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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 cases . Other sources include issues identified in other states, data calls, and collaboration with other units within DFR. 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 into insurers’ business practices . 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 change  to a policy or procedure, a market conduct examination is opened, or the case is referred to the Enforcement Section to determine whether an enforcement action is warranted. 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 2023
Cases opened
Cases closed
Cases referred to Enforcement
Amount recovered*

*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  click a year to view reports for that year

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Aetna Life Insurance Company  (12/31/2020)
   -  Company response

Allstate Vehicle and Property Insurance Company  (07/10​/2023)
   -  Exam report cover letter​​

BridgeSpan Health Company  (12/31/2020)
   -  Company response

California Casualty General Insurance Company of Oregon  (02/27​/2023)
   -  Exam report cover letter​​​

Cigna Health and Life Insurance Company  (12/31/2020)
   -  Company response

CSAA General Insurance Company  (11/14/2023​)
   -  Exam report cover letter
   -  Company response

​Health Net Health Plan Of Oregon, Inc.  (12/31/2020)
   -  Company response

Homesite Insurance Company of the Midwest  (08/23/2023​)

Kaiser Foundation Health Plan Of The Northwest  (12/31/2020)
   -  Company response

Moda Health Plan Inc.  (12/31/2020)

Oregon Mutual Insurance Company  (07/15/2023)
   -  Exam report cover letter​​

PacificSource Health Plans​  (12/31/2020)
   -  Company response

Providence Health Plan  (12/31/2020)
   -  Company response

Regence Bluecross Blueshield Of Oregon  (12/31/2020)
   -  Company response

Safeco Insurance Company of Oregon  (03/21/2023)
   -  Exam report cover letter​​​​
   -  Company response

Samaritan Health Plans, Inc.  (12/31/2020)
   -  Company response

Travelers Personal Insurance Company  (10/31/2023)
   -  Exam report cover letter​​​​
   -  Company response

UnitedHealthcare Insurance Company  (12/31/2020)
   -  Company response

UnitedHealthcare of Oregon, Inc.  (12/31/2020)
   -  Company response

​​​​​ Kaiser Foundation Health Plan(4/24/2018)
– ​Kaiser Foundation’s response

​​​​ Providence Health Plan ​  (12/31/2018)

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: 2022-2023