Pennsylvania Returns $66.8M in Restitution Payments to Consumers in Q1

April 24, 2015

Pennsylvania’s Acting Insurance Commissioner Teresa Miller announced Thursday that nearly 5,000 Pennsylvania consumers received $66.8 million in restitution payments or credits through the restoration of stolen funds, the payment of denied or underpaid claims, and the refunding of overcharged premiums during the first quarter of 2015.

“My Administration is committed to protecting consumers across the commonwealth,” said Pennsylvania Gov. Tom Wolf. “These types of predatory practices will not be tolerated on my watch. Families should always get the coverage they deserve at the prices they have agreed to pay.”

“Pennsylvanians spend hard earned money to protect their families by purchasing many types of coverage, including life, home, auto, and health insurance. The state has a competitive insurance market, which is good for consumers, because competition increases options and holds down prices,” said Miller. “But, if a customer is victimized by an unscrupulous insurance producer or an unfair business practice, the PA Insurance Department will do everything possible to make that consumer whole.”

Miller said 4,830 Pennsylvania consumers received restitution payments or credits in the first three months of 2015, primarily in four main areas.

  • Restoration of stolen funds: The Insurance Department has investigated cases where an insurance agent collects a personal check or cash as payment for a policy or annuity, but never sends that money to the insurance company, often stealing the customer’s money. In these instances, the department requires the agent to repay the customer, or if the agent cannot make this repayment, the insurance company for which the agent sold the policy must do so.
  • Processing and payment of previously denied or underpaid claims: When an Insurance Department investigation finds a customer’s claim was inappropriately denied or only partially paid, the department requires the company to pay the claim as it should under the policy.
  • Refunding of overcharged premiums: Private auto and homeowners insurers must, under Pennsylvania law, receive prior approval from the Insurance Department for the rates they charge. When an investigation finds an insurance company is using rates not approved, any premium payments above the rate that would have been approved are returned to the customers either in refunds or credits to the policy premiums.
  • Making payments under a multi-state settlement with life insurance companies: Pennsylvania is a leader in a multi-state examination of life insurance companies, resulting in companies entering into settlement agreements requiring them to reform the way they do business for the benefit of policyholders and beneficiaries across the country. Insurance regulators nationwide focused on the life insurance industry’s selective use of the Social Security Administration’s Death Master File (DMF), and found that while some companies properly used this file, others used it to terminate the payment of annuity benefits, while at the same time failing to trigger the payment of life insurance policy benefits. Moving forward, life insurance companies that have entered these settlement agreements will use the DMF to identify potentially unpaid insurance benefits and search for beneficiaries to whom benefits might be due.

Miller urged anyone with concerns about insurance issues to visit, and click on “Services for Consumers”, or call 1-877-881-6388.

Source: Pennsylvania Insurance Department


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