Regulatory Roundup: Washington Tackles Fraud, NOAA Purges Staff Ahead of Storm Season

State-by-state variations of laws, compliance protocols, industry transparency, and general regulatory culture can lend one the impression that keeping up with industry changes is a little bit like herding cats. So, what better way to wrangle some of the more localized insurance news than in a Regulatory Roundup?

On an ongoing basis, in no particular order or rank, we’re wrestling the various regulatory changes, compliance actions, and commissioner decisions into our roundup. As a disclaimer: There’s a lot going on at any given time in these here United States, so this isn’t a comprehensive picture of state-level action by any means. Think of it, instead, as a sampler platter of regulation. 

Also important to note: If we’re recapping interpretations of legal decisions, this is some armchair insurance speculation and not at all legal advice. If you need legal advice, get a lawyer. 

Insurance fraud doesn’t pay in Washington (the state)

Two Washington state residents pleaded guilty to insurance fraud in the state.

The Office of the Insurance Commissioner put out a news release to point to two different Washingtonians. One fraudster employed a carpet cleaning firm to clean his home, and then filed a claim against the business’s insurance, saying they had damaged his property in the cleaning. When the carpet cleaning company disputed the claim and then found the pictures from his “claim” as stock photos online, the insurer confidently forwarded the information to the state.

The fraudster pled guilty to insurance fraud and must pay $500 in court fees, serve 24 months of probation, and do 80 hours of community service.

The second fraudster filed a claim that an attempted carjacking damaged his sweet ride. Sadly for him, his insurer realized the damage reported to his ride was identical to those he reported in a 2022 claim. His $7,000 claim was denied, he pleaded guilty to fraud, and was also sentenced to serve 80 hours of community service and 24 months of probation.

Feds purge NOAA workers ahead of storm season

The current purge of federal agencies has yet-untold results: Will it be a needed cut to funding flab that gets the national debt straightened up for a future of low taxes and an economy on a safe upward cruise? Or will it result in long-term chaos, including unmeasurable lost institutional knowledge that erodes public confidence and has a domino effect of dangerous consequences for public health and safety? Maybe some combination of both? Maybe neither?

That’s not our place to speculate, but as President Donald Trump’s administration cuts hundreds of jobs from the U.S. National Oceanic and Atmospheric Administration (NOAA) and its downstream agency, the National Weather Service (NWS), current and former officials are pulling red flags. Officials’ prevailing concern is that NWS and NOAA infrastructure are key to sounding alarms about weather systems. Whether we’re talking about the meteorologist at the local TV station, the app on your phone, the data a state uses to declare an emergency, a model an insurer uses to assess claims adjuster needs in a region, the stats parametric models use for a coverage trigger, or even the information that powers IoT devices to prevent losses, virtually any weather-related data is powered by the NWS. 

As storm season begins, with its tornadoes, hurricanes, windstorms, and the ever-present threat of wildfires, the purge of more than 800 federal workers from NOAA is certainly something worth a watch.

Other state regulatory changes

Alabama Department of Insurance officials issued a news release that they recovered $8.4 million through complaint resolutions and help with disputed claims settlements in 2024.

California Department of Insurance officials selected Secure Screenings Solutions, Inc., doing business as “Capital Live Scan,” to handle state fingerprinting. Producers should be prepared to pay $74 total – $17 for the FBI processing fee, $32 for Department of Justice processing, and $25 for Capital Live Scan.

Colorado Division of Insurance officials have withdrawn regulations concerning prior authorization reporting: Amended Regulation 4-2-49, Regulation 4-2-101, Regulation 4-2-102. The state has adopted a regulation about drug pricing transparency and reporting requirements for health care insurers and pharmacy benefits managers to submit each January and July. The state also adopted a bulletin clarifying how the state law requiring insurance carriers to cover abortions (effective Jan. 1, 2025) works for carriers that offer coverage on the state’s healthcare exchange.   

Delaware updated bulletins for producers and adjusters and for insurers to reiterate that they shouldn’t be soliciting new business from consumers during a loss event (i.e., don’t go door-to-door during flood cleanup trying to push policies). Revisions to the bulletin include updates from a new state law that gives insurers the ability to limit policy assignability and that requests that insurers start putting more terms about adjusters and contractors in clear, consumer-friendly language. 

Florida has issued a memorandum to remind property insurers that, when evaluating claims that run into “concurrent causation”––for instance, a windstorm breaks in your window and the rain drenches your living room––they shouldn’t just wait for policyholders to try to work it out in court before they pay out on a policy. The state Office of Insurance Regulation is also expanding its call for data related to National Flood Insurance Program’s Write Your Own (WYO) Program. The Florida CFO, Jimmy Patronis, also banned all Florida Department of Financial Services employees from using DeepSeek. 

Georgia issued a bulletin to open the applications for attorneys and adjusters to join an arbitration panel that’ll be arbitrating disputed total loss property claims. A directive (Directive 25-EX-1) outlines changes to the way health insurers have to file their “CATCH” reports. 

Hawaii released its annual report for third-party administrators (TPAs) to file, which are due every March 1 to ins-examtpa@dcca.hawaii.gov.

Michigan is still adjusting fees for inflation, with the Department of Insurance and Financial Services issuing updates for the annual medical provider fee schedule, the maximum deductible for health and accident qualified health coverage policies, and the maximum cemetery or funeral policy assignment value. Another state bulletin revises the forms auto insurers must issue to consumers to allow them to add personal injury protection and bodily injury liability benefits to their policies.

Minnesota legislators eliminated the fees for consumers to file an external appeal for an independent review of denied medical claims. This makes it more likely that consumers in the state will challenge insurer reviews. 

New Hampshire Insurance Department officials reminded business entities that they’re legally required to respond to the department in a timely manner––no ghosting the department just because you don’t know how to respond. The DOI said they have noticed a string of businesses where they’re being left “on read,” which can leave them with no choice but to find the business out of compliance. 

New Jersey producer appointments open April 1 and close June 3. If you don’t want to renew certain appointments, you need to post those producer terminations by March 25. There’s no easy button for renewals, yet, but renewal season is certainly easier if you’re practicing good appointment hygiene. Of course, if you are practicing good appointment hygiene and you’re sure that your records are up-to-date, you’re probably already using AgentSync. 🫶

Oklahoma announced the ZIP codes that qualify for the state’s home-hardening grant in its first rollout: 73049, 73051, 73065, 73069, 73111, 73127, 73129, 73135 (most are around the Oklahoma City area).

Washington Insurance Commissioner Patty Kuderer put Seguro Health on blast with the OIC Answers podcast, discussing how consumer complaints led state investigators to discover an entire network of fake companies scamming people out of health insurance. The Washington State Senate also passed a bill that, if made law, would require the insurance department to study how insurance carriers are using credit scores to inform premium rates. Currently, the state allows credit histories and credit scores to inform rates.

Stay on top of regulatory changes with AgentSync

While these points of interest aren’t comprehensive, our knowledge of insurance producer and variable lines broker license and compliance maintenance is. See how AgentSync can help make you look smarter today; head over to the Compliance Library and wrastle up some state-by-state regulation and more jurisdictional updates. If you’re looking for a solution that builds regulations like these into your distribution channel management workflows automatically, AgentSync can help. See us in action or talk to one of our experts today.