Through the efforts of the consumer affairs and market conduct divisions of the Missouri Department of Insurance, policyholders in that state received an additional $29 million from their insurance companies in 2016, exceeding the insurance department’s previous record of $27.4 million set in 2014.
In 2016, the Consumer Affairs Division, handled approximately 37,000 consumer contacts and received 3,908 formal complaints.
Health complaints were the largest portion of the complaints with 1,371. Those included complaints like an insurance company that had denied coverage for a medication to treat a chronic condition. The insurance company argued that a different medication should be prescribed, but that drug interfered with the consumer’s other prescribed medications.
After the division’s intervention, the company overturned the original denial and provided coverage for the preferred drug, which resulted in a $74,797 recovery for the consumer.
In a number of workers’ compensation cases, the Market Conduct Section found instances in which employers were overcharged for workers’ comp insurance when carriers failed to give premium credits that were owed to employers and/or used incorrect classification codes and experience modification factors.
Topics Missouri
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