TENTATIVE

      Occ. Code 6514500

New York State Department of Civil Service

Classification Standard

BRIEF DESCRIPTION OF CLASS SERIES

            Insurance Policy Examiners analyze and review health, life, and accident insurance products to ensure compliance with good insurance practices, and the requirements of various laws governing insurance policies.  These positions are classified only in the Insurance Department.

DISTINGUISHING CHARACTERISTICS

            SENIOR INSURANCE POLICY EXAMINER:  full performance level; works independently on normal policy forms.

            ASSOCIATE INSURANCE POLICY EXAMINER: first supervisory level; supervises Senior Insurance Policy Examiners; is typically in charge of a unit; performs research and prepares the more difficult legal opinions.

            SUPERVISING INSURANCE POLICY EXAMINER: second supervisory level; section head; directly supervises Associate Insurance Policy Examiners; performs research and prepares the most difficult and sensitive legal opinions. 

            CHIEF INSURANCE POLICY EXAMINER: manager; directs a Bureau; supervises Supervising Insurance Policy Examiners; responsible for all Bureau studies, reports, legislative proposals, and policy decisions; and makes recommendations on sensitive legal issues involving insurance products.

RELATED CLASSES

Insurance Examiners audit the financial condition and treatment of policyholders of insurers licensed to do business in New York State (NYS); investigate complaints from consumers against licensees to determine compliance with NYS Insurance Law, Rules and Regulations, and perform other regulatory duties to assist the Insurance Department in carrying out its regulatory responsibilities.

ILLUSTRATIVE DUTIES

SENIOR INSURANCE POLICY EXAMINER

Review insurance policy forms for compliance with State and federal insurance laws, rules, and regulations.

Compose post approval reviews of insurance policies, annuity contracts, and funding agreements to determine compliance with standard insurance industry practices, the requirements of the Insurance Department, and the various State and federal laws governing insurance policies.  Partake in the processing of violations of the Insurance Law.

Develop and review proposed legislation and regulations regarding market conduct, corporate conduct, post approval reviews, and financial conditions.

Research and answer inquiries from the public, insurance companies, and other governmental agencies.

Provide legal advice and interpretations regarding corporate mergers, demutualization, financial condition, corporate conduct, and governance matters to ensure compliance with statutes and regulations.

ASSOCIATE INSURANCE POLICY EXAMINER

Supervise subordinate staff and oversee a unit that regulates health or life insurance products.

·         Manage workflow, organize and adjust work schedules and assignments, and determine work priorities.

• Schedule and participate in staff meetings to disseminate the units goals and objectives.

·         Train and evaluate subordinate staff.

• Review work submitted by subordinate staff to ensure accuracy and compliance with regulations, industry standards, and State and federal laws.
• Oversee the proper implementation of State and federal insurance statutes and regulations.

Research, prepare, and review proposed regulations and legislation to assess impact of proposals.

Personally review the more difficult insurance policies, along with contracts and other legal documents submitted for compliance with regulations, industry standards, circular letters, and State and federal laws.

Participate in the resolution of market conduct issues resulting from examinations or post approval reviews of policy forms.

Prepare legal opinions and drafts circular letters, legislation, regulations, and other regulatory guidance for the insurance industry. Assist in the preparation of special reports.

Represent the Supervising and Chief Insurance Policy Examiners at meetings, task forces, National Association of Insurance Commissioners (NAIC) workgroups, and speaking engagements.

SUPERVISING INSURANCE POLICY EXAMINER

Direct the daily operations of a section that regulates health or life insurance products.

• Oversee assignments to ensure an equitable distribution of work.
• Review work performed by Senior and Associate Insurance Policy Examiners to ensure accuracy and consistency with regulations; industry standards; and State and federal laws.

Draft, review, and analyze proposed legislation and regulations.

Monitor the effectiveness of existing laws and regulations affecting insurance policies.

Convene with representatives of the insurance industry, NAIC workgroups, and other governmental agencies to discuss issues such as health insurance, and explain and clarify the Bureaus position on insurance issues.

Participate in speaking engagements with representatives of the insurance industry, NAIC workgroups, and other governmental agencies.

Represent the Department on task forces studying insurance issues.

CHIEF INSURANCE POLICY EXAMINER

Oversee the daily operations of the Bureaus review of insurance policy forms, contracts, and general claim practices.

• Review and prepare recommendations for the Bureaus annual budget.
• Recommend the Bureaus priorities and assist in establishing goals.
• Review and evaluate performance of Bureau personnel.

Preside at conferences with insurance company representatives and Insurance Department staff regarding insurer advertising, marketing, pricing, and disclosure.

Consult and confer with staff of other state and federal agencies regarding the effect of insurance regulations and laws on insurance products.

Direct the development and eventual implementation of legislative proposals affecting insurance products.

Advise the Chief Health and Life Policy Bureau on matters pertinent to NAIC.

• Formulate with the Chief Health and Life Policy Bureau drafts and model regulations for adoption by NAIC.

Maintain contacts with governmental staff and the insurance industry regarding any new trends or proposed actions in the insurance industry.

Prepare the Bureaus portion of the annual report to the Legislature, and assist in the preparation of other reports required by law.

Review legal briefs prepared by Bureau staff, and assist the Office of General Counsel in the preparation of legal briefs involving insurance industry regulatory matters where the Bureau is a party.

MINIMUM QUALIFICATIONS

            SENIOR INSURANCE POLICY EXAMINER

Open Competitive: Graduation from an accredited law school with an LLB or a JD degree, and/or eligibility to take the NYS Bar Exam and successful completion of a two-year traineeship.

            ASSOCIATE INSURANCE POLICY EXAMINER

Promotion:   one year of service as a Senior Insurance Policy Examiner.

            SUPERVISING INSURANCE POLICY EXAMINER

Promotion:   one year of service as an Associate Insurance Policy Examiner.

            CHIEF INSURANCE POLICY EXAMINER

Promotion:   one year of service as a Supervising Insurance Policy Examiner.

Date:  4/11

NOTE:  Classification Standards illustrate the nature, extent and scope of duties and responsibilities of the classes they describe.  Standards cannot and do not include all of the work that might be appropriately performed by a class.  The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written.  Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.