| 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 $20.00. 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
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