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The Complaint Handling and Reporting Standards Sub-Group is comprised of members of the former Complaint Handling and Reporting Standards Working Group, which now operates as a Sub-Group reporting to the Consumer Protections (D) Working Group. The former Working Group was first convened at NAIC’s 2006 Spring Quarterly Meeting, with the charge to create and promote uniformity in complaint handling and reporting. Ultimately, successfully accomplishing this mission will benefit regulators, companies, and consumers alike, by ensuring that complaint data are meaningfully interpretable for market analysis and public information purposes while at the same time improving regulator response and intervention on behalf of consumers.
It was recognized that fulfilling this charge would require attention to a wide range of complaint-related issues, potentially including:
- Clarifying/editing the existing reason codes and disposition codes within NAIC’s existing CDS (Complaint Database System) coding scheme.
- Modifying the structure of the CDS coding scheme, to properly group reason codes into broader categories, and create new fields to properly track complaint themes and findings.
- Establishing guidelines for consistent complaint handling starting with the definition of a complaint and examining state processes for receipt and recording, including inquiries, correspondence investigation, including complaints against individuals (Producers,etc.) as well as insurance companies, closure, complaint verification/reconciliation to ensure correct coding.
- Developing/enhancing training materials, including NAIC’s CDS manual, for regulators who work with complaints.
- Establishing guidelines for the consistent reporting of complaint-related statistics, whether at the NAIC, including coordination with the Consumer Protection Ex Taskforce, now the “D” Committee Consumer Protection Working group or state level.
- Examining best practices and technology applications and models that would assist the states in promoting uniformity and enhance services to the insurance consumer.
Shortly after the first meeting in March, 2006, a Sub-Group representing several states and NAIC was formed to begin addressing items 1 and 2 above, and it has continued to meet following merger with the Consumer Protections Working Group. Taking into consideration comments from regulators and other interested parties, the Sub-Group embarked upon an intensive discussion and review of the CDS reason codes and disposition codes to arrive at a package of consensus recommendations.
The Sub-Group’s work plan is to finalize any remaining discussion of this initial package of recommendations in time for the September meeting of the Consumer Protections Working Group, when the recommendations will be presented for a vote by the Working Group. The Sub-Group has scheduled three calls, to be held at 2:00pm EST on June 28, July 26, and August 30. Upon the Working Group’s approval of these recommendations, the Sub-Group will commence work on the other related tasks listed below the first paragraph above. |
