PURPOSE OF JOB CLASS (NATURE OF WORK)
In the Insurance Department, this class is accountable for performing a full range of tasks related to the regulation of insurance policy forms and rates, examination of insurance company market and/or business practices or investigation and mediation of disputes between claimants and/or consumers and insurance companies or analysis of financial statements and related records.
GUIDELINES FOR JOB CLASS USE
This is the professional working level used to assist and participate in professional investigation, examination and policy review work. This class is distinguished from lower level classes by responsibility for investigation, policy review and examination work requiring the application of relevant insurance statutes, regulations and guidelines. This class is distinguished from higher level examiner classes by responsibility for examining, investigating or reviewing generally routine filings, complaints or other related activities. Incumbents in this class may specialize in the excess line area and respond to complaints and examine all records relating to this line.
Works under the general supervision of an Insurance Principal Examiner or other employee of higher grade.
May lead and/or supervise lower level employees as assigned.
EXAMPLES OF DUTIES
Independently reviews individual consumer complaints, examines required rate and policy form filings or conducts routine market conduct examinations for compliance with statutes, regulations and guidelines; responds to mail, telephone and personal inquires from customers, insurance personnel and governmental agencies; prepares reports of rate and policy review work, examinations and investigations; participates in investigations or examinations of complex complaints and/or filings; may assist in review of loss reserve methodology, testing underlying claims data and adequacy of an insurer's loss reserve; may investigate bail bond fraud; may work with prosecuting officials in preparation of criminal or administrative cases; performs related duties required.
KNOWLEDGE, SKILL AND ABILITY
Knowledge of and ability to interpret insurance licensee laws, regulations and guidelines; knowledge of accounting and auditing principles and practices; knowledge of business practices and operational procedures of insurance licensees; knowledge of policy contracts and forms; knowledge of methods and procedures for conducting investigations and examinations; some knowledge of insurance rates and rating procedures; some knowledge of contract and property law; interpersonal skills; oral and written communication skills; ability to calculate complex mathematical formulas; ability to utilize computer software.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Six (6) years of experience in one or more of the following areas: claims, claims adjusting, sales, underwriting, contract development, actuarial work or agency services within the insurance industry OR governmental regulation of the insurance industry OR governmental examination of financial condition of insurance companies.
MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE
Two (2) years of the General Experience must have been at the paraprofessional level. Paraprofessional experience will be interpreted as work requiring the exercise of some independent judgment in the application of basic principles and practices of claims, claims adjusting, sales, underwriting, contract development, actuarial work or agency services within the insurance industry or in governmental regulation of the insurance industry.
MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED
1. College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one-half (1/2) year of experience to a maximum of four (4) years for a Bachelor's degree.
2. A Master's degree in insurance, business administration, economics or a closely related field may be substituted for an additional year of the General Experience.
3. A Certified Life Underwriter (CLU) or Certified Property and Casualty Underwriter (CPCU) designation may be substituted for the Special Experience requirements.
1 Incumbents in this class may be required to travel.
2. Incumbents in this class may be required to possess and retain a valid Motor Vehicle Operator’s license.
JOB CLASS DESIGNATION
(15)-Insurance Programs and Control
(16)-ADMIN & RESID (P-5)
This replaces the existing specification for the class of Insurance Examiner in Salary Group AR 22 approved effective October 1, 1996. (2012 SCOPE Review)