Market conduct exam management that tracks every examiner request to its due date and answers it from the file
Every examiner request tracked to its due date, answered from the file.
See one case, screen by screen ↓Software that runs a market conduct examination from the call letter to the closing report: every examiner request tracked with its owner and due date, the files and answers gathered, and responses to criticisms and remediation kept on record. Market Conduct Exam Management adds agents that pull each sampled file, test it against the standards the examiners use, and draft cited answers and explanations.
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A market conduct exam opens with a call letter from the department: dozens of requests for data files, procedures, manuals, letters and samples of claim, complaint and policy files, most due in ten business days — and fieldwork adds a new batch of follow-ups every week. The exam coordinator runs it from a spreadsheet and a shared drive, and chases claims and underwriting experts for every file and every answer.
A 79-file sample of closed claims is hundreds of documents — notes, letters, photos, estimates, payments — pulled by adjusters between their own claims. The company usually learns what is wrong with a sampled file when the examiner writes it up: a late acknowledgement, a denial letter that never quotes the policy provision, a count that does not agree with the MCAS filing. Each one is a criticism answered under a deadline, and every re-request adds billed examiner hours.
Estimated split for one 79-file claims sample, by hand and with the solution, in business days.
Seven specialist agents pull, check and explain every requested file; counsel approves and the exam coordinator submits.
Harrow Ridge Mutual is on day 6 of fieldwork in a targeted market conduct exam by the Ohio Department of Insurance. The examiner-in-charge has asked for 79 homeowners claims closed without payment, due Thursday. Here is what happens, screen by screen, in the working solution.
Nora opens the request room, not a to-do list. The exam’s life runs across the top — call letter 21 Sep, fieldwork 5 Oct to 11 Dec, draft report Feb 2027 — and under it all 57 requests by exam area, each with its owner, its business-day clock and one cell for every file or answer it needs. 34 submitted, 11 due this week, 0 late.
“Please replace 4 claim numbers in the list sent 7 Oct — they were closed with payment. The due date is unchanged: Thursday 15 October.” — Paul Okonkwo, CIE, 09:55
R-23 asks for homeowners claims closed without payment, a sample of 79. Nora presses Fill R-23. The call letter reader reads the corrected sample list — 4 claim numbers replaced, due date unchanged — and counts 5 business days to Thu 15 Oct, with Columbus Day skipped. The file puller brings each file in from the claim system, the policy system and the agency mailbox: notes, letters, payments, photos. The 79 cells turn blue as they arrive.
As each file is tested, its cell turns green or amber. File 38 is HO-24-118406, the Amundsens’ water claim in Westerville. The claim system says it was acknowledged in 7 days. The pre-checker counts from the day the insureds called their agent, Kessler & Vance, on 4 March 2024 — and that is 18 days.
“Late acknowledgement · 18 days, limit 15. Acknowledged 18 days after the insured called the agent (Kessler & Vance, 4 Mar 2024); the claim system shows 7.”
79 files, 782 documents, 73 clean and 6 with an issue — each standard against the 7% claims tolerance. Acknowledgement within 15 days: 3 of 79 (3.8%). Decision within 21 days of proof of loss: 0. Status letter every 45 days: 1 of 79 (1.3%). Denial cites the policy provision: 2 of 79 (2.5%) — two free-form letters, and a repeat of the 2022 exam’s finding 3.
The pre-checker explains and routes; it never concludes that an exception is a violation.
The sampled file opens on its timeline: the call and email to the agent on 4 Mar, the agency entering the claim on 15 Mar, the acknowledgement letter on 22 Mar, inspection, proof of loss, and the denial on 16 Apr citing Section I Exclusion 2.c.(6). The agent’s email sits beside it with the margin note: under Model 902 §6A, notification to an agent is notification to the insurer.
The response drafter writes the company’s explanation from the file and the fix already made: since 1 July 2025 agents report claims through the direct first-notice line, and late acknowledgements on agent-reported homeowners claims fell from 4.1% to 0.6%. It cites the agency email, the first-notice record, procedure CP-03 and the acknowledgement report. Teresa Whitlock confirms the facts; Nora sends it to counsel.
The draft is marked Draft. It never goes to the examiner on its own.
R-23 says 1,391 homeowners claims closed without payment in 2024; the MCAS filing says 1,427. The consistency checker finds why: 36 claims were reopened and closed again in 2024, and MCAS counts each closure. The 36 claim numbers go in the package. Elsewhere it finds a real contradiction — the complaint register is 7 short of the department’s count — and sends that one to counsel.
Never changes a number to make it agree.
Daniel approves the three explanations at 11:12; Ifeoma Adeyemi, the market conduct manager, signs off the package at 11:16. Only then does Submit to the examiner light up. The package goes to Paul Okonkwo through the department’s exam portal: 79 claim files and 782 documents, a cover letter with 6 self-identified issues and 3 explanations, and the MCAS reconciliation of 36 claims.
Nora submits R-23 at 11:20 on Monday, three business days before it is due. The request room now counts 35 submitted, with the agents’ run kept beside it, step by step.
When the examiners write a criticism, it arrives with its draft response. C-03 says 3 of 50 complaints were answered to the department after 21 days. The draft agrees, explains the mailbox routing during a system change, cites the complaint files and procedure CH-01, and commits to a daily check of the department mailbox by 30 Nov 2026. Counsel approves every agree or disagree.
The same exam, seen by the five people who carry it — what their weeks looked like, and what they look like now.
Seven specialist agents pull, check and explain every requested file; counsel approves and the exam coordinator submits.
Turns the call letter and every follow-up into requests with exam areas, owners and business-day due dates, counted with the state holiday calendar.
Pulls each sampled claim, complaint or policy file — notes, letters, payments, photos, estimates and agency mail — into the package, every document numbered with its source.
Tests every sampled file against the standards the examiners use and the state rule — acknowledgement from the earliest notice, decision, status letters, denial wording, payment — with the error rate against tolerance and repeats of prior findings.
Drafts narrative answers from past exam responses, procedures and manuals, using the version in force during the exam period and saying when it changed.
Compares every count and ratio given the examiners with the MCAS filings, other requests in the exam and prior exam answers — agree, explained or contradicts.
Drafts explanations of self-identified exceptions and responses to examiner criticisms — agree, disagree or explain — with the fix and its proof.
Counts business days to every open request each morning, warns the owner and the coordinator two business days out, and drafts extension requests to the examiner-in-charge.
Submits; counsel approves exceptions; the manager signs off. The agents propose; a named person decides.
The coordinator, the manager and counsel can ask about anything in the exam in plain words — or tell it what to change. Every answer points to its source.
Why was HO-24-118406 flagged?
Late acknowledgement: 18 days, the limit is 15. The Amundsens called and emailed their agent, Kessler & Vance, on 4 Mar 2024; the agency entered the claim on 15 Mar, and the letter went on 22 Mar. Notice to the agent is notice to the company, so the examiner will count 18. The explanation is drafted with the 2025 fix — late acknowledgements on agent claims fell from 4.1% to 0.6%.
Which requests could miss their due date?
One is at risk: R-41 nonrenewal notices, due Wed 14 Oct — the missing proof of mailing for NR-25-04417 is not yet explained. A one-day extension request for Paul Okonkwo is drafted and waits for you. The other 10 due this week are on track.
Do our numbers agree with what we filed in MCAS?
Six of ten agree exactly and three are explained. R-23’s 2024 count is 36 below MCAS because claims reopened and closed again count twice in MCAS. One contradicts us: the complaint register is 7 short of the department’s count, against our 2022 answer — that one needs Daniel Ferro.
Check every sample for a repeat of the 2022 findings
Done. The 2022 report’s finding 3 was denials without the policy provision. Re-testing the letters in R-18, R-19, R-20 and R-24 found one more free-form letter in R-24, AU-25-208114, that names no section. The explanation is drafted, and R-24 now shows 3 issues.
12 screens from the working solution, on its sample data. Pick one to see it large.
Clocks, tolerances, sign-off and owners differ by state and by exam. Each one is a setting.
| Setting | Default | Choose from |
|---|---|---|
| Count due dates in | Business days, Ohio calendar | Business days, Ohio calendar · Calendar days |
| Warn the owner | 2 business days before | 1 · 2 · 3 business days before |
| Draft an extension request | When a request is at risk | When a request is at risk · Never |
| Acknowledgement within 15 days | Tolerance 7%, counted from the earliest notice | Tolerance 5 · 7 · 10% |
| Complaint answered to the department in 21 days | Tolerance 10% | Tolerance 5 · 10% |
| Signs off every response package | Ifeoma Adeyemi | Ifeoma Adeyemi · Gregory Haines |
| Approves explanations and criticism responses | Daniel Ferro | Daniel Ferro |
| Submits through the department’s exam portal | Nora Lindqvist | Nora Lindqvist · Ifeoma Adeyemi |
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“demo” = seen in the working solution, on its sample exam data · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures (NAIC Market Regulation Handbook — 7% error tolerance on claims standards; the claims timelines follow the NAIC Unfair Property/Casualty Claims Settlement Practices Model Regulation #902 §§6–7). People, companies, insureds, agencies and examiners named on this page are fictional — characters and sample data in the working solution.
Software that runs a market conduct examination from the call letter to the closing report: every examiner request tracked with its owner and due date, the files and answers gathered, and responses to criticisms and remediation kept on record. Market Conduct Exam Management adds agents that pull each sampled file, test it against the standards the examiners use, and draft cited answers and explanations.
The standards pre-checker tests each file for acknowledgement within 15 days counted from the earliest notice — including notice to an agent — a decision within 21 days of proof of loss, a status letter every 45 days, a denial that cites the policy provision, and payment within 30 days of agreement. It shows the error rate for each standard against its tolerance and flags repeats of prior exam findings.
No. The pre-checker explains and routes; it never concludes that an exception is a violation. Any response that admits or disputes an exception needs regulatory counsel’s approval, and the market conduct manager signs off every package before the coordinator submits it.
The consistency checker compares every count and ratio given the examiners with your MCAS filings, other requests in the exam and prior exam answers, and marks each one agrees, explained or contradicts. It never changes a number to make it agree; contradictions go to counsel.
In business days, with the state’s holiday calendar — Columbus Day was skipped in the sample exam. The clock keeper warns the owner and the coordinator two business days out and drafts an extension request to the examiner-in-charge only when the coordinator agrees.
It drafts them. Each criticism arrives with a draft response — agree, disagree or explain — built from the files, the procedure in force and the remediation already made, with its sources listed. Counsel approves every agree or disagree, and nothing is sent by an agent.
It reads them, read-only, and only for files in the sample and the exam period. Every pulled document keeps its source, and the activity trail records who pulled, drafted, approved and submitted what.
The Agentic Solution Engine builds and deploys it from your requirements — your procedures, letter templates, prior exam reports and MCAS filings — and it goes live once every quality gate has passed. We will walk you through it on a call letter and a claims sample of your own first.
Each new rule mapped to its policy and owner the day it is published.
1-min demo50-State Regulatory ResearchEvery state answered side by side, each with the statute that says so.
1-min demoInsurance Complaint ManagementEvery complaint logged on its legal clock and answered from the file.
1-min demoWe’ll run Market Conduct Exam Management on a call letter and a claims sample of your own.