The Georgia Department of Insurance:
The state of Georgia is part of the U.S. insurance regulatory framework which is a highly coordinated state-based national system designed to protect policyholders and to serve the greater public interest through the effective regulation of the U.S. insurance marketplace. Through the National Association of Insurance Commissioners (NAIC), U.S. insurance regulators establish national standards and best practices, conduct peer reviews and coordinate their regulatory oversight to better protect the interests of consumers while ensuring a strong, viable insurance marketplace. U.S. insurance regulators also participate in the International Association of Insurance Supervisors (IAIS) along with the NAIC by participating in major standard setting initiatives, including working with fellow regulators from around the world to better supervise cross-border insurers, identifying systemic risk in the insurance sector, and creating international best practices.
Our vision is to have a well-trained workforce, utilizing state of the art technology to facilitate regulation, coordination and uniformity among state regulators and provide public access to services and fire safety information that results in a consumer friendly and competitive market place.
INSURANCE DIVISION: Consumer Services Division
The Consumer Services Division investigates policyholder complaints and responds to inquiries from the public. Our goal is to answer insurance related questions promptly and to ensure fair and equitable resolution of disputes involving insurance transactions between insurers, agents, and policyholders.
If you are a consumer with a complaint, please use our new Consumer Complaint Portal. The Complaint Portal helps speed up the complaint process by allowing you to submit your complaint electronically, including pertinent documents, check the progresss of your case, and view the case up to one year after closure. If you wish to use the mailing process, please click here for more information.
The Consumer Services Division also has a Managed Care Unit that works to resolve complex claims problems between health care providers and managed care insurers. If you are a provider with a complaint, you may also use the Complaint Portal in order to speed up the complaint process - or use the traditional mailing process.
Our Consumer Services office hours are from 8:00 AM-6:00 PM Monday through Friday.
INSURANCE DIVISION: Insurance Financial Oversight
The Insurance Financial Oversight Section of the Insurance Department is responsible for the licensing of companies desiring to transact business in Georgia.
Companies are licensed by issuing a Certificate of Authority to transact insurance business in the state. These certificates must also be renewed annually. The section also approves or disapproves petitions filed with the Secretary of State for insurance companies who want to be incorporated in Georgia, known as domestic insurers.
In the process of deciding on an application for a license, this section must judge the eligibility, soundness, and amount of securities to be deposited with the Commissioner of Insurance by the insurer. Securities may only be withdrawn after the company applies for and receives a written order from the Commissioner.
In addition to licensing insurance companies, the Regulatory Services Section is also responsible for licensing and regulating premium finance companies, prepaid legal service plans, domestic farmers mutual insurance companies, workers compensation group self-insurance funds, and funeral homes that come under the Pre-Need Funeral Service Contract Act.
The section conducts financial, actuarial, rate, market conduct and other forms of examinations of all companies, persons or entities regulated by the Insurance Commissioner. Reviews are also done for proposals for mergers involving a domestic insurer, and the surplus lines law is administered through this section.
All domestic companies must be examined at least once every five years (three years for Health Maintenance Organizations or Medicaid Care Management Organizations), or whenever the Commissioner deems it necessary. Companies licensed in Georgia but incorporated in other states (foreign or alien insurers) are examined by order of the Commissioner, either as an independent examination or by participation in an examination conducted by the insurer's home state. The Commissioner may choose to accept a report of the last examination of a foreign insurer certified by the insurance supervisory official of the company's home state.
If unfair trade practices or other violations of insurance law or regulations are found, the Commissioner can revoke or suspend a company's certificate of authority, or levy fines against the company.
INSURANCE DIVISION: Insurance Product Review
The primary functions of the Insurance Product Review - Property & Casualty Section involve the review of property and casualty insurance rates and the review for approval or disapproval of all policy forms for property and casualty insurance. Rates and rate revisions are reviewed to determine if they comply with the insurance law that requires that rates not be excessive, inadequate or unfairly discriminatory. Statistical plans which are reasonably adopted to each of the rating systems on file are received from statistical agencies and advisory organizations.
Policy forms are reviewed to determine that wording is not ambiguous, that coverage is not unduly restrictive, and that the contract covers a legitimate, insurable interest. This section is responsible for licensing rating bureaus and regulating advisory organizations and collecting such fees associated with new or renewal licenses. The Commissioner may examine any advisory organization in accordance with certain provisions found within O.C.G.A. Section 33-9-22.
In addition, the Property & Casualty Section regulates and/or coordinates with the FAIR Plan Governing Committee, the Federal Flood Insurance Plan, the Georgia Automobile Insurance Plan, and the Workers' Compensation Assigned Risk Plan.
Finally, this section deals directly with local government officials and the public by answering numerous consumer questions.
The primary functions of the Insurance Product Review - Life and Accident and Sickness Section is responsible for reviewing, regulating and approving all policy forms for life and health insurance used in the state.
Insurance policy forms, including riders, endorsements, applications, etc., are disapproved if they contain inconsistent, ambiguous or misleading language, or if they contain provisions which are unfair or contrary to the public policy of the state.
In addition to dealing with insurance companies, this section also works directly with the public, answering many consumer questions. Typical inquiries relate to the legality of certain policy forms, regulation of rates, and veracity of advertising for life and accident and sickness insurance.
The Insurance Product Review - Examinations Section is charged with the responsibility of conducting applicable financial, actuarial, rate, market conduct, and other forms of examinations of all persons or entities regulated by the Office of Commissioner Insurance. The section works in conjunction with the Regulatory Services Section, the Property and Casualty Section, and the Life and Accident and Sickness Section in the performance of its duties.
INSURANCE DIVISION: Agents Licensing Section
The Agents Licensing Section is charged with the responsibility of licensing insurance agents, solicitors, counselors, brokers and adjusters for all classes of insurance.
In order to accomplish this, this section has been given the following authority and duties:
- Administer license qualifications.
- Approve formal classroom or other training courses required of applicants.
- Issue temporary licenses to qualified, first-time applicants.
- Assist in the preparation of examination study manuals to aid applicants in gaining the knowledge required to pass the required written exams.
- Issue permanent licenses as prescribed by law and department regulations.
- Collect and account for all fees as required by law.
- Work out reciprocal agreements with other states for licensing non-resident applicants.
- Handle complaints filed by insurers against agents involving misappropriation of funds, and conduct informal conferences if necessary.
- Work in conjunction with the Consumer Services and Enforcement Sections on other complaints, to determine if there is satisfactory evidence of a violation of the Georgia Insurance Code to warrant administrative action against an agent.
Through strict enforcement of qualification requirements, and firm but fair disposition of violations of the Georgia Insurance Code, the Agents Licensing Section strives to eliminate those licensees who, through unethical, unfair or illegal practices, tend to destroy confidence in the insurance industry.
INSURANCE DIVISION: Enforcement Section
The Enforcement Section represents the various divisions of the Office of Insurance Commissioner at public hearings called by the Commissioner, and renders a variety of administrative and legal research services to the Commissioner and members of his staff.
The section investigates and makes recommendations to the Commissioner regarding agents' license revocations, cease and desist orders, and other such matters involving the Commissioner's regulatory responsibilities.
This section drafts "Notices to Correct Conditions" for the Safety Fire Division to notify facilities that are in violation of the state's fire safety laws, and coordinates with the Attorney General's Office when further legal action is necessary.
Other duties of Enforcement include the administration of Georgia's insurance holding company laws; the handling of insurance company receiverships; drafting proposed legislation; drafting reciprocal agreements with other states; and responding to requests for information or legal interpretation from consumers, outside counsel, insurance companies, and insurance agents
INSURANCE DIVISION: Fraud Investigation Unit
This unit is an integral part of the Enforcement Section and plays an essential role in the overall mission of the Office of Commissioner of Insurance. The unit investigates illegal insurance activities that are perpetrated by companies, agents, or individuals. There are those who design and implement criminal fraud schemes of incredible complexity and magnitude. Fraudulent activities that consume dollars reserved for legitimate claim payments or otherwise undermine the stability of the insurance financial network affect all Georgians.
Investigators of the Fraud Investigation Unit cover a wide variety of crimes and fraudulent schemes. Some involve autos, boats, or heavy equipment; others involve health care fraud. Still others include "rings" made up of doctors, lawyers, chiropractors, auto repair facilities, adjusters and claim handlers. Whatever the "specialty," the unit will probably work them time and again. After an investigation is completed, the unit's investigators obtain warrants, arrest the perpetrators, and assist the state prosecutors in bringing them to trial.
INDUSTRIAL LOAN DIVISION
The Industrial Loan Division is charged with the responsibility of licensing and regulating the small loan industry in the state of Georgia. These businesses are licensed under the Georgia Industrial Loan Act to lend cash to consumers in amounts not to exceed $3000, for a period not to exceed 36 months, 15 days.
An industrial loan company applicant must meet three requirements in order to be licensed: (1) A net worth of at least $25,000; (2) Be of good character; (3) Meet the convenience and advantage criteria of the Industrial Loan Act (i.e., prove that the people within the community need this service). There are approximately 1037 industrial loan offices licensed in the state.
The loan offices are audited by the Loan Division to ensure that borrowers have not been overcharged in any manner. These examinations, as required by statute, are purely for the benefit of the borrowers, and are not directed toward examining the financial stability of the lender. However, the division does require the filing of an annual financial statement by each loan office.
The Industrial Loan Division also furnishes a complaint service to the citizens of Georgia. Complaints may be lodged in writing, in person, or by phone. Each complaint is answered or investigated, and action is taken where appropriate.
SAFETY FIRE DIVISION: Georgia State Fire Marshal's Office
As a direct result of the Winecoff Hotel fire in which 119 people lost their lives in 1946, the Georgia Safety Fire Law came into being. The General Assembly enacted legislation relating to fire safety in public buildings and assigned the responsibility for executing the law to the Commissioner of Insurance, who was named ex-officio Safety Fire Commissioner. The law further authorized the appointment of a State Fire Marshal and the creation of the State Fire Marshal's Office.
The Safety Fire Commissioner is responsible for investigating and examining construction and engineering techniques, construction material properties and fire prevention and protection techniques. Based upon research, the Commissioner then adopts Rules, Regulations, codes and standards that provide reasonable and practical protection for persons and property from fire. The Rules, Regulations, codes and standards adopted by the Commissioner have the force and effect of law and have statewide application as the state minimum fire safety standards.
The responsibilities of the Fire Marshal's Office fall into six main categories: Building Inspection, Engineering, Manufactured Housing, Fire Scene Investigation, Hazardous Materials and Fire Safety Education.
The office enforces fire safety rules and regulations for hotels, apartment houses, schools, day care centers, personal care homes, churches, hospitals, nursing homes, industrial buildings, race tracks, and other buildings throughout the state. The engineering staff deals with buildings in the planning and construction stages, reviewing and approving plans. Fire Safety Compliance Officers examine new and existing structures for compliance with applicable state and national safety fire laws and adopted codes. When a facility is determined to be in compliance with the adopted codes, a certificate of occupancy is issued.
The office issues licenses to traveling carnivals, circuses and racetracks, and issues Certificates of Competency to fire sprinkler contractors. Under contract with the Georgia Department of Human Resources, the office conducts Medicaid/Medicare fire safety surveys.
In conjunction with the federal Department of Housing and Urban Development (HUD), the office monitors the Georgia manufactured housing industry to ensure fire safety and durability of new manufactured homes. Also, this office performs consumer complaint handling to assist citizens who are experiencing problems and are unable to secure help from the manufacturer and/or dealer. Dealer lot facilities are inspected to prevent dealer tampering and alterations to manufactured homes.
Upon the request of local officials, fire scene investigators assist in determining the cause and origin of suspicious fires. When evidence of suspected arson is found, investigators help local authorities prosecute, and serve as witnesses when cases go to trial.
The Fire Marshal's Office regulates the storage, transportation and handling of various hazardous materials, and enforces the blasting act. Regulatory licenses are issued annually for control of explosives, liquefied petroleum gas, and fireworks manufacturing facilities. Permits are issued for control of anhydrous ammonia, self-service dispensing of motor fuels, fireworks public exhibition, and explosive blasting.
Additional public safety responsibilities include pipeline safety, environmental protection, and jurisdiction over underground storage tanks. The State Fire Marshal also has the duty of collecting and analyzing data on fires that occur in the state and reporting this information to the National Fire Incident Reporting System.
Finally, the Office is responsible for promoting fire safety education. To this end, the office requires fire drills in the local school systems and encourages schools, fire departments and community groups to participate in fire prevention education. Such activities include the Junior Fire Marshal Program, the Fire Safety House and the National Fire Protection Association's Learn Not to Burn Program. The Office coordinates statewide participation in the National Fire Prevention Week activities each October. Additionally, the Office has established programs to promote citizen involvement in fire safety education through programs such as the day care provider program, smoke detector programs and statewide seminars.
The Premium Tax Division is responsible for ensuring compliance with the insurance tax laws, rules and regulations and for processing the premium tax returns for all insurance companies and surplus lines transactions in the State of Georgia. In addition, the Premium Tax Division assesses collects and distributes the County/Municipal Tax and, assesses and collects the Special Insurance Fraud Fund.