Insurance News

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April 30, 2013

Department of Insurance returns more than $6 million to consumers in first quarter of 2013

Claim denial, health insurance drive complaints in Missouri

Jefferson City, Mo. - The Missouri Department of Insurance announced today that consumers who filed complaints against their insurance companies received an additional $6.2 million in claim payments in the first quarter of 2013.

"Consumers should not assume that they've run out of options if their claims have been denied by their insurance company or they feel that their settlement is unfair," said John M. Huff, director of the Missouri Department of Insurance. "Our department is here to protect Missourians and provide them help when they've reached an impasse with their insurance company."

Health insurance generated the most complaints in the first quarter of 2013 with 309 formal complaints, followed by auto and homeowners insurance. The top reason for complaints in the first quarter was claim denial, while delay of claim processing and unsatisfactory offer rounded out the top three.

Some notable accomplishments from the first quarter:

In the first quarter of 2013, the department handled more than 900 formal complaints against insurance companies, assisted nearly 2,300 in writing and helped out more than 5,000 consumers over the telephone.

The top categories of complaints were:

By reason

By line of insurance

Denial of claim (241)

Health (309)

Delay of claim processing (170)

Auto (216)

Unsatisfactory offer (108)

Homeowners (121)

In addition, the department's Market Conduct Section has returned more than $1 million to consumers as a result of exams and investigations in the first quarter.

In market conduct exams and investigations, the department reviews insurance company files and procedures relating to the treatment of policyholders - from the rates the companies charge to the way claims are handled to other responsibilities under state law. Exams can result in refunds for consumers, fines, changes in business practices or other remedies.

Since the beginning of 2009, Market Conduct enforcement actions have generated more than $15 million in fines and consumer restitution from insurance companies. Amounts recovered for consumer restitution are paid directly to consumers and fines are remitted to the Missouri State School Fund.

Consumer with complaints or questions about their insurance agent or company can call the department's Insurance Consumer Hotline at 800-726-7390 or visit 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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