Market Regulation

The Market Regulation Division monitors market conduct activity of domestic and foreign Property and Casualty (P&C) insurance companies, Life and Health (L&H) insurance companies, Premium Finance companies, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO) etc…as required by North Carolina General Statute, Chapter 58.

Examinations are used to monitor compliance with statutes and regulations in the following areas: Policyholder Treatment, Sales, Marketing, Underwriting and Rating, Agent Appointments and Terminations, Nonforfeitures General Administration, Provider Relations and Delivery Systems, Utilization Management, Quality Management, Provider Credentialing, Delegated Oversight, and Claims.

Staff members perform a combination of in-house reviews of various documents submitted by the regulated entities and on-site examinations of company records and operations.

The Market Analysis team performs market conduct analysis by collecting and analyzing data on domestic insurance entities and insurance entities that are licensed to do business in the State of North Carolina but are not domestic to this state.

This is done to identify general market disruptions early and to eliminate or limit harm to consumers, policyholders and/or claimants.

Published Examination Reports

https://www.ncdoi.gov/insurance-industry/market-regulation