REPORT OF MARKET CONDUCT EXAMINATION OF

[Pages:29]REPORT OF MARKET CONDUCT EXAMINATION

OF

FIRST PRIORITY LIFE INSURANCE COMPANY

Wilkes-Barre, PA AS OF

December 13, 2010 COMMONWEALTH OF PENNSYLVANIA

INSURANCE DEPARTMENT MARKET CONDUCT DIVISION

Issued: February 1, 2011

FIRST PRIORITY LIFE INSURANCE COMPANY TABLE OF CONTENTS

I. Introduction

2

II. Scope of Examination

5

III. Company History and Licensing

6

IV. Forms

8

V. Claims

9

A. Subscriber Submitted Medical Insurance Claims

10

B. Provider Submitted Medical Insurance Claims

11

C. Provider Submitted Clean Insurance Claims Over 45 Days 12

D. Mammography Insurance Claims Denied

12

E. Mammography Insurance Claims Denied < Age 40

13

F. Subscriber Submitted Emergency Room Claims Denied

13

G. Provider Submitted Emergency Room Claims Denied

14

VI. Recommendations

15

VII. Company Response

16

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