Claims News Service, Jan. 31, 2:48 p.m. EST — Claim issues continue to top the list of reasons why consumers file formal complaints against their insurers, according to an annual study completed by the National Association of Insurance Commissioners (NAIC). The NAIC's results showed that issues with delays, denial of claims, and unsatisfactory settlement offers were the top three reasons that spurred consumers to report their insurers to their state's department of insurance. While the NAIC said that these reasons have remained largely unchanged in the last four years, there was a silver lining for claim managers and professionals. There was a decrease of almost four percent over 2006 in the number of complaints reported, with a little more than 222,000 filed in NAIC's complaint database system (CDS).In addition to listing complaint types, the NAIC also broke down the complaints by types of coverage. While Accident and Health had the largest single percentage of complaints by type of coverage, Property and Casualty policies — such as auto and homeowners' insurance — made up nearly half of the total number of complaints. The NAIC said that it collects data through the CDS, which is where states voluntarily report closed complaints. A closed complaint is one that has been investigated and resolved to the satisfaction of the state or jurisdiction in which it is filed. The database now holds data on more than two million complaints. The NAIC said that it does not collect all complaint data from all states, however.

Top Complaints in 2007

Below are the top five complaints by number received, followed by the percentage they made up.

Delays

42,524 (16.0%)

Denial of Claim

39,152 (14.7%)

Unsatisfactory Settlement/Offer

26,127 (9.8%)

Cancellation

12,240 (4.6%)

Premium and Rating

11,916 (4.4%)

Top Five Complaints by Type of Coverage in 2007

Below are the number of complaints broken down by type of coverage.

Accident and Health

71,407 (36.4%)

Auto

67,327 (34.4%)

Homeowners

24,530 (12.5%)

Life and Annuity

17,727 (9.0%)

Commercial Multi-Peril

3,675 (1.8%)

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