DCI News

Jefferson City, Mo. - Consumers who filed complaints with the Missouri Department of Insurance have received almost $8 million in additional claims payments from their insurance companies. The department has recovered $7.7 million for consumers through the first three quarters of 2012.

Consumers have contacted the department with more than 26,600 complaints and inquiries.

"Consumers have a free but valuable resource in the Department of Insurance," said director John M. Huff. "A claim denial is not the end of the road - I strongly encourage consumers to contact our department if they reach an impasse with their insurance company."

Some notable accomplishments from the past three months:

• A St. Louis man was hurt on the job in 2004 and suffered a brain injury. He filed a disability insurance claim, which was denied by the insurance company for lack of sufficient information. This summer, the man filed a complaint with the Department of Insurance. The department was able to secure $66,530 in back payments and an ongoing monthly benefit of $795.
• A northwest Missouri woman complained that her insurance agent misrepresented two annuities when she bought them. The insurance company initially resisted her request for a refund, but when the Department of Insurance got involved, the company agreed to cancel the annuity policies and refund her entire premium of $152,694.
• A Saline County family had extensive fire damage to their home over the holidays. After 10 weeks of delays from the homeowners insurance company, the family finally filed a complaint with the department. Once the Department of Insurance became involved, the company paid $230,419 to the family to rebuild their home.

The department received 10,216 written inquiries and complaints - and took more than 16,000 phone calls from consumers. The most common categories of complaints received from consumers statewide:

The department's Market Conduct Section has returned nearly $1.5 million to consumers, health care providers and the state as a result of exams and investigations in the first half of the year. Enforcement actions have also resulted in more than $4.8 million in penalties paid by insurance companies to the Missouri State School Fund.

Market conduct exams and investigations aim to ensure 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 $11.9 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 their insurance claim or policy provisions can call the Insurance Consumer Hotline at 800-726-7390 or file a complaint at insurance.mo.gov.