· Personnel Home · MQ’s · Index · Examination Code: R ·
Nature of Work
Under general supervision, performs full-performance level professional
work in the examination of the business practices, policies and rates of
insurance companies, resident agents, brokers, non-resident agents, third
party administrators, agencies and other regulated entities to ensure
compliance with applicable insurance laws and regulations. As part of an on
site market conduct examination team, examines records, files and practices of
regulated entities. Trains and mentors new employees. May act as Examiner-in
Charge on select in-state examinations. May supervise the work of other Market
Conduct Examiners when acting as Examiner-in-Charge. Market conduct
examination work requires extensive travel in and outside West Virginia.
Assignments may range from three weeks to six months. Performs related work as
required.
Distinguishing Characteristics
This is the full-performance level in the Market Conduct Examiner class
series. At this level candidates will possess credentials to sign in-state
examinations and has achieved the Accredited Insurance Examiner (AIE)
designation. Possesses the knowledge, skills and abilities to function
independently as lead regulator on more complex assignments.
Examples of Work
Essential Job Functions - Any specific position in this class may not include all of
the duties listed, nor do the examples listed cover all of the duties which may be
assigned.
Participates in or leads market conduct examination of insurance companies and
insurance agent operations to determine compliance with insurance laws
and regulations.
Reviews agent listing compliance, volume of complaints, category of
complaints, number of settlements in each complaint category, number of
hearings in each complaint category, advertising compliance and claims
administration practices.
Reviews records and practices relating to policy form filings for adherence to
insurance laws and regulations.
Reviews license applications to determine compliance with state agent
licensing requirements.
Reviews settlement of claims paid to clients to assure compliance with policy
provisions.
Informs supervisor of findings of non-compliance and suggests appropriate
corrective actions to recommend to the Insurance Commissioner.
Recommends additional investigation of insurance company's financial status or
new policies and rates to ensure solvency and compliance with insurance
regulations.
Oversees the preparation of the final market conduct examination report as
assigned; informs insurance company of non-compliance and recommends
appropriate corrective actions to the Insurance Commissioner; monitors
insurance company's compliance with corrective action plans.
Trains and mentors subordinate market examiner staff in practices and
procedures of market conduct examinations.
Prepares time and expense budgets for examinations.
Reviews and approves work papers prepared by other examiners when serving as
examiner-in-charge.
Assists in the identification and prioritization of companies to be scheduled
for examinations, market analysis or desk audits.
May serve as Insurance Commissioner's liaison to select NAIC Working Groups.
May testify in administrative hearings and civil court proceedings.
Knowledge, Skills and Abilities
Knowledge of the business practices and procedures of insurance companies,
brokers, agents, insurance agencies, underwriters and adjusters.
Knowledge of federal and state laws, rules and regulations relating to the
insurance industry.
Knowledge of the records maintained by insurance companies and other regulated
entities.
Knowledge of operational auditing principles and practices relating to
auditing and examining insurance company documents and records.
Knowledge of database and spreadsheet applications.
Ability to plan, coordinate and direct the work of market conduct examiners.
Ability to compile and analyze data and draw valid conclusions on insurance
practices, policies and rates of regulated entities.
Ability to interpret and comprehend insurance related data.
Ability to maintain effective working relationships with other employees,
industry representatives and the general public.
Ability to use a personal computer.
Ability to convey ideas clearly and concisely in business correspondence and
reports.
Ability to communicate effectively, orally and in writing.
Minimum Qualifications
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Training:
Bachelor's degree from a regionally accredited four-year college or
university. Must hold the Accredited Insurance Examiner (AIE)
designation and comply with the continuing education requirements for
maintaining the designation.
Substitution:
Certifications of Chartered Property Casualty Underwriter
(CPCU), Chartered Life Underwriter (CLU), Fellow Life Management
Institute (FMLI) OR experience as described below may substitute for the
required training on a year-for-year basis.
Experience:
Two years of full-time or equivalent part-time paid experience as
an insurance regulator, one year of which must have been in conducting
market conduct examinations or analysis of regulated insurance entities.
NOTE: The Accredited Insurance Examiner (AIE) designation takes 2 years of
experience to obtain the certification.
Established: 12/18/2009
Effective:
02/01/2009