Wis. Reports Above Average Complaints for 2002

July 8, 2003

Wisconsin’s Office of the Commissioner of Insurance (OCI) has released its “2002 Insurance Complaints and Administrative Actions” report, noting complaints were above average. The annual report lists companies with six or more complaints in 2002 in relation to the premiums the company wrote in Wisconsin in 2001, and those with an above-average ratio of complaints per $100,000 of premium volume.

“The complaints we get from consumers help us to resolve the problems they may have with an insurer or insurance agent and help us monitor the insurance industry,” Jorge Gomez, Commissioner of Insurance, commented. “We rely on consumer input to help us direct our efforts, and we encourage anyone with an insurance problem to contact our office.”

OCI defines a complaint as “a written communication received by the Commissioner’s Office that indicates dissatisfaction with an insurance company or agent.” In 2002, OCI received 8,131 complaints that required further investigation.

“Last year alone, OCI recovered $4,408,425 for consumers,” Gomez said. “We’re getting results, and we’re righting situations, so we hope the citizens of Wisconsin take advantage of the services OCI provides them.”

The 2002 report breaks complaints down into the following categories:

Homeowner’s, Farmowner’s and Tenant’s Insurance
Automobile Insurance
Life Insurance and Annuities
Individual Accident and Health Insurance
Group Accident and Health Insurance

Prior to 2002, the Insurance Complaints and Administrative Actions report listed companies with 10 or more complaints. To better assist consumers, that number was lowered to six complaints for this year’s report. Although OCI received 9,164 complaints, only the 8,131 requiring further investigation by OCI were counted in calculating the ratios listed in the report. Complaints against agents are assigned to the company the agent represents.

In addition, all health plans in Wisconsin are required to establish a grievance process to resolve disputes with their enrollees. Grievances are also tracked and can be found in OCI’s Consumer’s Guide to Managed Care Health Plans in Wisconsin. The updated guide is available on the Web at http://oci.wi.gov/pub_list/pi-044.htm.

OCI also monitors its own internal performance by surveying complainants. In 2002, 92 percent of those surveyed said that OCI responded to their complaint quickly, 97 percent said they were treated courteously, and 80 percent felt that they were given an adequate explanation about their complaint.

“We are very encouraged by these numbers. The overwhelming majority of consumers who contact OCI were happy with their service, and 90 percent of those surveyed said they would contact OCI again,” Gomez noted.

The 2002 Complainant Survey results are based on 719 responses received by OCI out of 1,410 surveys mailed out.

The complete 2002 complaints report is on the Web at http://oci.wi.gov/pub_list/pi-030.htm.

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