Insurance News

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January 24, 2013

Missouri Department of Insurance returns nearly $11 million to consumers in 2012

Jefferson City, Mo. - Consumers who filed complaints with the Missouri Department of Insurance received nearly $11 million in additional claim payments from their insurance companies in 2012.

"Protecting Missouri consumers is our top priority, and they need to know we are a free resource that can assist when they run into problems with insurance claims," said John M. Huff, director of the Missouri Department of Insurance. "Sometimes all it takes is a call or letter from one of our technical experts to resolve a dispute between policyholders and their insurance companies."

Health insurance generated 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 past three months:

In 2012, the department handled 3,851 formal complaints, while answering questions from 9,240 consumers in writing and more than 22,000 over the telephone.

The top categories of complaints were:

By reason

By line of insurance

Denial of claim (891)

Health (1068)

Delay of claim processing (631)

Auto (809)

Unsatisfactory offer (587)

Homeowners (717)

The department's Market Conduct Section returned nearly $2.4 million to consumers, health care providers and the state as a result of exams and investigations in 2012. Enforcement actions against insurance companies resulted in nearly $5.1 million in fines paid.

Market conduct exams and investigations aim determine whether 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 nearly $13.1 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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