Wisconsin OCI Releases Consumer Complaint Info

According to the 2007 Insurance Complaints and Administrative Actions report issued by the Wisconsin Office of the Commissioner of Insurance (OCI), more than 8,000 consumers contacted OCI last year to file a complaint. OCI also assisted consumers in recovering more than $8 million from insurers.

A complaint is defined as any written communication that expresses dissatisfaction with an insurance company or agent. The report lists those insurance companies who have had at least five complaints and a complaint ratio that exceeds the statewide average for a specific type of insurance.

The report, which is available in English and Spanish, categorizes complaints by the type of coverage - auto, property and casualty, accident and health, life, and annuities, and also by the reason for the complaint - underwriting, marketing and sales, claim handling, policyholder service or "other."

Also available from OCI is the annual Independent Review Requests for 2007. Each year Independent Review Organizations (IROs) certified to do reviews in Wisconsin are required to submit to the OCI a report for the prior calendar year's experience. The independent review process allows a consumer to appeal some health insurance claims denials to an independent third party. According to the report, in a third of the cases reviewed in 2007, the IRO ruled in favor of the consumer - fully or partially reversing the insurer's denial of coverage. Full versions of both reports can be viewed on the OCI Web site.

Consumers interested in obtaining a copy of the 2007 Insurance Complaints and Administrative Actions report or other free publications from OCI can visit the OCI Web site at oci.wi.gov, write to OCI Publications, P.O. Box 7873, Madison, WI 53707-7873, or call 800-236-8517.