February 17, 2021
Over $23 million returned to Missouri consumers with the assistance of the Missouri Department of Commerce and Insurance
Jefferson City, Mo. – Missouri consumers received an additional $23.9 million from their insurance companies in 2020, thanks to the dedicated work of the department’s Consumer Affairs Division and Market Regulation Division.
“One of our primary responsibilities is to protect Missouri consumers and ensure they are treated fairly by insurance companies,” said Chlora Lindley-Myers, Director of the Missouri Department of Commerce and Insurance. “We are a free resource to help people resolve any disputes they have with their insurance company.”
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 Regulation Division in ensuring compliance with Missouri insurance laws.
In 2020, the Consumer Affairs Division received 2,952 formal complaints and returned $8 million to consumers.
“There were some impacts to our annual numbers (recoveries, phone calls, and complaints) due to COVID-19. We attribute these impacts mostly to consumers not utilizing their auto and health insurance during the pandemic,” said Carrie Couch, Consumer Affairs Division Director.
The largest driver of complaints continues to be health insurance with claim denials and delays as the top reasons for complaints. In one notable accomplishment for 2020, a complaint was filed regarding payment for autism services. An internal error was discovered at the company level resulting in the denied claims. The Consumer Affairs Division monitored the reprocessing of the affected claims which resulted in a recovery of nearly $89,000.
The Department’s Market Regulation Division focuses on identifying and resolving systemic issues that impact Missouri insurance consumers. In some instances, Market regulation 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 a review of insurance company filings and by monitoring insurance company activities in the insurance marketplace. In 2020, the Market Regulation Division recovered $15.9 million. That money went to 82,219 Missouri insurance consumers. Consumers benefit from restitution by receiving refunds from insurance companies for premium overcharges and by receiving payment from insurance companies for claims that were improperly denied or were underpaid.
“Market regulation serves two important roles in the insurance market. The first is to address issues that impact numerous consumers in the market and 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 regulation 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.
The Consumer Affairs Division and the Insurance Market Regulation Division are essential components of the Department of Commerce & Insurance. DCI is charged with protecting Missouri consumers through oversight of the insurance industry, banks, credit unions, utilities and various professional licensees operating in the state. For more information on DCI, please visit our website at dci.mo.gov.