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Nature of Work
Under general direction, performs highly responsible supervisory work
in planning, directing and evaluating the market conduct examination and
market conduct analysis programs in the Offices of the Insurance Commissioner.
Work involves supervising the Market Conduct Unit in the examination and
analysis 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. Responsible for supervising the market conduct
analysis and the market conduct examination functions of the unit. Responsible
for market conduct examinations and reports and for ensuring compliance with
corrective action plans. Oversees the development of market conduct analysis
and market conduct examination policies and procedures and ensures that
examinations meet national regulatory standards. Advises Commissioner and
senior staff on market analysis and market conduct policy matters. Serves as
Insurance Commissioner's principle liaison to National Association of
Insurance Commissioners (NAIC) Working Groups. Extensive in-state and out-of
state travel may be required. Performs related work as required.
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.
Plans, organizes and coordinates the operation and work of the market conduct
and market analysis sections.
Ensures Market Conduct Examiner and Market Conduct Analyst personnel are
properly trained on NAIC procedures and maintain progression toward
industry recognized professional designations.
Trains, reviews the work and performs performance appraisals of junior staff.
Forecasts and ensures compliance with overall budget for examinations and
related activities.
Reviews and approves the identification and prioritization of companies
selected for market conduct examinations.
Prepares initial data requests for examinations, market analysis and desk
audits.
Schedules market conduct examinations; ensures examinations are properly
planned with appropriate level of staff assigned.
Reviews and approves time and expense budget for examinations.
Ensures all areas within OIC are in compliance with NAIC Core Competencies for
Market Regulation Accreditation.
Reviews insurance companies' consumer complaint records to ensure compliance
with insurance laws and regulations of West Virginia.
Reviews rate applied to policies sold to consumers to ensure compliance with
established procedures.
Reviews settlements of claims paid to claimants to ensure compliance with
provisions of policies in resolving complaints filed by claimants.
Organize and present exit interviews with management to answer questions,
inform management of the contents of the formal report of examination
and gain commitment for corrective action.
Informs insurance companies of non-compliance and recommends to the Insurance
Commissioner fines or other appropriated corrective actions.
Recommends additional investigation of insurer's financial status or new
policies and rates to ensure solvency and compliance to insurance
regulations.
Requests subpoenas to o obtain information from insurance companies, agents,
broker's agencies, or other entities licensed to operate the business of
insurance in West Virginia.
Reviews and approves work papers prepared by other examiners.
Prepares formal examination reports.
Monitors companies' compliance with corrective action plans submitted.
Advises Insurance Commissioner on policy matters and assists in drafting and
proposing legislation.
May hold additional duties such as Market Analysis Chief, Chief Market Conduct
Examiner, or Collaborative Actions Designee.
Knowledge, Skills and Abilities
Knowledge of the practices of insurance companies, brokers, agents, and
adjusters.
Knowledge of National Association of Insurance Commissioners (NAIC) guidelines
for examinations, insurance rating, underwriting, claims and
policyholder services.
Knowledge of sampling methods.
Knowledge of data and procedures used by all divisions within the Offices of
the Insurance Commissioner.
Knowledge of Chapters 23 and 33 of W.Va. Code as well as Titles 85 and 114 of
W.Va. Code of State Rules and pertinent federal regulations.
Skill in the use of a personal computer especially in the area of auditing
applications.
Ability to analyze and evaluate specific practices, policies, and rates of
insurance companies in order to identify noncompliance.
Ability to interpret contractual provisions of insurance policies.
Ability to establish and maintain effective working relationships with other
employees, industry officials and the general public.
Ability to accurately analyze financial and non-financial information and to
draw valid conclusions.
Ability to testify as an expert witness.
Ability to create and manage examination expense budgets.
Minimum Qualifications
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Training:
Bachelor's degree from a regionally accredited four-year college or
university. Must hold the Certified Insurance Examiner (CIE)
designation from the Insurance Regulatory Examiners Society and comply
with the continuing education requirements for maintaining the
designation.
Substitution:
An insurance designation of Chartered Property Casualty
Underwriter (CPCU), Chartered Life Underwriter (CLU) or Fellow Life
Management Institute (FMLI) OR experience as described below may
substitute for the required training on a year-for-year basis.
Experience:
Five years of full-time or equivalent part-time paid employment as
an insurance regulator including at least four years in conducting
market conduct examinations or analysis of regulated insurance entities.
Established: 12/18/08
Effective:
02/01/09