North Carolina Insurance Dept. Reports $29.8M in Savings, Recoveries in 2015

March 15, 2016

The North Carolina Department of Insurance saved or recovered $29.8 million for North Carolinians in 2015, according to a statement from North Carolina Insurance Commissioner Wayne Goodwin.

In 2015, the Department of Insurance assisted more than 150,000 people with questions or complaints about the following types of insurance coverage:

  • Medicare: Assisted 108,047 consumers with general Medicare questions and helped more than 6,598 Medicare recipients apply for the federal low-income subsidy program that provides savings for prescription drug costs. NCDOI estimated cost savings for Medicare beneficiaries at approximately $12.6 million.
  • Health insurance: Took more than 19,420 calls; responded to 2,052 consumer complaints and appeals; and handled 424 requests for external reviews for denied medical claims. NCDOI said it returned or saved $2,041,183 to consumers as a result of services provided.
  • Homeowners, auto, life and other insurance-related issues: Handled 31,659 calls and 7,260 written complaints from the public. Through these calls and complaints, NCDOI said it was able to help consumers recover approximately $6.8 million in benefits from insurance companies.
  • The Criminal Investigations Division employs 20 sworn law enforcement officers dedicated to investigating claims of insurance fraud and criminal concerns associated with bail bonding, motor clubs, collection agencies and premium finance companies. In 2015, the work of these criminal investigators led to 296 arrests, 169 criminal convictions and more than $6.6 million in restitution and recoveries. Another 232 cases are currently pending in court.
  • The Agent Services Division regulates all licensed agents, brokers, limited representatives, appraisers, adjusters, premium finance companies, collection agencies, motor clubs, bail bondsmen, surety bondsmen and bail bond runners authorized to do business in North Carolina. Oversight includes licensure qualification, pre-licensing education, continuing education, telephone inquiries, complaint investigations and agency examinations. In 2015, the Agent Services Division investigated 1,954 complaints and recovered $17,408 in premium funds for consumers.
  • The Market Regulation Division conducts both routine and targeted market conduct examinations and market analysis investigations on foreign and domestic licensed companies (insurance companies, premium finance companies, HMOs, PPOs and more) to ensure compliance with state laws and regulations. Through market conduct examinations and market analysis investigations, the Division ordered $1,756,584 returned to policyholders.

Source: North Carolina Department of Insurance

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