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Insurance market regulation

Insurance market regulation

The Division of Financial Regulation (DFR) monitors insurance companies for compliance with the Oregon Insurance Code through market analysis, market conduct examinations, and interstate collaboration.

Consumer complaints from the Advocacy Section are the main origin of market analysis. Other reasons include issues identified in other states, data calls, and other sources. A data call is a survey about a specific topic the division sends to all insurers it regulates.

DFR market analysts conduct in-depth investigations on insurer business. The focus of this work is to investigate regulatory issues that have the most potential for consumer harm. The division often collaborates on compliance issues with other states through the National Association of Insurance Commissioners.

A market analysis investigation can have many outcomes. These include the investigation is closed with no regulatory action, the insurer is asked to make a small change to a policy or procedure, a market conduct examination is opened, or the case is referred to an enforcement action. Most investigations do not result in a formal enforcement action. 

A market conduct examination is a formal evaluation of an insurer's business practices that may be in conflict with contract provisions, state laws, rules, regulations, or orders of the insurance commissioner. The insurance companies pay for the costs of these exams. The relevant statutes are ORS 731.308 and 731.312.


Market Analysis Cases 2021
Cases opened
111
Cases closed
104
Cases referred to Enforcement
16
Amount recovered*
$627,063

*Financial benefit, reported as a monetary amount, DFR is able to achieve for consumers through a process other than an administrative action that results in an enforcement order.

Market Conduct Examination Reports

Valley Property & Casualty Insurance Co.

Kaiser Foundation Health Plan

SB 860 Reports

Current and future exams topics

  • HB 3272
  • Virtual adjusting
  • Total loss notifications/valuations
  • Timely communications
  • Prompt pay
  • Network directories
  • External review

Market analysis case statistics: 2021 - 2022


Consumer Complaints Casework Statistics