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Filing a Complaint about your Insurance problem (cont.)

BEFORE YOU FILE AN INSURANCE COMPLAINT READ THIS ESSENTIAL INFORMATION FOR CONSUMERS WITH DISPUTES WITH THEIR INSURANCE COMPANY


1. Complaints filed with the Maryland Insurance Administration (MIA) are reviewed to decide whether a Maryland insurance law has been violated. Click to find Maryland Insurance Laws relating to:

2. Before you file a complaint with the Maryland Insurance Administration, gather up documents to support your claim or position and submit them with the complaint form. Examples of documents are contractor estimates detailing the work that needs to be done or an estimate from a plumber or other document stating what work was done and what the problem was.

3. Generally, the investigator assigned to your complaint decides your complaint without contacting you. You may want to call your investigator to request copies of any documents that your insurance company provides to the investigator to justify their position in the matter. Otherwise, the correspondence from the insurance company will not be provided to you.

4. The MIA will not tell the insurance company to pay a claim unless a violation of the law is found. For example, in the case of a claim complaint, the MIA investigator will generally decide whether the insurer violated the law prohibiting denial of a claim for an “arbitrary or capricious” reason. If the insurer provides an engineer’s report supporting a claim denial and the homeowner has a plumber’s report supporting a claim payment, the claim denial most likely will not be found to be arbitrary or capricious. That is because the engineer’s report gives the insurer a valid reason to deny the claim. The fact that the homeowner’s report disagrees with the report of the engineer does not make the claim denial arbitrary or capricious. In such a case, the complaining consumer will usually receive a letter from MIA advising them that the insurance company did not violate the law.

5. Since 2006 when the Division began reviewing complaint letters issued by the Maryland Insurance Administration, there have been a few claim-related complaints where the investigator concluded that the insurance company violated the insurance laws. Most of them involved a delay in paying the claim and the insurance company was ordered to pay 6% interest to the homeowner, in addition to the claim payment, for the period of the delay. In a few cases, a claim denial was found to be a violation and the insurer was ordered to pay the claim plus 6% interest on the claim settlement amount.

6. Hundreds of complaints filed by consumers are reviewed by the MIA each year but violations of the law are rarely found. The People’s Insurance Counsel Division’s Annual Report for Fiscal Year 2009 shows in Appendix A that MIA found 17 violations in the 359 homeowner’s insurance complaints reviewed between July 1, 2008 and June 30, 2009.

7. Another option for resolution of your dispute with your insurance company is to file an action against the insurance company in the Maryland District Court. This is not difficult and a case may be commenced with the completion of a form and payment of a fee of $28.00. The Court will look at the facts of the claim and the insurance policy language to decide whether the claim should have been paid. Click here for more information.

To proceed with filing a Complaint with the Maryland Insurance Administration, click HERE.



Maryland Attorney General’s Office
People’s Insurance Counsel Division
200 St. Paul Street
Baltimore, Maryland, 21202
410-576-6432
1 (888) 743-0023
email: PIC@oag.state.md.us

 

Attorney General of Maryland 1 (888) 743-0023 toll-free / TDD: (410) 576-6372
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