UPDATED: Mar 13, 2020
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Insurance companies have an obligation to operate in good faith. When an insurance company fails to operate responsibly, the policyholder may choose to file a complaint.
Wherever you are in America, there are a number of different ways to file a complaint with your insurer. Whether you’re unhappy with an insurer’s claim decision, its customer service, or its rates, you have a number of ways to express your dissatisfaction with your insurance company. Today, we’re explaining the best ways to file a complaint with your insurer.
Use NAIC to Find Your State Insurance Department’s Complaints Division
Every state in America has its own insurance department. This insurance department is in charge of overseeing insurance companies within that state. All insurance departments have a specific division to handle all complaints.
The National Association of Insurance Commissioners (NAIC) has a page that lets you easily select your state from a map or a list and get direct contact information for that state’s complaint department. You can view NAIC’s insurance complaint map here: https://eapps.naic.org/cis/fileComplaintMap.do
When you click on California, for example, you will be taken to this page of the California Department of Insurance. That page features contact information in English and Spanish that allows you to submit a complaint online or over the phone. There’s a toll-free phone number where you can submit a complaint. You can also submit a complaint online. The online form asks basic questions about your complaint, including the name of the insurance company, the nature of the complaint, and what led to the incident.
The insurance departments of all 50 states have their own complaint departments viewable from that list on NAIC.org. Just visit the insurance complaints page, choose your state from the list or map, and you will be taken directly to your state’s complaint department. If you’re unhappy with any aspect of the insurance company, then you can file a complaint through this system. This complaints system is designed to handle complaints about claims decisions, customer service, rates, and other aspects of the insurance industry.
The insurance complaints departments for American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands are also all viewable from that list.
What Types of Complaints Can My State’s Department of Insurance Handle?
Your state’s department of insurance handles thousands of complaints a year. Some of the complaints your state’s department of insurance can process include:
- Improper denial of claim
- Improper or unexplained delays in the settlement of a claim
- Alleged illegal cancellation or non-renewal of an insurance policy
- Problems regarding insurance premiums and rates
- Misconduct by an agent or broker, including misrepresentation, theft of premiums, etc.
Your state’s department of insurance handles all types of insurance claims disputes – including health insurance, car insurance, and other insurance cases.
What You Need to File a Claim
Whether filing a claim online or over the phone, you are typically required to have the following information:
- Policy information, including the name of your insurance company, its NAIC number, your policy number, or your claim number
- Your contact information, including your address, telephone number, and cell phone number
- A description of the problem or issue, including the nature of the complaint, the reason the claim was denied, and other information
Once you have all of this information, you can proceed with filing your complaint to your state’s department of insurance.
What Happens After Submitting a Complaint Online?
If you go through the process above and submit a complaint, then your state’s insurance department will investigate the claim further. Your state’s department of insurance will request certain documentation proving your allegation. Then, the department will investigate the matter.
Some state insurance departments receive thousands of complaints every day. Some complaints can be processed in minutes. Other claims take months. Some insurance complaints lead to a satisfactory outcome for all parties. Other complaints lead to no resolution whatsoever.
In certain cases, your state’s department of insurance will take the matter to mediation, at which point a mediator will attempt to bring all parties together to resolve the issue. Sometimes, the mediator will side with you. In other cases, the mediator will side with the insurance company.
In most states, insurance companies have to respond to a department of insurance complaint within a certain number of days. In most states, insurance companies need to respond within 20 to 40 days of receiving a request from the department of insurance.
Consider Hiring an Attorney
If you’re involved in a serious dispute with your insurance company, then it may be in your best interest to hire an insurance attorney. These attorneys specialize in representing clients against insurance companies.
Some insurance attorneys specialize in bad faith insurance claims. During a bad faith insurance claim case, an attorney may be more aggressive at pursuing the insurance company than the state’s department of insurance.
Don’t make the decision to hire an insurance attorney lightly. Hiring an insurance attorney can limit your ability to mediate your claim with the state’s department of insurance. You might be waiving certain rights when hiring an attorney. However, some attorneys can also get the job done more quickly than your state’s department of insurance.
Ultimately, policyholders in the United States have a number of different ways to submit complaints about an insurance company. Contact your state’s department of insurance complaints department to get started. Or, consider hiring an insurance attorney.