May 23, 2014

Department of Insurance returns nearly $5 million to Missouri consumers in first quarter of 2014

Consumer Affairs Division helps more than 7,000 Missourians in first quarter

Jefferson City, Mo - The Missouri Department of Insurance helped consumers who filed a complaint against their insurance company receive an additional $4.7 million in claim payments in the first quarter of 2014.

"The Consumer Affairs Division stands ready to assist Missourians who reach an impasse with their insurance company," said John M. Huff, director of the Missouri Department of Insurance. "Consumers are encouraged to call us when a claim has been unfairly denied or when they feel their settlement is inadequate. Our team is trained to investigate all types of insurance issues."

Health insurance generated the most complaints in the first quarter of 2014 with 437 formal complaints followed by auto with 199 formal complaints. Consumers filed the most complaints for denial of claims and delays in processing.

Some notable accomplishments form the first quarter:

  • A storage facility damaged in the May 2011 Joplin tornado received payment for demolition in the amount of $110,000 after contacting the department. The insurance company previously made two attempts to settle the demolition clean-up which were rejected by the policyholder. The first offer was for $55,000 and the second offer was for $85,000.
  • A Callaway County consumer was denied coverage for damage to the interior of his home that appeared to be caused by the settling of his foundation. The consumer informed the company that he was concerned that the settling was caused by an exterior-water-line break. Although the company's engineer's report did not rule out the possibility that the settling had been caused by such a break, they denied his claim partially based on the consumer's inability to produce evidence of the line break. After the consumer contacted the department, the company revised its position and offered coverage in the amount of $9,578.57 for damages to the home caused by the water line break.
  • A Jasper County woman filed a complaint against her insurance company for delaying payments after a house fire. The fire occurred just days before her policy was due to cancel and the insurance company gave multiple excuses for delaying payments. The contractor was unable to make repairs without a down payment. After the consumer filed a complaint with the department, the insurance company made a settlement of $77,855 and she was able to repair her home.
  • A Newton County mother and her son sustained serious injuries from an automobile accident in 2012. They were experiencing many delays in settling their bodily injury claims. The consumer then filed a complaint with the department and the insurance company issued a $60,000 settlement.

In the first quarter of 2014 the department answered 7,120 phone calls, handled 2,544 inquiries and assisted with 1,077 complaints.

The top categories of complaints were:

 

Complaints by reason

Complaints by line of insurance

Denial of claim (248)

Health (437)

Delay of claim processing (238)

Auto (199)

Delays or No Response (98)

Life & Annuities (135)

Unsatisfactory offer (93)

Homeowners (123)

 

 

 

 

 

In addition to individual consumer recoveries, agent investigations levied 37 fines and collected over $16,000 in the first quarter.

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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