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 investigates and enforces state laws and regulations pertaining to insurance and responds 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 (CL)

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 (F)

 

 

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 (MC)

 

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 (SRB)



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 (PL)



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 (CS)



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


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, 2009, the DOI employed 124.4 full time equivalent (FTE) staff.


 



DIVISION OF INSURANCE BUDGET

Main Appropriation

$11,132,928

Medical Malpractice Fund

$365,558

Health Care Access Bureau

$1,100,000

Workers' Compensation Fund

$729,976

SRB Medical Malpractice Fund

$348,557

Total

$13,677,019

 

1.5 Budget, Revenue & Assessments

Budget



REVENUE

Appointments

$38,207,891

Company Licenses

$291,589

Domestic Company Exams

$686,786

Fines & Penalties

$148,982

Rate & Form Filing Fees

$1,035,190

Annual Statements

$217,467

Life Insurance Valuations

$676,074

Miscellaneous

$281,877

Total from Companies

$41,545,856

 

 

Special Brokers Tax

$26,197,678

Producer Licenses

$8,595,706

Other Licenses & Exam Fees

$281,625

Board of Appeal Filing Fees

$2,192,131

DPH Lead Paint Surcharge

$853,125

Miscellaneous

$50,761

Total from Individuals

$38,171,026

 

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

$1,750,995

Attorney General - Auto Fraud

$438,506

Attorney General - Workers' Compensation Fraud

$284,456

Department of Fire Services

$17,218,793

DOI Operations

$11,132,928

Health Care Access Bureau

$978,855

Medical Malpractice Analysis Bureau

$362,044

Merit Rating Bureau

$9,240,064

Special Life Assessment

$1,014,000

SRB Operations

$974,118

SRB Medical Malpractice

$467,685

SRB Workers Compensation

$865,993

Total Assessments

$44,728,437

 

The Commissioner of Insurance is required by the Massachusetts General Laws to bill assessments to insurance companies for various purposes. In Fiscal Year 2009, the Division billed twelve assessments totaling more than $44 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 2009, the Division of Insurance collected a grand total of more than $124 million.



TOTAL 2008 DOI REVENUE COLLECTIONS

Company Revenue

$41,545,856

Individual Revnue

$38,171,026

Assessments

$44,728,437

Total Collections

$124,445,319

 


Budget, Revenue and Assessment figures on this page are from the 2009 Fiscal Year - July 1, 2008 through June 30, 2009.
 




A Bargain for Taxpayers


Insurance Written in Massachusetts

According to a 2009 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. The survey consisted of data from 2008.

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 Massachusetts 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 2009, Massachusetts was the domicile of:

 

  • 56 property & casualty insurers
  • 19 life, accident and health insurers
  • 3 title insurance companies
  • 11 health maintenance organizations
  • 2 lodge fraternal organizations
  • 3 medical, dental or vision service corporations
  • 22 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, Homeowners, 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