N.J. Regulators Recovered $21M for Consumers, Health Care Providers in 2013

March 25, 2014

New Jersey Department of Banking and Insurance Commissioner Ken Kobylowski announced last week that his department recovered nearly $21 million for consumers and health care providers, including nearly $7 million for victims of Superstorm Sandy, in 2013.

“The Department’s mission is to promote the growth and financial stability of the industries we regulate and to protect consumers. We take both parts of that mission very seriously,” Commissioner Kobylowski said.

“We are constantly working to streamline regulations, cut red-tape and expand the banking and insurance markets, but when our licensees violate our laws and regulations, we take action and hold them accountable.”

The Department recovered $18.3 million from insurance companies and $2.6 million from banks and related licensed financial institutions such as mortgage lenders and brokers, from probes into consumer complaints and enforcement investigations.

Officials said insurance consumers and health care providers received the payments for such things as claims processing delays, improper claims handling, denials of claims, and premium refunds due to improper ratings.

In addition, banking consumers received the payments mostly as refunds of fees improperly collected. Financial institutions made the payments as a result of investigations into specific consumer complaints and errors found during routine regulatory compliance examinations.

$6.9M in Recoveries for Sandy Victims

The $6.9 million in recoveries related to Superstorm Sandy resulted from improper denial or claims processing delays of homeowner’s and commercial non-flood insurance claims resulting from the storm. Another $4.1 million was recovered for consumers who have been unable to settle their Sandy-related homeowner’s insurance claim through the state’s mediation program.

The mediation program, which was launched in May 2013, allows consumers to submit unsettled homeowner’s, automobile and commercial insurance claims to an independent mediator who will review the case and assist in settlement discussions, free of charge. Disputed, non-flood Sandy-related claims greater than $1,000 that do not include a reasonable suspicion of fraud and are based on policies in force at the time Sandy made landfall are eligible for mediation. Insurance carriers pay for the cost of mediation.

To date, the Department has received 848 requests for mediation and 593 mediations have been completed. Of those mediations completed, 399, or 67 percent, have been settled, bringing $4.1 million in settlements to consumers. Cases are mediated through the American Arbitration Association.

Source: New Jersey Department of Banking and Insurance Commissioner

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