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About Insurance
Office of the Director
The director’s office includes the department director, deputy director and general counsel, enforcement counsel, public information staff, legislative coordinator and support staff. The director’s office is responsible for policy decisions, regulation, legislation and communications. The director’s office also includes receivership activities. When a judge orders an insurance company into receivership, the director is responsible for either rehabilitating the company or liquidating it. The department’s enforcement counsel represents the department director in circuit court and various divisions in proceedings before the director.
Resource Administration Division
The Resource Administration Division is responsible for the general operation and support within the department. The division includes the Support Services, Human Resources and Insurance Licensing sections. The division prepares the department’s annual budget request and strategic plan, monitors department revenues and expenditures, organizes training and professional development opportunities for department employees and handles all accounting, procurement and grant management for the department. The division is also responsible for the licensing and renewals of all insurance producers, bail bond agents and public adjusters operating within the state. Prior to granting each license, an application review process is conducted to determine if applicants are sufficiently qualified.
Consumer Affairs Division
The Consumer Affairs Division assists the general public in resolving complaints, providing information to consumers regarding insurance policies and investigating alleged acts of insurance fraud. The division has two sections: Consumer Services and Investigations. The Consumer Services Section fields inquiries from the insurance-buying public and provides general information regarding insurance companies operating in the state of Missouri. The division operates the Consumer Insurance Hotline at 800-726-7390. Consumers can file a complaint or inquiry electronically through the department’s web site, which has a broad array of consumer and industry information available.
The Investigations Section records complaints filed on behalf of consumers against insurance producers, bail bond agents and public adjusters. The staff also investigates unlicensed insurance activities and reviews license applications that are referred from the Insurance Licensing Section. Department investigations may result in license denials, revocations or suspensions, cease and desist orders, injunctions and referrals for criminal prosecution.
The department receives a federal grant from the Centers for Medicare and Medicaid Services, which funds the CLAIM program in Missouri. The CLAIM (Community Leaders Assisting the Insured of Missouri) program provides counseling and educational activities to seniors on health insurance coverage and Medicare benefits. The department contracts with a not-for-profit organization to administer the CLAIM program. The program recruits sponsors and volunteers, develops and conducts volunteer training, publicizes the program and maintains a toll-free number (800-390-3330) for consumers to call. Volunteers are recruited locally and community organizations such as hospitals, community centers, extension offices or senior centers serve as co-sponsors and provide space, supplies and local publicity for the program.
Insurance Company Regulation Division
The Insurance Company Regulation Division monitors the financial condition of all domestic (Missouri based) and foreign (non-Missouri based) insurance companies operating in Missouri. The division includes the Financial Analysis, Financial Examination, Premium Tax and Surplus Lines sections.
The Financial Analysis Section reviews financial statements received from insurance companies on quarterly and annual bases. By monitoring insurance companies, this section is able to identify financially troubled companies so that further action may be taken to prevent insolvencies. The analysts recommend action on proposed business transactions by Missouri-domiciled companies and evaluate mergers and acquisitions, payments of dividends and other proposed transactions for financial and operational impact. The division conducts financial examinations of domestic insurance companies at least every four years and analyzes the financial condition of all foreign companies licensed to sell insurance in Missouri. The department director can call for an examination of a licensed insurer at any time.
The Tax Section audits and determines premium taxes, which insurance companies pay in lieu of income taxes. The department certifies to the Department of Revenue the tax due from each company. The Tax Section certified for collection premium taxes each year, which are deposited into general revenue and the state school fund. The Tax Section regulates the placement of policies and collection of premium taxes on business written in the non-admitted market known as surplus lines.
Insurance Market Regulation Division
The Insurance Market Regulation Division protects the interests of Missouri’s insurance buying consumers by ensuring companies are conducting business in compliance with applicable state statutes and regulations. The division reviews insurance contracts, endorsements and other insurance documents, by reviewing and analyzing a number of rate structures and underwriting practices and by analyzing and examining companies’ marketing and claims handling processes. This division works with insurance company compliance offices to strengthen internal compliance systems. The division includes four sections: the Market Conduct Examination, Statistics, Life and Health, Property and Casualty, and Managed Care sections.
The Life and Health and Property and Casualty Sections approve policy forms, endorsements, illustrations and some rate filings. The Managed Care Section oversees activities of Missouri HMOs and reviews company applications for new certificates of authority or service area changes and analyzes trends in HMO activities. The Statistics Section analyzes and publishes industry and market data as well as trends in the overall industry.
The Market Conduct Examination Section performs exams of insurance companies operating in the state to ensure equitable treatment of policyholders. The department director can call for a market conduct examination at any time. Market conduct examiners review insurers’ operations, including marketing, claims handling, policies and rates. If violations of the laws are detected, the director may issue an order requiring future compliance. For some violations, the director may also require the insurance companies to pay restitution to Missouri citizens, either through re-adjudication of claims or re-evaluation of the premium charged for the policy and/or a fine or penalty.