The Missouri Department of Insurance recovered over $9 million for consumers who filed complaints against their insurance companies during the first nine months of 2016.
In the first three quarters of 2016, the Consumer Affairs Division received 3,182 formal complaints. The top reason for complaints was claim denial followed by delays of claim processing, coverage questions and cancellation. The division handled 15,509 consumer phone calls and 3,222 inquiries.
Some notable accomplishments for the first nine months of 2016:
- St. Louis consumer was in accident and the at-fault party had the state minimums for bodily injury. The injuries she sustained surpassed the coverage limit on the at-fault party’s policy so she pursued a claim under her own underinsured motorist coverage. She was experiencing delays, but after filing a complaint with our department, the company settled the claim and paid her policy limit of $25,000.
- A Missouri consumer is battling cancer and his physician recommended a specific type of radiation treatment. The prior-authorization was denied by the insurance company. The consumer filed a complaint with our department and after additional review the company overturned the denial and provided coverage per the policy’s benefit schedule resulting in a total recovery of $58,181.30.
- A Southeast Missouriman and his children were out of town when their house caught fire and completely destroyed by fire. The consumer experienced delays when dealing with the company and he decided to file a complaint with our office. After the complaint was received, the company issued payment for the limits on the structure and contents. Total payments of $212,660 were issued to the consumer.
Source: The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP)
Topics Missouri
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