Insurance regulators saved or recovered $11.6 million for Ohioans in 2011, the Ohio Department of Insurance announced. The department said it received 5,336 consumer complaints, the majority of which dealt with the denial of insurance claims.
Of the recoveries realized on behalf of Ohio consumers, $7.6 million came from complaints related to personal auto, homeowners and renters insurance. In addition, $2.6 million came from accident and health claims, $566,000 came from life and annuity claims, and all other coverage claims totaled $154,000.
Also included in the total savings is more than $757,000 from last fall’s eight week Medicare annual open enrollment period. From Oct. 15 to Dec. 7, 2011, the Ohio Senior Health Insurance Information Program (OSHIIP) provided counseling and assistance to Ohioans over the phone and in person at more than 100 events across the state.
Following are the top consumer complaints for Ohio and the United States in 2011:
Top Types of Ohio Consumer Complaint Reasons:
- Denial of Claim – 32.3%
- Claim Settlement/Payment Delay – 15.5%
- Claim Settlement/Unsatisfactory Offer – 12.6%
- Premium Rating – 5.3%
- Policy Cancellation/Non-Renewal – 4.6%
Top Types of National Consumer Complaint Reasons (as of 12/26/11):
- Claim Handling/Delays – 24%
- Claims Handling/Denial of Claim – 14%
- Claim Handling/Unsatisfactory Settlement/Offer – 14%
- Claim Handling/State Specific – 7%
- Underwriting/Cancellation – 4%
Top Types of Ohio Complaints by Coverage:
- Accident and Health – 43%
- Personal Auto – 22%
- Life and Annuity – 11.8%
- Homeowners and Renter – 18%
- Other Coverage – 5.2%
Top Types of National Complaints by Coverage (as of 12/26/11):
- Accident and Health – 42%
- Auto – 33%
- Homeowners – 13%
- Life and Annuity – 7%
- Misc. – 2%
This information is based on the submission of closed complaint data to the National Association of Insurance Commissioners (NAIC). Aggregate data can be accessed at www.naic.org.
The Ohio Department of Insurance advised that in order to help facilitate payment on insurance claims consumers should: know their policies; file claims as soon as possible; provide complete and correct information when filing; ask questions, especially if there is a disagreement about a settlement; and do not rush into a settlement.
The department also advised those filing accident and health claims to ask their physician to provide the insurance company with details about treatment, medical conditions and prognosis. If a provider is suspected of overcharging, ask the insurance company to audit the bill and verify whether the provider used the proper billing procedure.
Source: Ohio Department of Insurance
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