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Insurance tops list of consumer complaints in Massachusetts

Jill Overmyer

When it comes to consumer complaints in Massachusetts, insurance comes out on top. Consumers are confused about their policies and frustrated that their claims are being denied.

The Massachusetts Office of Consumer Affairs and Business Regulation recently compiled complaints filed by Massachusetts residents in 2010. Insurance issues were cited as the top two most problematic issues for consumers. Contractor fraud, “lemon” laws and telecommunications issues rounded out the top five.

Auto insurance

Auto insurance issues took the top spot. According to the Office of Consumer Affairs and Business Regulation, more than 7,000 people contacted the Division of Insurance with auto insurance complaints and questions. The main issues had to do with claim denials and delays as well as questionable adjuster practices.

So which Massachusetts auto insurance companies did consumers complain about the most? Specific numbers for 2010 are not yet available. But, in 2008, Commerce Insurance Co. received just under one-third of total complaints. Safety Group came in second at 11 percent.

Health insurance

Health insurance issues came in as the second most problematic issue. More than 6,000 people in 2010 complained about their insurance companies and policies. COBRA issues, coordination of benefits and denial of claims were the most common problems facing consumers.

Massachusetts has a unique health insurance system. Most residents are required to buy coverage or face financial penalties. Yet the cost of care is still high, and those without group health insurance coverage through an employer still must navigate the individual insurance market.

How to complain

Insurance issues in Massachusetts are handled and investigated by the Division of Insurance within the Office of Consumer Affairs and Business Regulation. If necessary, these groups will intervene on your behalf after an investigation into questionable insurance practices.

If you have a complaint or issue you feel needs to be investigated, you can get an insurance complaint form from the Division of Insurance website. Here, you will list details of your complaint, the insurance company and policy number, and the names and contact information of those who’ve been handling your claim. Keep in mind that the information you provide when filing a complaint is not confidential and will be sent to all parties involved.

Certain health insurance plans, including some self-funded plans (which are more common for large companies with many employees), are regulated by the federal government. If you have a federally regulated plan, your employer can help you find the right place to complain.

Auto and health insurance issues can be confusing, so familiarizing yourself with the details of your policy and knowing your rights are crucial to ensure you are being treated fairly. In the event you do have a complaint, be persistent and document everything.

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