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Unhappy with your insurance company? Here’s how to complain about it

Mary Lou Jay

Did an auto insurance company offer you an accident settlement that you think is too low? Do you feel like your home insurance company took too long to settle your claim? Do you just feel like your insurance company isn’t there for your when you need it?

When you’ve tried to resolve your issues with an insurance company and don’t think you’re making any progress, there is an option. All 50 states and the District of Columbia have formal complaint processes that may help you resolve your difficulties.

The National Association of Insurance Commissioners has an online resource that connects consumers with the appropriate agencies in their states. Several states, including Missouri, Rhode Island, Maryland, West Virginia and the District of Columbia, now allow consumers to file their complaints directly through NAIC’s “State Based-Systems” technology. All other states except Massachusetts which requires hard-copy complaints) allow consumers to file complaints either via email or online.

When you report your grievance to the state agency usually the state insurance department), you’ll need to provide basic information about yourself, your insurer and the incident that prompted the complaint. You’ll be asked to provide copies of paperwork to support your complaint.

Every state has its own system for handling complaints, but the Maryland Insurance Administration MIA) is fairly typical. MIA forwards a copy of a consumer’s complaint to the insurer, gets an explanation back from that insurer and checks to be sure that the company has not violated any insurance laws or policies. It will explain its findings to the consumer and suggest possible courses of action that he or she can take. If the insurance company is guilty of a violation of a law or policy, MIA may take corrective action.

MIA also makes it clear, however, that it cannot serve as the legal representative for the person making the complaint and cannot intervene in a lawsuit. It can’t help in cases that involve insurance that’s not under its jurisdiction like workers’ compensation or Medicare). It can’t decide issues like the value of a claim or who was at fault in an accident.

NAIC tracks insurance complaints from the states and analyzes the data from closed, confirmed reports. Its analysis reveals that the most frequent causes for complaints nationally in 2010 were delays in claims handling 21.82 percent of complaints), denial of claims 13.22 percent) and unsatisfactory settlements or claim offers 12.15 percent). State insurance regulators can access 10 years’ worth of NAIC claims information and get reports that enable them to track issues that they may need to address.

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