State RegulationsFL specificDifficulty 3/5
Complaints have surfaced about an insurer's systematic delays in paying health claims. Which Florida regulator examines the insurer's market conduct?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Market conduct examinations of insurers, covering claims practices, underwriting, and marketing, are conducted by the Office of Insurance Regulation under the Florida Insurance Code. The Department of Financial Services investigates agents and handles consumer complaints and criminal insurance fraud, but the market conduct examination of an insurer is OIR's function.
Why the other options are wrong
- A) The Division of Insurance Fraud pursues criminal insurance fraud, not regulatory examinations of claims practices.
- B) The Office of Financial Regulation supervises banks and securities firms, not insurers' market conduct.
- D) State attorneys prosecute crimes; they do not conduct market conduct examinations of insurers.
Memory hook
Company behavior is examined by OIR; agent behavior by DFS.