1 - Division of Insurance

 

The Division of Insurance administers the laws of the Commonwealth as they pertain to the protection of the insurance consumer through the regulation of the insurance industry. The Division monitors financial solvency; licenses insurance companies and producers; reviews and approves rates and forms; and coordinates the takeover and liquidation of insolvent insurance companies and the rehabilitation of financially troubled companies. The Division also investigate and enforce state laws and regulations pertaining to insurance and respond to consumer inquiries and complaints. The Division provides the public with information regarding various types of insurance through its website and assorted publications.

1.1 Mission

The primary mission of the Division of Insurance is to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products. Protection of consumer interests is of prime importance. The Division safeguards these interests by providing accurate and unbiased information so consumers may make informed decisions and by intervening on behalf of consumers who believe they have been victimized by unfair business practices.

1.2 Primary Activities


The Division of Insurance protects consumers and promotes a fiscally sound insurance marketplace through the performance of six primary activities. Taken together, these activities represent the core of effective insurance regulation.

License Insurance Companies


The process of licensing insurance carriers promotes a marketplace of solvent, fiscally sound companies through the review and analysis of filings and financial statements.

Examine the Financial Condition of Insurance Companies

 

The Division monitors the financial condition of insurance carriers through quarterly financial analyses. This process provides an early warning of possible financial problems so that appropriate regulatory action can be taken before the extreme situation of an insolvency. The monitoring process also includes periodic on-site financial examinations of all domestic carriers to value assets, determine liabilities and verify compliance with applicable statutes and regulations.

Examine the Market Conduct of Insurance Companies

Beyond the financial health of an insurer, the Division also examines how the company interacts with policyholders and potential customers. The market conduct process looks beyond the financial condition of a company by examining business practices such as policy underwriting and rating practices; cancellations and non-renewals; claim settlements; original insurance applications; and advertising materials. The goal of these examinations is to confirm that Massachusetts consumers are treated with fairness and according to the terms of the insurance contract.

Regulate Insurance Policy Forms, Rates and Programs

 

By reviewing and approving insurance policy forms, rules, rates, and associated program procedures and operations, the Division verifies that insurance products sold to Massachusetts consumers by licensed insurance companies comply with the laws and regulations of the Commonwealth.·

License Insurance Producers and Others

 

The process of licensing insurance producers and other key participants in the insurance industry allows the Division to promote a marketplace where individuals and firms conducting the business of insurance are qualified and that they conduct business within the requirements of the laws and regulations of the Commonwealth.·

Resolve Insurance Consumer Complaints

 

The Division provides the general public with a non-judicial alternative for pursuing complaints against insurance companies and producers. Every consumer submitting a complaint receives a reply and a resolution that is consistent with Massachusetts law.

1.3 Organizational Chart

1.4

Division of Insurance

Staffing Levels

 

 

 

Human Resources

The Administration Department works closely with the Human Resources department of the Office of Consumer Affairs and Business Regulation on all aspects of managing the Division's workforce, including hiring, promoting, and training. In addition, working with the Division's Labor Relations Counsel, the Administration department responds to various labor relations issues, including employee complaints, grievances and other activities. As of December 31, 2008, the DOI employed 129.27 full time equivalent (FTE) staff.


 



DIVISION OF INSURANCE BUDGET

Main Appropriation

$10,960,219

Medical Malpractice Fund

$342,670

Health Care Access Bureau

$600,000

Workers' Compensation Fund

$723,616

SRB Medical Malpractice Fund

$359,250

Total

$12,985,755

 

1.5 Budget, Revenue & Assessments

Budget



REVENUE

Appointments

$34,168,469

Company Licenses

$295,050

Domestic Company Exams

$654,710

Fines & Penalties

$411,200

Rate & Form Filing Fees

$692,775

Annual Statements

$213,085

Life Insurance Valuations

$666,474

Miscellaneous

$189,658

Total from Companies

$37,291,421

 

 

Special Brokers Tax

$27,590,625

Producer Licenses

$8,259,485

Other Licenses & Exam Fees

$281,075

Board of Appeal Filing Fees

$2,245,123

DPH Lead Paint Surcharge

$807,640

Miscellaneous

$64,857

Total from Individuals

$39,248,805

 

The Division receives an annual appropriation to account 7006-0020 from the General Court, the value of which is then assessed back on the entities regulated by the Division. In addition, the Division has three statutorily created trust accounts: State Rating Bureau Workers Compensation Trust Account - 9222-7650; State Rating Bureau Medical Malpractice Trust Account - 9222-7900; and, the DOI Medical Malpractice Trust Account - 9222-7500. These appropriations are funded through direct assessment on the insurance industry.

The Administration Department works closely with the Budget Department of the Administrative Services Unit of the Office of Consumer Affairs and Business Regulation on the Division's budget, the Governor's budget recommendation for House 1, the allocation of funds into lower subsidiaries and the management of the spending throughout the year.

Revenue & Assessments

The Division of Insurance collects revenue from individuals and companies as part of its statutory responsibilities. In addition, the Division also bills assessments to the industry and collects these funds for the General Fund. Most revenue collected from companies and individuals comes from application and filing fees as well as some fines and penalties.



ASSESSMENTS

Attorney General - Rate Setting

$1,862,332

Attorney General - Auto Fraud

$432,026

Attorney General - Workers' Compensation Fraud

$280,146

Department of Fire Services

$12,207,596

DOI Operations

$10,960,219

Health Care Access Bureau

$654,793

Medical Malpractice Analysis Bureau

$309,996

Merit Rating Bureau

$9,241,546

Special Life Assessment

$1,014,000

SRB Operations

$917,221

SRB Medical Malpractice

$452,692

SRB Workers Compensation

$817,141

Total Assessments

$39,149,726

 

The Commissioner of Insurance is required by the Massachusetts General Laws to bill assessments to insurance companies for various purposes. In Fiscal Year 2008, the Division billed twelve assessments totaling more than $39 million. The revenue collected from these assessments fund a number of state agencies, including the Division of Insurance, Registry of Motor Vehicle's Merit Rating Board, the Department of Fire Services and various fraud fighting programs in the Attorney General's Office.

Taken together, these revenues and assessments are typically nine to ten times greater than the annual budget appropriation for the Division. In Fiscal Year 2008, the Division of Insurance collected a grand total of more than $115 million.



TOTAL 2008 DOI REVENUE COLLECTIONS

Company Revenue

$37,291,421

Individual Revnue

$39,248,805

Assessments

$39,149,726

Total Collections

$115,689,952

Budget, Revenue and Assessment figures on this page are from the 2008 Fiscal Year - July 1, 2007 through June 30, 2008.
 

 
 

A Bargain for Taxpayers

2007 Staffing & Budget National Rank:

 

 



 

A Bargain for Taxpayers

 

 



 

Insurance Written in Massachusetts

According to a 2008 survey by the National Association of Insurance Commissioners (NAIC), Massachusetts ranks 10 th among 56 U.S. states and territories with respect to premium written by domestic insurers.

Considering that the Commonwealth's population is much smaller than the other states in the top 10, Massachusetts shoulders a disproportionate share of the responsibility to regulate U.S. insurers. In fact, by most any measure of regulatory performance, the Massachusetts Division of Insurance does more with less. Compared to most other states, the Division represents a relative bargain for taxpayers, policyholders and insurers in the Commonwealth.

The Division of Insurance does more…

 
 

 
 

 


…with less

 
 

1.6 The Massachusetts Insurance Marketplace

Massachusetts Domestics



Hundreds of insurance companies are licensed to do business in the Commonwealth of Massachusetts. Each year, these companies write tens of billions of dollars in premium in Massachusetts. The Division of Insurance licenses each of these companies and regulates all aspects of their business conduct. For those companies chartered in Massachusetts, the Division is responsible for ensuring company solvency. Monitoring the solvency of Massachusetts domestics not only protects citizens of the Commonwealth, but policyholders across the nation and around the world.

In 2008, Massachusetts was the domicile of:

· 59 property & casualty insurers

· 19 life, accident and health insurers

· 3 title insurance companies

· 10 health maintenance organizations

· 2 lodge fraternal organizations

· 3 medical service corporations

· 24 workers' compensation self-insured groups

· 4 residual market pools

· 162 fraternal benefit and mutual aid societies

Company Market Share

Among the scores of insurance products marketed and sold in Massachusetts, certain lines of insurance represent the lion's share of premium and policies. Premium written under Accident and Health, Homeowner's, Life, Automobile and Worker's Compensation policies make up approximately 50% of all premium written in the Commonwealth. With the exception of Private Passenger Automobile Insurance, most lines of insurance operate with diverse markets. Consumers can choose from among large numbers of competing companies. 

Top 10% of Selected Market Sectors












* Most health insurance is offered through Health Maintenance Organizations (HMOs). For HMO market share data, see appendix C-20