An Act To Clarify the Authority of the Attorney General To Seek Restitution and To Require the Superintendent of Insurance To Investigate Certain Insurance Practices
Maine Legislature, Session 121, LD 1347
Committee: Insurance and Financial Services
Sponsors: TREAT, BRENNAN, DAGGETT, MAYO, DUDLEY, HUTTON, LEMOINE, MAILHOT
Amends: 24-A MRSA §214

Legislative Document 
No. 1347 
S.P.438 
In Senate, March 12, 2003 
An Act To Clarify the Authority of the Attorney General To Seek 
Restitution and To Require the Superintendent of Insurance To 
Investigate Certain Insurance Practices 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
plinted. 
Presented by Senator TREAT of Kennebec. 
Cosponsored by Representati ve O'NEIL of Saco and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senators: BRENNAN of Cumberland, President DAGGETT of Kennebec, LafOUNTAIN of 
York, MAYO of Sagadahoc, Representatives: DUDLEY of Portland, HUTTON of 
Bowdoinham, LEMOINE of Old Orchard Beach, MAILHOT of Lewiston. 
Printt'J l,ln recycled p .. lper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24-A MRSA §214, sub-§2, as amended by PL 1973, c. 585, 
§12, is further amended to read: 
2. 
If the superintendent has reason to believe that any 
person has violated any provision of this Title, or of other law 
as 
applicable 
to 
insurance 
operations, 
for 
which 
criminal 
prosecution 
is 
provided 
and 
would 
be 
in 
order, 
Re 
the 
superintendent shall give the information relative thereto to the 
Attorney General. The Attorney General shall promptly institute 
such 
action or 
proceedings, 
including, 
but 
not 
limited to, 
actions ordering restitution against slieR that person as in Ris 
the Attorney's General's opinion the information may require or 
justify. 
Sec. 2. Report on insurance practices. 
The Super intendent of 
Insurance 
shall 
investigate 
and 
prepare 
a 
report 
analyzing 
changes 
made 
in 
underwriting 
standards, 
product 
design 
and 
benefit 
structure 
that 
affect 
the 
availability 
of 
health 
insurance products and personal or commercial insurance products 
available in this State. 
The report must encompass changes made 
from January 1, 2001 through June 30, 2003. 
The report must include, without limitation: 
1. 
A 
comparison 
coinsurance 
required; 
beneficiary cost sharing 
category available; 
of, 
and 
changes 
deductibles; 
and 
for each type of 
in, 
premium 
rates; 
any 
other 
form 
of 
insurance package or 
2. 
Any changes, 
including increases, 
modifications in benefit and claim packages 
time being examined; 
decreases or other 
offered during the 
3. 
Any additions or changes to underwriting criteria used 
in maintaining or determining coverage or eligibility or denying 
coverage, including, without limitation: 
A. 
Credit screening or scoring; 
B. 
Preexisting conditions; 
C. 
Standards that result in the failure to meet insurance 
portability protections; and 
D. 
Any 
other 
factors 
that 
influence 
eligibility 
for 
coverage; and 
Page l-LR1313(1) 
4. 
A summary of telephone calls to 
phone 
line maintained by 
the 
Department 
Financial Regulation, 
Bureau of Insurance 
which those calls were handled. 
a consumer assistance 
of Professional 
and 
and the manner with 
The superintendent may request any information required to 
complete the report required by this section, subject to the 
confidentiality provisions of the Maine Revised Statutes, Title 
24-A, section 216, subsection 5. 
The superintendent shall submit the report and the Attorney 
General and the superintendent's recommendations no later than 
January 1, 2004 to the Attorney General and the Joint Standing 
Committee on Insurance and Financial Services. 
The committee may 
report out legislation to the Second Regular Session of the 121st 
Legislature necessary to implement the recommendations of the 
superintendent or to address other issues raised by the report. 
SUMMARY 
This bill clarifies that, 
Superintendent of Insurance has 
a 
violation of 
the 
insurance 
required to institute actions 
in 
those 
instances 
when 
the 
notified the Attorney General of 
laws, 
the Attorney General 
is 
against the violator, 
including 
actions requiring restitution. 
This bill also requires the superintendent to investigate 
and report on certain insurance practices, including changes made 
in underwriting standards, product design and benefit structure 
of health, life, personal and commercial insurance products. 
The 
superintendent 
is 
required 
to 
submit 
the 
report 
and 
any 
recommendations to the Attorney General and the Joint Standing 
Committee on Insurance and Financial Services.