The state Department of Insurance recovered approximately $5.7 million for policyholders and taxpayers in 2015. The consumer affairs unit recovered $4 million while the market conduct division levied $1.7 million in fines.
Some of the 2015 recoveries included:
- $27,000 for home healthcare services for a senior citizen under her long-term care policy;
- $13,000 to pay for speech therapy for an autistic child;
- $16,000 paid to a policyholder for an inpatient stay at a skilled nursing facility; and,
- $37,000 in an additional payment to a homeowner to settle a claim
The department’s consumer affairs unit yielded more than 6,100 complaints and inquiries and helped recoup more than $4 million in 2015. Also in 2015, the market conduct division levied approximately $1.7 million in fines against carriers and returned that money to the state General Fund. The fines resulted from a variety of violations and settlements ranging from untimely claim payments to improper licensing.
The majority of the funds recovered for policyholders stemmed from complaints over health, accident, homeowners and life and annuities policies. The following is the breakdown of funds recovered in 2015, according to a statement:
- Accident, Health – $2.7 million;
- Auto – $430,000;
- General Liability – $17,200;
- Homeowners – $530,000;
- Life, Annuities – $294,000; and,
- Miscellaneous – $68,000.
The department said it calculates its consumer recoveries based on what the policyholder received as a result of the department’s intervention. The inquiries and complaints also help the department identify industry trends that may adversely affect consumers and trigger investigation by the market conduct division.
