[§431:2D-102]  Definitions.  As used inthis article, unless the context indicates otherwise:

"Commissioner" means the insurancecommissioner of the State of Hawaii.

"Complaint" means a written ordocumented oral communication to the insurance division primarily expressing agrievance, meaning an expression of dissatisfaction.  For health companies, agrievance is a written complaint submitted by or on behalf of a covered person.

"Comprehensive market conductexamination" means a review of one or more lines of business of an insurerdomiciled in this State that is not conducted for cause.  The term includes areview of rating, tier classification, underwriting, policyholder service,claims, marketing and sales, producer licensing, complaint handling practices,and compliance procedures and policies.

"Insurance compliance audit" means avoluntary, internal evaluation, review, assessment, audit, or investigation forthe purpose of identifying or preventing noncompliance with, or promotingcompliance with laws, regulations, orders, or industry or professionalstandards, which is conducted by or on behalf of an insurer, or which involvesan insurer activity regulated by the commissioner.

"Insurance compliance self-evaluativeaudit document" means documents prepared as a result of or in connectionwith an insurance compliance audit.  An insurance compliance self-evaluativeaudit document may include a written response to the findings of an insurancecompliance audit.  An insurance compliance self-evaluative audit document mayinclude, but is not limited to, as applicable, field notes and records ofobservations, findings, opinions, suggestions, conclusions, drafts, memoranda,drawings, photographs, exhibits, computer generated or electronically recordedinformation, telephone records, maps, charts, graphs, and surveys; providedthat this supporting information is collected or developed for the primarypurpose and in the course of an insurance compliance audit.

"Market analysis" means a processwhereby market conduct surveillance personnel collect and analyze informationfrom filed schedules, surveys, required reports, and other sources to develop abaseline and to identify patterns or practices of insurers licensed to dobusiness in this State that deviate significantly from the norm or that maypose a potential risk to the insurance consumer.

"Market conduct action" means any ofthe full range of activities that the commissioner may initiate to assess themarket and practices of individual insurers, beginning with market analyses andextending to targeted examinations.  The commissioner's activities to resolvean individual consumer complaint or other reports of a specific instance ofmisconduct are not market conduct actions for purposes of this article.

"Market conduct examination" meansthe examination of the insurance operations of an insurer licensed to dobusiness in this State to evaluate compliance with the applicable laws andrules of this State.  A market conduct examination may be either a comprehensiveexamination or a targeted examination.  A market conduct examination isseparate and distinct from a financial examination of an insurer performedpursuant to article 5, but may be conducted at the same time.

"Market conduct surveillancepersonnel" means those individuals employed or contracted by thecommissioner to collect, analyze, review, or act on information about theinsurance marketplace, which identifies patterns or practices of insurers.

"National Association of InsuranceCommissioners" means the organization of insurance regulators from thefifty states, the District of Columbia, and the four United States territories.

"Qualified contract examiner" means aperson under contract to the commissioner, who is qualified by education,experience and, where applicable, professional designations, to perform marketconduct actions.

"Targeted examination" means afocused examination conducted for cause, based on the results of marketanalysis indicating the need to review either a specific line of business orspecific business practices, including but not limited to underwriting andrating, marketing and sales, complaint handling operations, advertisingmaterials, licensing, policyholder services, non-forfeitures, claims handling,or policy forms and filings.  A targeted examination may be conducted by deskexamination or by an on-site examination.

"Third party model or product" meansa model or product provided by an entity separate from and not under direct orindirect corporate control of the insurer using the model or product. [L 2007,c 227, pt of §1]