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9195
MARKET CONDUCT EXAMINER

Nature of Work
Under general supervision, performs full-performance level professional work in examining the practices, policies, and rate of insurance companies, resident agents, brokers, non-resident agents, third party administrators and agencies licensed to operate in the State of West Virginia to assure compliance with the state insurance statutes. Travel is required. Performs related work as required.

Examples of Work
Reviews insurance company's consumer complaint records to assure compliance with insurance laws of West Virginia.
Reviews rates applied to policies sold to consumers to assure compliance to established procedures.
Reviews settlements of claims paid to clients to assure compliance to provisions of policies in resolving complaints filed by clients.
Informs insurance company of non-compliance and recommends to the Insurance Commission, fines or other appropriate corrective actions.
Writes reports and summaries of investigations and examinations.
Recommends additional investigation of insuring company's financial status or new policies and rates to assure solvency and compliance to insurance regulations.
Requests subpoenas to obtain information from insurance companies, agents, brokers or agencies.
May assign and supervise the work of subordinate market conduct examiners.

Knowledge, Skills and Abilities
Knowledge of the practices of insurance companies, brokers, agents, and adjusters.
Knowledge of insurance underwriting and claims procedures.
Knowledge of federal and state laws, rules, and regulations pertaining to the insurance industry.
Knowledge of database and spreadsheet applications.
Ability to analyze and evaluate specific practices, policies and rates of insurance companies in order to identify non compliance.
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 communicate effectively both orally and in writing.

Minimum Qualifications       [Top]
Training:
Graduation from an accredited four-year college or university. Preference may be given to those candidates with Chartered Property Casualty Underwriter (CPCU), Chartered Life Underwriter (CLU), Fellow Life Management Institute (FMLI), Certified Insurance Counselor (CIC), Registered Health Underwriter (RHU), Associate in Claims (AIC), Associate in Underwriting (AU), Associate in Premium Auditing (APA), and Accredited Adviser in Insurance (AAI).
Other insurance designations may also be considered.
Substitution:
Experience as described below may be substituted 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 agent, broker, examiner, adjuster, underwriter, premium auditor or investigator with an insurance company or insurance regulatory agency in the areas of life, accident and health, or property and casualty.

SPECIAL REQUIREMENT:
Candidates will be expected to demonstrate progress toward Accredited Insurance Examiner (AIE) designation within a specified time period.

Established: 8/19/93
Revised:      8/06/07
Effective:     8/06/07

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