You asked about the insurance commissioner's investigative and enforcement authority with respect to utilization review companies (URCs). You also want to know whether the Connecticut Unfair Insurance Practices Act applies to URCs.

The insurance commissioner has both general and specific authority to investigate the conduct and activities of URCs.

The commissioner may also enforce her finding, after notice and hearing, by:

1. issuing a cease and desist order,

2. imposing civil penalties, or

3. suspending or revoking a URC's license.

The commissioner is authorized to conduct investigations and hearings in aid of such investigations on any matter under Title 38a of the General Statutes (CGS § 38a-16(a)). In conducting such investigations or hearings, she may issue subpoenas; administer oaths; compel testimony; and order the productions of books, records, papers, and documents for her examination (CGS § 38a-16(a)). She may also apply to a Superior Court judge to enforce an order that has not been honored and request the attorney general to issue a temporary or permanent restraining order or enjoin any party from violating the

insurance laws of the state (CGS §§ 38a-16(a) and (b)). In addition to the commissioner's general investigative authority, she has specific investigative and enforcement authority over URCs.

Whenever the commissioner believes or has reason to believe that a URC has violated or is engaged in a violation of the statutes and that proceedings would be in the public interest, she must issue and serve the URC with a statement of charges and notice of hearing. At the hearing, the URC has the opportunity to be heard and to show cause why a cease and desist order should not the issued (CGS § 38a-226b(1)).

If, after a hearing, the commissioner determines that a URC has violated the statutes, she must make her findings in writing, serve them on the company, and issue a cease and desist order. The commissioner may also order one or more of the following:

1. payment of a civil penalty of up to $ 1,000 per violation or act up to a $ 10,000 aggregate or for intentional violations or acts, payment of up to $ 5,000 per violation or act up to a $ 50,000 aggregate;

2. suspension or revocation of license; or

3. payment of a $ 50,000 civil penalty or the suspension or revocation of license, after subsequent notice and hearing, for violation of a cease and desist order (CGS §§ 38a-226b(2)(A) and (B) and CGS § 38a-226(4)).

URCs must also pay the reasonable expenses incurred to compensate the commissioner for costs associated with the proceeding (CGS § 38a-226(C)).

The Connecticut Unfair Insurance Practices Act does not apply to URCs.

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