February 05, 2018

Millions returned to consumers with the help of Missouri Department of Insurance

Jefferson City, Mo. – Because of the work of the department’s Consumer Affairs Division and Market Conduct Section, Missouri consumers received an additional $16.8 million from their insurance companies in 2017.

 “The department is here to ensure Missouri consumers are treated fairly”, said Chlora Lindley-Myers, Director of the Missouri Department of Insurance.  “And when they come to an impasse with their insurance company, we are a free resource to help resolve that dispute.”

The monies were returned as a result of the Consumer Affairs Division’s mediation work on complaints filed by consumers as well as the efforts of the Market Conduct Section that examines insurance company operations and practices to ensure compliance with Missouri insurance law.

In 2017, the Consumer Affairs Division, which was established by the Missouri Constitution, handled approximately 35,000 consumer contacts, received 3,574 formal complaints and returned over $8.5M to Missourians.  Health complaints were the largest portion of the complaints with 1,270.  Those included concerns about a company determining that a prescription was not medically necessary or a consumer learning that his or her coverage had been terminated just days prior to a scheduled procedure.  Because of the division’s intervention, an additional review was conducted in each of these cases and a needed drug was approved resulting in an over $112,000 recovery for the consumer and a reinstatement of a policy when it was most needed. 

And when disaster strikes, the division is a presence for those affected, participating in over 24 Multi-Agency Resource Centers across the state in 2017. This was in addition to other scheduled outreach events, providing important insurance education and outreach to thousands of Missourians. 

The Department’s market conduct section focuses on identifying and resolving systemic issues that impact Missouri insurance consumers.  In some instances, market conduct actions may originate from consumer complaints that have been filed with the Department’s Consumer Affairs Division.  In other instances, the issues are identified through monitoring insurance company activities in the insurance marketplace.  In 2017, the Market Conduct Division recovered over $8.3 million to Missouri consumers.

 “Market conduct serves two important roles in the insurance market.  The first is to address issues that impact numerous consumers in the market and which may involve violations of law that consumers may not know to complain about,” says Director Lindley-Myers. “The second is to ensure a level playing field for all insurance companies, which encourages competition in the market.  Missouri consumers directly benefit from a competitive insurance market when they have more choices in insurance products, companies and better premiums.”   

A comprehensive list of enforcement and market conduct actions taken by the department is available on the department's website. Consumers 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.