Investigating Bias in Claims Handling and Anti-fraud Practices Among Insurers – Department Survey

Conducted by Consumer Federation of America

Please provide as much detail as you can. You can send additional information and material directly to CFA.

Question Title

* 1. Are you responding on behalf of a State Department of Insurance? Please identify the Department and provide your contact information in the box below.

Yes, on behalf of a Department. (Please provide contact details in the box below)

No, on my own behalf. (Please provide contact details in the box below)

Please provide contact information here.

Question Title

* 2. In the last three years, has your department reviewed any insurer's anti-fraud and claim settlement algorithms for unfair discrimination, generally, and for racial bias, specifically? If the answer is more than 0, please use the comment box to explain how the Department conducted the review and what methods were used to identify unfair discrimination and racial bias?

0

1-3

4-9

10+

Briefly describe your methods of review.

Question Title

* 3. In the last three years, has the Department asked or required insurers to test their anti-fraud and claims settlement algorithms and practices for racial bias? If yes, how many insurers were asked or required to test, what did the Department ask of these insurers, and what guidance for testing was provided to the insurers? (Please use the comment box below.)

Yes

No

If yes, please provide additional information here.

Question Title

* 4. In the last three years, has the Department required any third-party vendors to submit anti-fraud or claim settlement algorithms to the Department for review? If yes, which vendors and what models has the Department reviewed and what were the results of the review(s)? (Please use the comment box below)

Yes

No

If yes, please provide additional information here.

Question Title

* 5. In the last three years, has the Department collected actual anti-fraud and claims outcome data from insurers in sufficient detail to test for unfair discrimination and racial bias? If yes, what data were requested and what methods were used to test for unfair discrimination and racial bias? What were the results of such data collection and analysis?(Please use the comment box below.)

Yes

No

If yes, please provide additional information here.

Question Title

* 6. Has the Department worked with community organizations, consumer groups, agents’ organizations, or others to learn about the insurance outcomes experienced by communities of color? If yes, to whom and how has the Department done such outreach? What insights has the Department learned from this outreach? (Please use the comment box below.)

Yes

No

If yes, please provide additional information here.

Question Title

* 7. If the answers to one or more of questions 2 through 6 is "No," does the Department plan to or want to engage in such testing and analysis? If yes, what is the time frame for such activity and what resources or technical assistance does the Department need to proceed? (Please use the comment box below.)

Yes

No

If yes, please provide additional information here.

Question Title

* 8. Is there anything else you would like to add?

Yes

No

Additional comments