Illinois Administrative Code

Section 925.141 Internal Audit Function Requirements a) Exemption. An insurer is exempt from the requirements of this Section if the insurer: 1) has annual direct written and unaffiliated assumed premiums, including international direct and assumed premiums, but excluding premium…

Section 925.145 Penalties (Renumbered) (Source: Section 925.145 renumbered to Section 925.190 at 33 Ill. Reg. 6974, effective May 11, 2009)

Section 925.150 Conduct of Insurer in Connection with the Preparation of Required Reports and Documents a) No director or officer of an insurer shall, directly or indirectly: 1) Make or cause to be made a materially false or misleading statement to an accountant in connection wit…

Section 925.160 Management's Report of Internal Control over Financial Reporting a) Every insurer required to file an audited financial report pursuant to this Part that has annual direct written and assumed premiums, excluding premiums reinsured with the Federal Crop Insurance C…

Section 925.170 Exemptions and Effective Dates a) Upon written application of any domestic insurer, the Director may grant an exemption from compliance with any and all provisions of this Part if the Director finds, upon review of the application, that compliance with this Part w…

Section 925.180 Canadian and British Companies a) In the case of Canadian and British insurers, the annual audited financial report shall be defined as the annual statement of total business on the form filed by those companies with their supervision authority, duly audited by an…

Section 925.190 Penalties Failure of a company to meet any provisions of this Part shall subject the company to penalty provisions of Sections 139 and 403A of the Code, or other such action as the Director may deem necessary. (Source: Section 925.190 renumbered from Section 925.1…

Section 925.20 Purpose and Scope a) The purpose of this Part is to improve the Director's surveillance of the financial condition of insurers by requiring: 1) An annual audit of financial statements reporting the financial position and the results of operations of insurers by ind…

Section 925.200 Severability Provision If any Section or portion of a Section of this Part or the applicability of that Section or portion of a Section to any person or circumstance is held invalid by a court, the remainder of the Part or the applicability of the provision to oth…

Section 925.30 Definitions "Accountant" or "independent certified public accountant" means an independent certified public accountant or independent accounting firm in good standing with the American Institute of Certified Public Accountants (AICPA) and all states in which the ac…

Section 925.40 General Requirements Related to Filing and Extensions for Filing of Annual Audited Financial Report and Audit Committee Appointment a) All insurers shall have an annual audit performed by an independent certified public accountant and shall file an annual audited f…

Section 925.50 Contents of Annual Audited Financial Report a) The annual audited financial report shall report the financial position of the insurer as of the end of the most recent calendar year and the results of its operations, cash flows and changes in capital and surplus for…

Section 925.60 Designation of Independent Certified Public Accountant a) Each insurer required by this Part to file an annual audited financial report must, within 60 days after becoming subject to such requirement, register with the Director in writing the name and address of th…

Section 925.70 Qualifications of Independent Certified Public Accountant a) The Director shall not recognize any person or firm as a qualified independent certified public accountant if the person or firm: 1) Is not in good standing with the AICPA and in all states in which the a…

Section 925.80 Consolidated or Combined Audits a) An insurer may make written application to the Director for approval to file a consolidated or combined annual audited financial report in lieu of separate annual audited financial reports if the insurer is part of a group of insu…

Section 925.90 Scope of Audit and Report of Independent Certified Public Accountant a) Financial statements furnished pursuant to Section 925.50 of this Part shall be examined by an independent certified public accountant. The audit of the insurer's financial statements shall be …

Section 925.EXHIBIT A CPA Letter of Representation Upon completion of the review by the Department's examiners, the accountant shall submit a CPA Letter of Representation in this format. CPA LETTER OF REPRESENTATION Date: ______________ Attention: Illinois Department of Insurance…

Section 926.10 Authority (Repealed) (Source: Repealed at 43 Ill. Reg. 3246, effective February 25, 2019)

Section 926.20 Purpose and Scope a) The purpose of this Part is to establish guidelines for the handling of complaints received by the Department of Insurance against insurers, insurance producers or any other entity or individual licensed, registered, certified, or granted a Cer…

Section 926.30 Definitions "Code" means the Illinois Insurance Code [215 ILCS 5]. "Complaint" means any written communication primarily expressing a grievance. "Department" means the Illinois Department of Insurance. (Source: Amended at 43 Ill. Reg. 3246, effective February 25, 2…

Section 926.40 Complaint Handling Procedure a) Notification and Response Requirements When the Department receives a complaint against an entity or individual identified in Section 926.20 (respondent), and the Department determines that the complaint falls under its authority to …

Section 926.50 Maintenance of Complaint Records Insurance companies to which this Part applies shall maintain records containing the minimum information as outlined in Exhibit A and as defined in Exhibit B of this Part. The complaint record shall be kept on a calendar year basis …

Section 926.60 Severability Provision (Repealed) (Source: Repealed at 23 Ill. Reg. 5695, effective May 3, 1999)

Section 926.70 Effective Date (Repealed) (Source: Repealed at 23 Ill. Reg. 5695, effective May 3, 1999)

Section 926.EXHIBIT B Explanation Column A. Identification Number. As noted, this refers to the identification number of the complaint. B. Reason Code. Complaints are to be classified by the nature of the complaint within one of the involved company's functions of underwriting, m…

Section 928.10 Authority This Part is promulgated by the Director of the Department of Insurance under Section 401 of the Illinois Insurance Code [215 ILCS 5/401], which empowers the Director to make reasonable rules and regulations as may be necessary for making effective the in…

Section 928.20 Purpose and Scope a) This Part establishes a uniform format for the reporting of information relating to allegations of provider liability. Individual liability data records filed by insurers pursuant to this Part will be held confidential by the Department, to the…

Section 928.30 Definitions "Code" means the Illinois Insurance Code [215 ILCS 5]. "Department" means the Illinois Department of Insurance. "Director" means the Director of the Illinois Department of Insurance. "Insurance Claim" means a formal or written demand for compensation un…

Section 928.40 Reports a) All insurance claims and all lawsuits shall be reported electronically to the Director by the insurer and contain the information set forth in Exhibit B of this Part. b) All insurance claims closed and all lawsuits closed that were previously reported pu…

Section 928.42 Circuit Court Clerk Reporting Requirements (Repealed) (Source: Repealed at 36 Ill. Reg. 18677, effective December 17, 2012)

Section 928.43 Supplement A to Schedule T Reconciliation a) To ensure completeness of the data reported by insurers, medical professional liability losses and claim counts shall be reconciled for claims using NAIC Annual Statement Exhibit of Supplement A to Schedule T as seen in …

Section 928.44 General Submission Deadlines a) Data Submission Reports are due on a quarterly basis no later than 45 days after the quarter's end. The reports shall be submitted electronically to the Illinois Department of Insurance through the following website: http://insurance…

Section 928.50 Effective Date (Repealed) (Source: Repealed at 24 Ill. Reg. 19133, effective January 1, 2001)

Section 928.EXHIBIT B Illinois Medical Professional Liability Insurance Uniform Claims Report – Reporting Instructions As required by Section 155.19 of the Insurance Code [215 ILCS 5/155.19] and 50 Ill. Adm. Code 928: 1. File all opened, closed, re-opened, and re-closed medical p…

Section 930.10 Authority This Part is adopted and promulgated by the Director of Insurance pursuant to Section 401 and Article XXVI of the Illinois Insurance Code [215 ILCS 5/421 and 401] relating to unfair methods of competition and unfair deceptive acts and practices. (Source: …

Section 930.20 Purpose a) The purpose of this Part is to require insurers to deliver to purchasers of life insurance, information which will improve the buyer's ability to select the most appropriate plan of life insurance for his needs, improve the buyer's understanding of the b…

Section 930.30 Scope a) This Part shall apply to any solicitation, negotiation or procurement of life insurance occurring within this State. This Part shall apply to any issuer of life insurance contracts including fraternal benefit societies. b) This Part shall not apply to: 1) …

Section 930.40 Definitions For the purposes of this Part, the following definitions shall apply: a) Buyer's Guide. A Buyer's Guide is a document that contains the language contained in Exhibit A or the National Association of Insurance Commissioner's (NAIC) Life Insurance Buyer's…

Section 930.50 Disclosure Requirements a) Except in the case of a direct response insurance product, the insurer shall provide, to all applicants, a Buyer's Guide prior to accepting the applicant's initial premium or premium deposit. The Buyer's Guide must be delivered with a dir…

Section 930.60 Preneed Funeral Contracts or Prearrangements a) The following information shall be given in writing to the applicant at the time an application is made, prior to accepting the applicant's initial premium or deposit for a preneed funeral contract or prearrangement a…

Section 930.70 General Rules a) Each insurer shall maintain at its home office or principal office, a complete file containing one copy of each document authorized by the insurer for use pursuant to this Part. Such file shall contain one copy of each authorized form for a period …

Section 930.80 Life Insurance Buyer's Guide, Language and Content The form requirements of the Life Insurance Buyer's Guide are found in Exhibit A or Exhibit B of this Part. The reproduction of the Buyer's Guide should be as specified in Exhibit A or Exhibit B, except that the de…

Section 930.90 Failure to Comply Failure of an insurer to provide or deliver a Buyer's Guide, or a Policy Summary as provided in Section 930.50 shall constitute an omission which misrepresents the benefits, advantages, conditions or terms of an insurance policy. (Source: Amended …

Section 930.EXHIBIT A Life Insurance Buyer's Guide (The face page of the Buyer's Guide shall read as follows) LIFE INSURANCE BUYER'S GUIDE This guide can show you how to save money when you shop for life insurance. It helps you to: • Decide how much life insurance you should buy,…

Section 931.10 Authority The purpose of this Part is to implement Section 143c of the Illinois Insurance Code (Code) [215 ILCS 5], which requires insurance companies to provide certificate holders or policy holders with "written notice" regarding where to file a complaint. (Sourc…

Section 931.20 Scope a) This Part shall apply to all companies authorized to transact insurance business as set forth in Classes 1, 2 or 3 of Section 4 of the Illinois Insurance Code [215 ILCS 5], except for those lines of insurance enumerated in Section 931.50 of this Part. b) T…

Section 931.30 Form of Notification The requirement of providing "written notice " shall be satisfied by: a) Any printed notice delivered with a policy or certificate; b) Any adhering label attached to a policy or certificate; c) Any computerized notice issued concurrently with a…

Section 931.40 Notification Requirements In the required notice: a) Companies shall use the contact information for the Department of Insurance explicitly stating "You may file a consumer complaint online at the Illinois Department of Insurance's website or by mail. The Departmen…

Section 931.50 Exceptions The following types of insurance are exempted from this Part: a) Ocean Marine; b) Fidelity and Surety; c) Commercial Inland Marine risks which, by general custom, are not written according to manual rates or rating plans. (Source: Amended at 49 Ill. Reg.…

Section 931.60 Severability If any Section or portion of a Section of this Part, or applicability thereof to any person or circumstance, is held invalid by a court, the remainder of the Part, or the applicability of such provision or circumstance, shall not be affected thereby.