doing business in Virginia. The Agents Licensing Section handles an average of 4,000 telephone calls per month.

Demographic Information: 2008 House Joint Resolution No. 196 required the Bureau of Insurance to collect certain demographic and other information for a period of two years commencing July 1, 2008 from agent licensing examination candidates as follows:

Demographic Information: 2011 House Joint Resolution 586 required the Bureau of Insurance to collect certain demographic and other information for the period of July 1, 2011 through July 1, 2015 from agent licensing examination candidates as follows:

 

Automated Systems: This section is responsible for oversight of all the computer-based systems utilized within the Bureau of Insurance.

Agent Investigations: This section conducts field examinations of agent activities and reviews their financial transactions and business practices to ensure they are in compliance with Virginia insurance laws and regulations.

Administration: This section provides support to the Bureau of Insurance staff. The section is responsible for the Bureau’s biennial budget, preparation of vouchers for vendor payments and for reimbursement of travel expenses, assists with personnel functions, procurement, Bureau payroll, and leave keeping. Administration also administers the Bureau’s education program.

Administrative Assessments: This section is directly responsible for the collection and audit of the assessment for the maintenance of the Bureau, the Fire Programs Fund Assessment, the Flood Assessment, the Help Eliminate Auto Theft (HEAT) Assessment and the Fraud Assessment. The Assessment Division processes several thousand assessment filings from insurers and surplus lines brokers and generally collects revenues in excess of $45 million.

Settlement Agents: This section registers and conducts field examinations of title settlement agent activities, as well as reviews financial transactions and business practices to ensure compliance with Virginia laws and regulations.

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