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File a complaint against an insurance provider

Make sure you have all your supporting documentation and get in touch with your state's DOI.

Updated

Fact checked

According to the National Association of Insurance Commissioners (NAIC) as of August 2019, there were over 100,000 complaints filed against providers and closed in 2018. Luckily, each state has a Department of Insurance (DOI) to assist consumers who’ve had their claims mishandled.

How do I file a complaint against an insurer?

Follow these steps to file a complaint with your state’s DOI:

  1. Go to the NAIC website
  2. Select Consumers
  3. Under Consumer complaints select your state and hit Go
  4. Follow the instructions on your state’s page
  5. Wait to hear back about your complaint

What information do I need to provide?

What you’re required to fill out will vary by your state, but there are some basics that you’ll likely need regardless of where you live. Keep the following handy when you’re going to file a complaint:

  • Your name and contact details
  • Address and phone number
  • Date of the loss
  • Insurance provider
  • Agent or adjuster’s name
  • Policy number
  • Certificate number
  • Claim number
  • Policy start date
  • Policy cancellation date, if applicable
  • Details of the complaint
  • Any supporting documents

Your state’s DOI may be under another name

Not every state’s DOI is actually called the Department of Insurance. Some are the Insurance Department, Division of Insurance or — in Colorado’s case — the Department of Regulatory Agencies.

Each of these departments serve a similar function and will be where you file your complaint.

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When should I file a complaint?

A few steps are generally required before you take your complaint to your state’s DOI.

  • Try to settle things directly with the insurer. Negotiating with your insurance provider is probably your best first step before filing a complaint. If you have an issue with the amount being paid out, billing, renewal or an adjuster’s assessment, those are disputes that can likely be handled without the state’s involvement.
  • Talk to your independent agent. Your agent has more of a vested interest in seeing your case settled than your state’s DOI, and you may be able to get a faster resolution than if you filed a complaint.

What can my state’s DOI do?

Your state’s DOI office is limited in how much action they can take against the insurance provider. For the most part, the DOI can’t do much more than investigate the complaint and ask for an answer from the insurer.Complaints filed against insurers with the state also become public record. That means others looking into the provider can look up the details of the complaint and how it was resolved.

What if I’m unsatisfied with the resolution?

The state won’t be able to provide legal advice, make liability decisions or address any issues that don’t have legal backing. That means if you’re unsatisfied with the resolution, you may need to speak with an attorney if you believe further action is necessary.

When will I hear back about my complaint?

The complaint process is different depending on the state you’re in, and that includes processing times. You’ll probably need to be patient when it comes to waiting for your complaint to be processed and closed. With the possibility of your state handling hundreds of other complaints, it may take some time for it to be processed.

To get an accurate read on how long it will take to get a resolution, email or call your state’s DOI. You may also be able to get an update on the status of a complaint you already filed.

How do I check complaints against an insurer?

As mentioned above, complaints filed against providers with the state become a matter of public record. An annual report can typically be found through your state’s DOI with information on how many complaints were filed for what type of coverage and against which insurance providers.

You can also use the resources provided by NAIC on its website. You’ll be able to select the report type and view how many complaints were filed against a company by state and coverage type.

  1. Go to the NAIC website
  2. Select Consumers
  3. Type the company name, select the type of insurance and your state and click Search

Bottom line

The time it takes to file a complaint can be significantly cut down by using online tools and having the appropriate documentation ready. Be sure you understand what your state’s DOI can and can’t do for you before you file, and be prepared to wait for a resolution.

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