In its most recent annual report, the Massachusetts Division of Insurance published a summary of the types of complaints it has received from both its Consumer Hotline and in the form of written requests. In our aim to provide insight and transparency in the Massachusetts insurance industry, the following is a summary of those statistics:
How a consumer complaint is handled at the Division of Insurance
Consumer complaints made to the Massachusetts Division of Insurance are handled by the Consumer Services Unit or “CSU”. According to its mission outlined by the Division, the CSU is charged with responding “…to inquiries and assists consumers in resolving insurance complaints or disputes against insurers, producers and other licensees. The Unit works to ensure that consumers are being treated in a fair and consistent manner by licensees.”
Typically, the CSU helps consumers with the following types of issues:
- claims
- billing
- benefits
- underwriting
- misrepresentation of policies
- premium refunds
- cancellation concerns
One of the major goals of the CSU that was accomplished in 2018 was to investigate a majority of the complaints it receives within eight months of initial receipt. If a situation warrants further actions, the CSU will refer a consumer to another state agency or organization to help with their complaints such as the Massachusetts Health Connector, US Department of Labor, and the Office of Patient Protection. The Division outlined a number of goals that the CSU had and achieved for the calendar year 2018.
How many written complaints did the CSU field in 2018
The CSU administrated a total of 220 written information requests in 2018. The consumer information requests mainly concerned issues such as “insurance cancellations, a continuation of coverage, company contact information, denied claims, claim settlement delays, and premium rates.”
In addition to the 220 information requests, the CSU also received approximately 2,005 new complaints in 2018. Of that total number, the CSU says that it was able to investigate and close 2,201 of the 2,225 information requests and complaints received.
On average, it took about 240 days to investigate and close a consumer complaint, with the CSU emphasizing that the 240-day time period stems from the date of the CSU receiving the “full complaint file”.
In total, CSU investigations and resolutions obtained $3,201,524 for Massachusetts insurance consumers in response to the complaints they filed with the CSU..
The DOI’s Consumer Hotline
In addition to processing and investigating written information requests and formal complaints, the CSU staff also handles the Division of Insurance’s consumer hotline which fields consumer calls weekdays from 8:45 am to 5:00 pm. The consumer hotline responded to over 12,000 insurance calls for the calendar year 2018.
The most common insurance consumer complaints
Based on both the written requests and consumer hotline calls its receives, the CSU compiled the following list to outline what were the most common consumer complaints. The top five most popular consumer complaints are:
- Denials of Claim
- Claim Delay
- Unsatisfactory Settlement/Offer
- Adjuster’s Handling of Claim
- Delays/No Response
The Massachusetts insurance companies most complained about
Based on the same data used to compile the top five reasons for consumer complaints, the CSU also has been able to compile a list of the Massachusetts insurance companies that most consumers complain about.
They are as follows:
- Commerce Insurance Company
- Blue Cross and Blue Shield of Massachusetts, Inc.
- Liberty Mutual Insurance Company
- Safety Insurance Company
In listing these insurance companies as those with the most consumer complaints, however, it also should be noted that they also happen to be insurers with the largest market share within the respective insurance marketplaces in Massachusetts.
