DENVER - Last year, the Colorado Division of Insurance (DOI) recovered $21.5 million for Coloradans as a result of complaints filed by consumers, an increase of almost $2 million over the previous year. These recoveries, and details about the complaints, can be found in the DOI’s Annual Complaint and Recoveries Report for FY 2022-23.
The DOI, part of the Department of Regulatory Agencies (DORA), regulates insurance in the state. But beyond ensuring that the companies and agents are following the law, the DOI also serves as a resource for Colorado’s insurance consumers, with our Consumer Services Team answering questions, investigating complaints and helping people navigate the world of insurance.
The $21,523,066 put into consumers’ pockets in the last fiscal year of 2022-23 (July 2022 - June 2023) was a result of individual complaints like the following.
- Policyholder Receives Additional $513,000 in Coverage - A Marshall Fire survivor submitted a complaint about how their homeowners insurance policy was put together. After the DOI investigated, the company agreed to change the policy, which resulted in an additional $513,154 in coverage for the homeowner.
- Denied Claim Reversed - A policyholder who lost their home in the East Troublesome Fire had their claim for a total loss of their home denied by the insurance company. The DOI’s investigation determined the denial was because of agent error. The company reversed the denial of the claim, resulting in a payment of $500,703 to the insured.
- $2,000,000 Delayed Life Insurance Payout Secured - The DOI’s involvement led to an immediate payout from the insurance company of $2,000,000, plus $25,000 in interest for the delay.
“When things don’t work the way they should, we want to hear from people,” said Colorado Insurance Commissioner Michael Conway. "Insurance can be complicated, but we can help to navigate the problems. I encourage anyone who has any issue regarding their insurance to contact our Consumer Services Team.”
Beyond the individual investigation of nearly 6,000 complaints received in the last fiscal year, the complaints are reviewed to determine larger, possibly systemic issues. When the Consumer Services Team identifies patterns, they work with the rest of the DOI to require changes in insurance companies’ processes or work to tackle the root cause of the problem, such as these examples.
- In the wake of the Marshall Fire, consumers’ complaints about how a particular company was applying the additional living expenses (ALE) benefits led the DOI to require the company to change its processes and comply with the law on how to properly administer ALE for policyholders.
- As LGBTQ Coloradans seek gender-affirming care, the Consumer Services Team often sees issues around health insurance companies’ health care provider networks. DOI intervention is helping insurance companies address these network shortcomings.
- The DOI also receives a number of complaints around mental health benefits, specifically around insurance companies’ provider networks, as well as denial of benefits. The Consumer Services Team has worked with the DOI’s Behavioral Health section to identify systemic issues with the companies around mental health parity laws to help identify what actions need to be taken to protect Coloradans.
As this annual report demonstrates, when people have questions, concerns or complaints about their insurance, it is important and valuable to contact the Colorado Division of Insurance Consumer Services Team - 303-894-7490 / DORA_Insurance@state.co.us / doi.colorado.gov (click on “File a Complaint”).