A. In this article, unless the context otherwise requires:

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

1. "Insurance compliance audit" means a voluntary, internal evaluation, review, assessment, audit or investigation that follows adopted written standards and criteria for the purpose of identifying or preventing noncompliance with or promoting compliance with laws, regulations, orders or industry or professional standards that is conducted by or on behalf of a company licensed or regulated under this title and specified in subsection B of this section, or that involves an activity regulated under this title. An audit shall establish a start and end date.

2. "Insurance compliance audit document":

(a) Means documents prepared as a result of or in connection with an insurance compliance audit and identified specifically as part of an insurance compliance audit.

(b) Includes any of the following:

(i) An insurance compliance audit report prepared by an auditor, who may be an employee of the company or an independent contractor, which may include the scope of the audit, the information gained in the audit and conclusions and recommendations, with exhibits and appendices.

(ii) Memoranda and documents analyzing portions or all of the insurance compliance audit report and discussing potential implementation issues.

(iii) An implementation plan that addresses correcting past noncompliance, improving current compliance and preventing future noncompliance.

(iv) Analytic data generated in the course of conducting the insurance compliance audit.

(c) May include a written response to the findings of an insurance compliance audit and field notes and records of observations, findings, opinions, suggestions, conclusions, drafts, memoranda, drawings, photographs, exhibits, computer-generated or electronically recorded information, phone records, maps, charts, graphs and surveys if this supporting information is collected or developed for the primary purpose and in the course of an insurance compliance audit.

B. This article applies to insurance compliance audit documents prepared and insurance compliance audits conducted by or on behalf of an insurer licensed or regulated under this title including any:

1. Stock, mutual, reciprocal or title insurer.

2. Fraternal benefit society.

3. Health care services organization.

4. Hospital service corporation, medical service corporation, dental service corporation, optometric service corporation or hospital, medical, dental and optometric service corporation.

5. Prepaid dental plan organization.

6. Mechanical reimbursement reinsurer.

7. Prepaid legal plan.

8. Lloyd’s association.

9. Service company as defined in this title.