Exam Reports - Health Insurance Companies

Examination Reports - Health Insurance Companies

The Department is required by law to conduct examinations into the affairs of domestic insurers and HMOs. In addition, we also have the authority to conduct an examination into the affairs of any insurance corporation, or other insurer doing or authorized to do any insurance business in New York state. There are generally two types of examinations: financial and market conduct. Examinations that cover both financial and market conduct are referred to as "combined."

The purpose of a financial examination is to verify that an examined entity's financial statement, as of the examination date, as well as its corporate conduct during the examination period, are in compliance with Department laws, rules, and regulations.

A market conduct examination is focused on the fair treatment of policyholders and the scope of these examinations is on areas such as company operations, complaint handling, marketing, claims, rate and form filing and policyholder service.