Insurance Department Helped Ohioans Save Record $24.4M
COLUMBUS, Ohio -- The Ohio Department of Insurance saved or recovered a record $24.4 million for Ohio consumers last year, the department announced Wednesday. Its staff also helped more than 190,000 Ohioans, primarily through toll-free hotlines, community outreach and counseling.
The total saving includes $18.9 million and $5.5 million saved or recovered, respectively, by the agency’s Office of Consumer Affairs and its Ohio Senior Health Insurance Information Program, according to Lt. Gov. Mary Taylor, director of the insurance department.
The Office of Consumer Affairs received 5,503 consumer complaints in 2012, Taylor reported. Two-thirds of the complaints dealt with denial of sny insurance, claim delay or unsatisfactory claim settlement offers. The Senior Health program, the state’s lead Medicare educational and enrollment program, counseled 38,276 Ohioans during Medicare open enrollment.
The top types of reasons for complaints last year are:
- Denial of claim – 26.8%.
- Claim settlement/payment delay – 13.6%.
- Claim settlement/unsatisfactory offer – 11.8%.
- Underwriting/premium rating – 4.9%.
- Underwriting/policy cancellation – 4.4%.
- The top types of complaints by coverage include:
- Accident and health – 40.6%.
- Personal auto – 21.8%.
- Homeowners and renters – 17.4%.
- Life and annuity – 14.4%.
- Other Coverage – 5.8%.
The Ohio Insurance Department offers consumers these tips:
- Your policy is a contract between you and your insurance company. Know what’s covered, what’s excluded and deductible amounts.
- Call your agent or your company’s claims hotline as soon as possible after an insurance-related event.
- Incorrect or incomplete information can cause a delay in processing your claim, so make sure the information you provide is accurate.
- If there is a disagreement about the claim settlement, ask the company for the specific language in the policy that is in question. Find out if the disagreement is because you and the insurance company interpret your policy differently. If this disagreement results in a claim denial, make sure you obtain a written letter explaining the reason for the denial and the specific policy language under which the claim is being denied.
- If the first offer made by an insurance company does not meet your expectations, be prepared to negotiate to get a fair settlement. If you have any questions regarding the fairness of your settlement, seek professional advice.
- For health-related claims, ask your physician to provide your insurance company with details about your treatment, medical conditions and prognosis. If you suspect a provider is overcharging, ask the insurance company to audit the bill and verify whether the provider used the proper billing procedure.
Ohio consumers who would like to file a complaint or have insurance questions can call the department’s consumer hotline at 800 686 1526.
Published by The Business Journal, Youngstown, Ohio.
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