Each year, the “Top 5” reasons why Mass. consumers call the OCABR to inquire or complain
Insurance-related consumer complaints topped the Office of Consumer Affairs and Business Regulation’s (OCABR) “Top 5” list in 2013. Each year, OCABR’s Undersecretary Barbara Anthony holds a press conference to highlight which five issues dominated the consumer complaint/inquiry calls to the OCABR and its departments during the past year.
“These top five issues are no surprise given the consumer climate in 2013,” said Undersecretary Anthony. “We continue to see age old scams top the list, along with our mainstays of loan modification complaints and lemon law questions. We did see a spike in telecommunications complaints, possibly because of the digital age we live in.”
The Division of Insurance received top spot with nearly 10,000 consumer inquiries in 2013
In 2013 alone, over 9,500 people contacted both the OCABR and its agency, the Division of Insurance, to inquire or complain about various insurance products, insurance adjusters, denial of claims, and claim payment delays, to name just a few.
In addition to helping people with claims and inquiries the Division is also charged with investigating and enforcing “…state laws and regulations pertaining to insurance.” Aside from the 9,500 consumer calls that the Division took this year, the Division collected over $3,000,000 dollars from its efforts in investigating and enforcing regulations and laws.
For example, this year the Division’s market conduct unit collected over $2 million in monetary fines from its examinations of five insurers. The Market Conduct Section or Unit is responsible for reviewing the operations of both domestic and foreign licensed insurance companies to ensure that each insurer complies with Massachusetts state laws, regulations and regulatory bulletins. As a result of its efforts this year, the Division entered into settlement with five different insurance companies including the CIGNA Group, the UNUM Group, ING Group, TIAA Family Group and Transamerica.
The Special Investigations Unit pursues allegations of misconduct by those persons licensed by the Division, including “…insurance producers, advisors, public adjusters, reinsurance intermediaries, viatical brokers and providers, insurance companies, health maintenance organizations, and self-insurance groups.” This past year, the Division’s Special Investigations Unit assessed over $132,000 dollars in fines and penalties for conduct that was either unethical or in violation of Massachusetts law.
Lastly, the Division’s Consumer Services Unit dealt with over 1,000 consumer complaints in 2013 resulting in the recovery of nearly $1,000,000 from insurance companies. The Division says that the majority of its recovery efforts dealt with issues involving delays in the claim process, inappropriate claim denials and improper claim handling by insurance agents. The Division says this unit also dealt with one individual and seven businesses as a result of the Boston Marathon bombing, and ended up helping three of the business settle claims with their insurers. The Unit’s efforts resulted in two of the businesses recovering over $10,000.
Cambridge restaurant owner lauded the Division of Insurance for its help with his insurance claims
One attendee of the press conference, John Schall, came specifically to praise the work of the Division of Insurance in helping him with his insurance claims. Mr. Schall, who is the owner of Fire & Ice in Harvard Square, Cambridge, contacted the DOI to help him with a claim resulting from the Boston Marathon bombing last year. Mr. Schall said that as a result of the events surrounding the tragic event a year ago, his restaurant suffered significant interruption and loss of business.
“Without the efforts of the hard working employees of the Massachusetts Division of Insurance, my legitimate business interruption insurance claims for the Monday and Friday of the Marathon bombing week would have never been paid,” said Schall. “Many Massachusetts heroes were on display that entire week, and by advocating for my and many other Massachusetts businesses, thus helping to minimize our lost income, the Commonwealth’s employees at the Division of Insurance deserve to stand among them.”