Complaints to Wisconsin DOI Down 17%

June 4, 2004

According to the 2003 Insurance Complaints and Administrative Actions report, nearly 8,000 consumers contacted Wisconsin’s Office of the Commissioner of Insurance (OCI) last year to file a complaint, down 17 percent from the 9,265 complaints it received in 2002.

The annual report issued by OCI lists companies with at least six complaints received in 2003 and with a ratio of complaints per $100,000 of premium that exceed the average for their line of insurance. In 2003, OCI assisted consumers who filed complaints in recovering nearly $5 million from insurers in the form of claims that would not have otherwise been paid.

According to the report, OCI took 158 administrative actions against insurance companies last year and demanded $393,672 in forfeitures. In addition, 181 agent licenses were denied, revoked, surrendered, or suspended accounting for another $176,472 in forfeitures.

The report categorizes complaints by insurance type into four areas: auto, homeowners, farmowners and tenants, 3) accident and health, and 4) life and annuities. Of the agency’s 7,960 complaints, the type of coverage generating the most complaints was accident and health (4,763 complaints), while the least was life and annuities (816). The vast majority of complaints concerned claims handling.

Although OCI received 7,960 total complaints in 2003, only the 7,024 complaints requiring further investigation were used to calculate the ratios in the report. Complaints are defined by OCI as “a written communication received by the Commissioner’s Office that indicates dissatisfaction with an insurance company or agent.”

While it is a useful tool in evaluating certain companies, OCI said in a statement that the 2003 complaints report is only one source of information and the number of complaints does not reflect the department’s final determination on whether there has been a violation of the law. However, even when complaints do not involve violations of the law, they may indicate something about company communications with policyholders, deficiencies in policy design or agent training, OCI said.

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