Colorado's insurance division recovered close to $ 38.5 million for consumers over the last fiscal year, a third of which after consumer complaint investigations recently announced the division.
Although the number of proceedings initiated by the division against insurers during the fiscal year ended June 2018 was 22% lower than last year, the state increased its recoveries. on the basis of consumer complaints of 34%, according to the registers of the division.
In addition, the state said it has closed 16 percent fewer complaints against insurance companies, but has collected more than $ 11.3 million for consumers through these complaints. Most came from health insurance, followed by auto insurance.
"Answering people's questions, investigating their complaints, helping them get paid for their claims, and restoring coverage when it's been unduly canceled are areas where we can actually affect lives," he said. said in a statement the Acting Insurance Commissioner, Michael Conway.
The bulk of recoveries – $ 22.7 million – came mainly from the Division's Market Regulation Section, which reviews licensed insurance companies licensed to operate in Colorado.
"When people think about insurance, they think about premiums," said Conway. "But the division's work goes beyond simply reviewing premiums."
The largest collection – $ 924,335 – related to a health insurance claim that Kaiser Permanente had initially refused to pay for a long-term hospitalized patient for an undeclared illness. The patient's coverage ended at mid-hospital when his wife lost her job, insurance officials said.
Colorado law requires that a carrier provide insurance coverage until the patient leaves. The patient remained hospitalized nearly four months after the end of the blanket, officials said.
The second largest amount is $ 493,482 for a consumer who complains that he has received false information about the benefits of Anthem's HMO Colorado network, officials said.
The largest land claim amounted to $ 197,462, paid to a Golden owner whose home was hail-ridden in May 2017. The storm caused significant damage to the roof, windows and roof. coating, but the Underwriters claim at Lloyds of London lasted more than five years. months before the state is involved.
The same storm hit another Golden house and left $ 164,176 in damages that the division was able to recover from the American Family Mutual Insurance Company for replacement windows.
"We are investigating businesses and giving money back to people," said Bobbie Baca, Director of Consumer Services for P & C, "but we're also answering questions about the terminology and processes of business." 39, insurance, and we simply ask, "Can I my insurance company? do that?
The complaints filed against the auto insurance companies were the best among all types of insurance: 1,298 were filed during the previous fiscal year, a decrease of 21% over at the previous exercise.
The largest recovery in a car insurance case was $ 250,000 from State Farm Mutual Insurance Company, officials said. It was a refusal to pay for medical expenses and coverage of an uninsured motorist for a passenger in a car accident.
In addition to the money recovered, investigations can also result in the reinstatement of coverage after undue cancellations or non-renewals, results for which no amount is associated.