Missouri Insurance Department Returned $29M to Consumers in 2016

Missouri consumers and small businesses 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.

The monies were returned as a result of the Consumer Affairs Division’s mediation work on complaints filed by consumers as well as the efforts of the Market Conduct Section that examines insurance company operations and practices to ensure compliance with Missouri insurance law.

In 2016, the Consumer Affairs Division, which was established by the Missouri Constitution, 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.

Because of the division’s intervention, the company conducted an additional review. The company overturned their original denial and provided coverage for the preferred drug, which resulted in a $74,797 recovery for the consumer.

The department’s Market Conduct Section had a number of actions focused on workers’ compensation insurance in 2016. Market Conduct found many instances where employers were overcharged for workers’ compensation insurance by insurance companies failing to give premium credits to employers that were owed and through the use of incorrect classification codes and experience modification factors.

A comprehensive list of enforcement and market conduct actions taken by the department is available on the department’s website.

Source: Missouri Department of Insurance, Financial Institutions & Professional Registration

Topics Missouri