Types of Violations
Market Conduct - Market conduct violations are the result of audits or examinations. These are performed to ensure the company is operating within the boundaries of PA statutes and regulations. These examinations may include a review of claims handling, received complaints, services to policyholders, advertising and marketing, and underwriting and rating to ensure fair and non-discriminatory practices. If a violation is found the insurance company could be assessed penalties and ordered to pay restitution to policyholders and a market conduct order will be created.
Enforcement Action - An enforcement action is the result of a negative finding by the enforcement unit. Often initiated by a complaint, an investigation of an insurance licensee would take place. If a violation is found to have taken place they will impose fines, suspend and revoke insurance licenses, and order restitution to be paid to consumers and an enforcement action record will be created.
Continuing Care Retirement Communities (CCRCs) – CCRC Final Examination Reports are the result of statutory audits, and they are classified as financial examinations. These are performed to ensure the provider is operating within the boundaries of PA statutes and regulations. The examinations may include a description of the facilities, fees and services, refund policies, management and corporate details, annual disclosure statements, resident agreements, pending litigation, financial statements, and recommendations. If a violation is found the provider could be assessed penalties. More information about Pennsylvania’s continuing care retirement facilities can be found in our CCRC search portal.
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