The Missouri Department of Insurance (the "DOI") has reported that, because of the work of its Consumer Affairs Division and Market Conduct Section, Missouri consumers received an additional $16.8 million from their insurance companies in 2017.
"The department is here to ensure Missouri consumers are treated fairly," said Chlora Lindley-Myers, director of the Missouri Department of Insurance. "And when they come to an impasse with their insurance company, we are a free resource to help resolve that dispute."
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, which examines insurance company operations and practices to ensure compliance with Missouri insurance law.
In 2017, the Consumer Affairs Division, which was established by the Missouri Constitution, handled approximately 35,000 consumer contacts, received 3,574 formal complaints, and returned over $8.5 million to Missourians.
Health complaints were the largest portion of the complaints, with 1,270. Those included concerns about a company determining that a prescription was not medically necessary or a consumer learning that his or her coverage had been terminated just days prior to a scheduled procedure. According to the DOI, because of the division's intervention, an additional review was conducted in each of these cases and a drug was approved, resulting in an over $112,000 recovery for the consumer and reinstatement of the policy.
The DOI added that, in 2017, its Market Conduct Division recovered over $8.3 million for Missouri consumers.
"Market conduct serves two important roles in the insurance market. The first is to address issues that impact numerous consumers in the market and which may involve violations of law that consumers may not know to complain about," said Director Lindley-Myers. "The second is to ensure a level playing field for all insurance companies, which encourages competition in the market. Missouri consumers directly benefit from a competitive insurance market when they have more choices in insurance products, companies, and better premiums."
Learn more: insurance.mo.gov.