Press Releases - February 15, 2017
$7.5 Million for Policyholders, Taxpayers in 2016
Insurance Commissioner Katharine L. Wade announced today that the Connecticut Insurance Department recovered $7.5 million for policyholders and taxpayers in 2016, helping individuals, families and employers with their claims and complaints.
“Connecticut consumers turn to us every year to help them with claims and coverage issues or to just answer questions about their insurance,” Commissioner Wade said. “Our intervention in 2016 helped thousands of policyholders get much-needed answers, resolution and the benefits to which they are entitled.”
The Commissioner said among the many cases the Department worked on was a dispute that involved nearly $170,000 in hospital bills for a victim of a car accident. The patient had health care coverage under two plans – through his employer and as a dependent on his parent’s health insurance. When a dispute arose over which plan was the primary payer, the Department stepped in and determined it was the employer’s plan, which then covered the claims.
Another case involved a motorist whose car was totaled in an accident. When motorist’s insurer initially denied her claim, the Department required that the insurer review the case further. The insurer subsequently paid 100 percent of the motorist’s claims.
The Department’s Consumer Affairs Unit (CAU) fielded more than 5,800 complaints and inquiries and helped policyholders recoup nearly $6 million from January 1 to December 31, 2016. Also in 2016, the Department’s Market Conduct division levied approximately $1.6 million in fines against carriers and returned that money to the state’s 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 2016:
- Accident, Health - $3.63 million
- Auto - $432,000
- General Liability - $33,710
- Homeowners and Commercial Property - $874,250
- Life, Annuities - $820,000
- Miscellaneous - $160,000
The Department 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.
Complaint data also help determine topics for consumer education and serve as tools to help the Department monitor the industry. The Market Conduct enforcement actions are posted on the Department’s Web site at www.ct.gov/cid
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