More than $10M Returned to Missouri Consumers in First Half 2013

August 23, 2013

Consumers who filed complaints with the Missouri Department of Insurance received $10.1 million in additional claim payments from their insurance companies in the first half of 2013, the department said. That’s nearly twice the amount consumers received at this time a year ago.

For the first half of this year, health insurance generated the most complaints with 31 percent of formal complaints filed, followed by auto insurance (23 percent) and homeowners (16 percent). The top complaint was claim denial, while delay of claim processing and unsatisfactory offer rounded out the top three.

Some notable accomplishments from the first half of the year:

  • A Callaway County couple contacted the department after their home was destroyed by a fire. Their insurance company delayed paying for loss of the dwelling, ultimately forcing the couple into foreclosure proceedings. Working directly with the insurance company, the department requested a payment be issued to the mortgage holder. Additional payments also were made for the couple’s living expenses and possessions. The total payout was $248,847.
  • A medical provider filed a complaint on behalf of a patient with Medigap (Medicare Supplement) insurance for nonpayment of services in an acute long-term care hospital last year. The provider filed a claim with the insurance company, but received no payment. After the department got involved, the insurance company paid $276,183.
  • An insurance agent sold a variable annuity to an 85-year-old St. Louis woman. The agent named the purchaser as the owner of the annuity. After she died nine years later, her daughter was not paid the proceeds from the annuity as her mother wanted. The insurance company agreed the annuity was not a suitable sale and paid the daughter $109,115.
  • A Barry County woman was injured on the job in 1998. She suffered from her injuries and the company continued to deny her medical bills. After a complaint was filed with the department, the woman received $411,551.

Source: Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP)

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