DEPARTMENT OF REGULATORY AGENCIES
Division of Insurance
3 CCR 702-6
CONSUMER PROTECTION (GENERAL)
Amended Regulation 6-3-1
CONCERNING THE USE OF INDEPENDENT MARKET CONDUCT SURVEILLANCE PERSONNEL EXAMINERS AND APPEAL PROCESS FOR FEES AND EXPENSES
Section 1 Authority
Section 2 Scope and Purpose
Section 3 Applicability
Section 4 Definitions
Section 5 Rules
Section 6 Severability
Section 7 Enforcement
Section 8 Effective Date
Section 9 History
Section 1 Authority
This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109 and 10-1-204304, C.R.S.
Section 2 Scope and Purpose
The purpose of this regulation is to set forth requirements for the use of independent contract market conduct surveillance personnelexaminers and to provide a process for the appeal of fees and expenses charged by such surveillance personnelexaminers.
Section 3 Applicability
This regulation applies to all market conduct examinations conducted under Article 1 of Title 10.
Section 4 Definitions
A. “Commissioner” shall have the meaning as found at set forth in § 10-1-102302(51), C.R.S.
B. “Division” shall have the meaning as found at set forth in § 10-1-202302(24), C.R.S.
C. “Entity” shall have the meaning of: “company”, as set forth in §§ 10-1-102(6) and 10-1-202302(12), C.R.S.; “insurer”, as set forth in §§ 10-1-102(13) and 10-1-202(6), C.R.S.; “carrier”, as set forth in § 10-16-102(8), C.R.S.,; and “title insurance company” as set forth in § 10-11-102(10), C.R.S., “contract seller” as set forth in § 10-15-102(6), C.R.S.; and “general provider” as set forth in § 10-15-102(9), C.R.S..
D. “Examination” shall have the meaning as found at set forth in § 10-1-202302(36), C.R.S.
E. “Market Conduct Surveillance Personnel” (“Surveillance Personnel”) shall have the meaning as found at § 10-1-302(8) C.R.S.
Section 5 Rules
A. Selection of ExaminersMarket Conduct Surveillance Personnel
1. The Division may use independent contract market conduct examiners surveillance personnel to perform examinations of entities subject to this regulation using the following criteria:
a. Number and frequency of examinations;
b. Workload and availability of Division staff;
c. Out-of-state travel requirements and location of examination site;
d. Experience and background of an independent contractor;
e. Special expertise required for an examination; and
f. Market issues requiring an unanticipated examination
2. Preference will be given to Colorado domestic entities, and then to entities with Colorado regional home offices, in determining whether the examination will be conducted by state employee surveillance personnelexaminers rather than independent contract market conduct surveillance personnelexaminers.
B. Appeal Process for Fees and Expenses of Independent Contract Market Conduct Surveillance PersonnelExaminers
1. An entity may contest the reasonability of the fees, costs and/or expenses by filing an appeal with the Commissioner, with a copy to the independent market conduct surveillance personnelexaminer, within ten (10) calendar days after receipt of the surveillance personnelexaminer’s billing. Such appeal must set forth the charges that are considered to be unreasonable and the basis for the claim.
2. The entity shall pay any non-contested fees, costs and/or expenses to the independent contract surveillance personnelexaminer according to the independent contractor’s invoice.
3. The Commissioner shall review the appeal from the entity within fourteen (14) calendar days after receipt of such appeal and shall notify the entity in writing of the findings. Charges under dispute shall not be due until the Commissioner has reviewed the appeal and has rendered written findings, which constitute final agency action.
4. If the Commissioner determines that the charges under dispute are reasonable and in accordance with guidelines maintained by the Commissioner, the entity shall issue payment for such charges to the independent contract market conduct surveillance personnelexaminer within fourteen (14) calendar days of being notified of the Commissioner’s determination, and shall so notify the Commissioner.
Section 6 Severability
If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected.
Section 7 Enforcement
Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date
This amended regulation is effective on July 1, 2012 June 1, 2018.
Section 9 History
New regulation effective April 1, 1998.
Amended regulation effective August 31, 2005.
Amended regulation effective July 1, 2012.
Amended regulation effective June 1, 2018.