全美保险监督官协会11日通讯：美国商业保险续保涨幅放缓，佛罗里达破获10万美元工伤保险欺诈案
全美保险监督官协会（NAIC）11月11日的 NewsWire 通讯汇总了各州保险监管动态：Ivans 指数显示，10月美国主要商业险种续保费率同比涨幅普遍放缓；佛罗里达州宣布破获一起涉案约10万美元的工伤保险欺诈案；北卡罗来纳州保险专员呼吁房主购买洪水保险，联邦紧急事务管理署（FEMA）已开通国家洪水保险计划官网直购；密歇根州健康保险市场开放注册进行中。
Ivans 指数显示，10月商业汽车险续保费率平均上涨2.80%，商业综合险（BOP）上涨5.21%，一般责任险上涨3.10%，伞式责任险上涨6.08%，涨幅均低于9月的3.29%、5.45%、3.19%与6.40%；商业财产险续保费率涨幅由9月的5.11%升至5.37%；工伤保险续保费率则下降1.45%，降幅大于9月的1.14%。
执法方面，佛罗里达州首席财务官 Blaise Ingoglia 宣布，建筑公司老板 Israel Carballo 因涉嫌约10万美元的工伤保险欺诈被捕。调查指，Carballo 在投保时瞒报工资总额，未申报的工资敞口达968,278.71美元，并通过货币服务商兑现支票1,074,278.71美元以隐瞒工资，一个保单年度仅支付9,297.43美元保费，造成100,565.57美元保费损失。Carballo 于11月5日被捕，被控重大盗窃、有组织诈骗与工伤保险欺诈罪名，案件由迈阿密-戴德县州检察官办公室起诉。Ingoglia 说，这类犯罪推高了诚实企业的保费。南卡罗来纳州执法部门（SLED）同日通报，约克县男子 Franklin Denoris Thompson 11月5日被控提出虚假保险索赔（金额2000至1万美元），已被收押至约克县拘留中心。
消费者事项方面，北卡罗来纳州保险专员 Mike Causey 再次呼吁房主购买洪水保险，并指出 FEMA 已推出新渠道，消费者可通过 FloodSmart.gov 直接在线购买国家洪水保险计划（NFIP）保单；他提醒，普通房主保险不承保洪水损失。密歇根州保险与金融服务厅厅长 Anita Fox 提醒居民，健康保险市场开放注册已于11月1日开始、至2027年1月15日结束，12月15日前注册可自2027年1月1日起生效，并有免费本地协助。田纳西州商务与保险厅联合州总检察长办公室等多家机构发布消费者警示，提醒房主警惕以「快速现金收购」为饵的「销售备忘录」（memo of sale）骗局，这类安排会给房主日后卖房留下昂贵隐患，长者及其照护者尤其要当心。
监管与行业事项方面，科罗拉多州保险处新规 4-2-106 生效，就「乡村独立药房」认定为药品福利管理商（PBM）设定核查要求与年度报告义务；马里兰州保险管理局第 26-28 号公告提醒各保险公司履行经纪人执照、内部委任与登记册维护义务；爱荷华州保险处定于11月18日举办免费线上讲座，讲解联邦医疗保险（Medicare）变更与在 Medicare.gov 上比较计划；南卡罗来纳州保险处第 2026-04 号令核定了与消费信贷交易相关的信用意外与健康保险2027年费率。纽约州金融服务厅方面，州长 Kathy Hochul 宣布在纽约州立大学宾汉姆顿分校设立「超级智能责任与研究中心」（New York Center for AI Responsibility and Research），该厅将通过新设的 DIGIT 办公室落实 RAISE 法案，与该中心合作推进超级智能（SI）安全研究与先进系统独立测试。
NAIC NewsWire Nov. 11: U.S. Commercial Renewal Increases Slow; Florida Announces $100,000 Workers' Comp Fraud Arrest
The National Association of Insurance Commissioners (NAIC) NewsWire of November 11 rounded up insurance regulatory developments across the states: the Ivans Index showed that average U.S. commercial premium renewal rate increases slowed in October for most major lines; Florida announced an arrest in an alleged $100,000 workers' compensation fraud scheme; North Carolina's insurance commissioner urged homeowners to buy flood insurance as FEMA opened a direct purchase option for the National Flood Insurance Program; and Michigan's Health Insurance Marketplace open enrollment is under way.
According to the Ivans Index, average renewal rates in October rose 2.80% for commercial auto, 5.21% for BOP, 3.10% for general liability and 6.08% for umbrella, all down from September's 3.29%, 5.45%, 3.19% and 6.40%, respectively. Commercial property renewal rates rose from 5.11% to 5.37% month over month, while workers' compensation renewal rates were -1.45%, compared with -1.14% in September.
On enforcement, Florida Chief Financial Officer Blaise Ingoglia announced the arrest of Israel Carballo in an alleged $100,000 workers' compensation fraud scheme. As the owner of his construction company, Carballo allegedly concealed payroll when applying for coverage; the investigation uncovered $968,278.71 in unreported payroll exposure, and found he had cashed checks totaling $1,074,278.71 through money service businesses to hide payroll from his insurer. He paid only $9,297.43 for the policy year, resulting in a loss of $100,565.57 in premiums. Carballo was arrested on November 5 and charged with grand theft, organized scheme to defraud, and workers' compensation fraud; the case will be prosecuted by the Miami-Dade State Attorney's Office. Ingoglia said such crimes result in higher premiums for honest businesses. In South Carolina, the State Law Enforcement Division (SLED) charged Franklin Denoris Thompson of York County on November 5 with presenting a false claim for insurance payment (value more than $2,000 but less than $10,000); he was booked into the York County Detention Center.
On consumer matters, North Carolina Insurance Commissioner Mike Causey renewed his plea for homeowners to buy flood insurance, noting FEMA's new program allowing consumers to purchase NFIP coverage directly through FloodSmart.gov, and reminded consumers that homeowners policies do not cover flood damage. Michigan Department of Insurance and Financial Services Director Anita Fox reminded residents that Marketplace open enrollment began November 1, 2026 and runs through January 15, 2027, with a December 15 deadline for coverage beginning January 1, 2027, and that free local assistance is available. Tennessee's Department of Commerce & Insurance, joined by the state attorney general's office and other regulators and industry groups, warned homeowners about predatory "memo of sale" schemes that promise quick cash sales but create potentially expensive long-term problems, urging seniors and their caregivers to be alert.
On regulatory matters, the Colorado Division of Insurance adopted Regulation 4-2-106, setting requirements for pharmacy benefit managers (PBMs) to verify rural independent pharmacy designations, with annual reporting; the Maryland Insurance Administration's Bulletin 26-28 reminded insurers of their obligations on producer licensing, internal appointments and producer registers; the Iowa Insurance Division will host a free live webinar on November 18 on navigating Medicare changes and comparing plans on Medicare.gov; and South Carolina's Department of Insurance issued Order 2026-04 setting 2027 rates for credit accident and health insurance sold with consumer credit transactions. In New York, Governor Kathy Hochul launched the New York Center for AI Responsibility and Research at SUNY Binghamton University, and the Department of Financial Services said it will lead implementation of the RAISE Act through its new DIGIT Office, working with the Center on super intelligence (SI) safety research and independent testing of advanced systems.
来源：全美保险监督官协会
发布：GSM·美国（发布链接）
图片来源：图：全美保险监督官协会中央办公室所在的 Kansas City Town Pavilion 大楼。Drowzy 摄，公有领域，经 Wikimedia Commons。 / Photo: Town Pavilion in Kansas City, home to the Central Office of the National Association of Insurance Commissioners. Photo by Drowzy, public domain, via Wikimedia Commons.
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