Insurance News

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July 26, 2012

Missouri consumers receive additional $5 million in insurance claims payments in first half of 2012

Department of Insurance handles more than 17,000 inquiries this year

Jefferson City, Mo. - The Missouri Department of Insurance has helped consumers receive an additional $5.1 million in claim payments from their insurance companies through the first half of 2012.

"Consumers who have reached an impasse with their insurance companies need to know they have a free resource available to them that can help assist with their insurance claims," said John M. Huff, director of the Department of Insurance. "A call or letter from our technical experts may be all it takes to resolve a dispute between policyholders and their insurance companies."

Health insurance continues to generate the most complaints from consumers, followed by auto and homeowners. The most common reasons for complaints were denial of claims, claim delays and unsatisfactory offers.

Some notable accomplishments from the first half of the year:

In the first half of 2012, the department handled nearly 1,955 formal complaints, while assisting 5,008 consumers in writing and another 10,043 over the telephone.

 The top categories of complaints were:

   By reason

   By line of insurance

  Denial of claim (491)

  Health (531)

  Delay of claim processing (371)

  Auto (401)

  Unsatisfactory offer (276)

  Homeowners (355)

The department's Market Conduct Section has returned more than $1 million to consumers, health care providers and the state as a result of exams and investigations in the first half of the year. Enforcement actions also resulted in nearly $2.1 million in fines paid by insurance companies. Recent settlements with major insurance companies AIG and Aflac netted the Missouri State School Fund $1.7 million.

Market conduct exams and investigations aim to ensure insurance companies are complying with state law in their treatment of customers, including the rates being charged and the way claims are handled. Exams can result in refunds for consumers, fines for companies, changes in business practices and other remedies.

Since 2009, market conduct enforcement actions have generated $8.7 million in payments from insurance companies. The money goes toward refunds for consumers, general revenue and the State School Fund.

Consumers with complaints or questions about insurance claims or policy provisions can call the Insurance Consumer Hotline at 800-726-7390 or file a complaint at insurance.mo.gov.

About the Missouri Department of Insurance, Financial Institutions & Professional Registration

The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department's seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.

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