January 22, 2014

Missouri Department of Insurance reaches settlement with EMC Insurance Companies after market conduct exams

Jefferson City, Mo. - Missouri insurance regulators today announced a settlement agreement with EMCASCO Insurance Company and Employers Mutual Casualty Company after market conduct examinations into their handling of workers' compensation insurance. Department of Insurance Director John M. Huff announced that as part of the settlement, Missouri will receive $207,350 and policyholders will receive restitution of over $14,000.

The examinations found that the companies failed to maintain updated schedule rating worksheets, failed to properly notify insureds of their potential eligibility for a premium adjustment, failed to file their large deductible policies individually and used a schedule rating credit that is not approved for use in Missouri. The credit allowed companies to subjectively adjust for "classification peculiarities" through schedule rating that could potentially lead to unfair rating practices.

The companies will conduct a review of its workers' compensation policies to determine if other policyholders are entitled to restitution. In addition to paying restitution and fines, the companies agree to take remedial action to come in compliance with statutes and regulations of Missouri.

In market conduct exams and investigations, the Department of Insurance reviews insurance company practices regarding the treatment of policyholders. This includes the way premium rates are charged, the way insurers handle claims and other responsibilities under state law. These reviews can result in refunds for consumers, fines and corrections in business practices, as well as other remedies. Since the beginning of 2009, Market Conduct enforcement actions have generated more than $20 million in payments from insurance companies. The money goes toward refunds for consumers, General Revenue and the Missouri State School Fund.

Consumers who have complaints or general questions about life and other types of insurance, can call the department's Insurance Consumer Hotline at 800-726-7390 or by visiting insurance.mo.gov.