Insurance Department Recovers $7.5 Million for Policyholders, Taxpayers in 2016; Highest Total in 4 Years

Connecticut’s Insurance Department recovered $7.5 million for policyholders and taxpayers in 2016, helping individuals, families and employers with their claims and complaints.  That is the highest amount in four years and an increase from the $6 million that the department saved taxpayers and policyholders the previous year. “Connecticut consumers turn to us every year to help them with claims and coverage issues or to just answer questions about their insurance,” said Insurance Commissioner Katharine L. Wade. “Our intervention in 2016 helped thousands of policyholders get much-needed answers, resolution and the benefits to which they are entitled.”

Consumer recoveries and industry fines totaled approximately $6.3 million in 2014, $7.3 million in 2013 and approximately $8.7 million for policyholders and state taxpayers in 2012, the high water mark in recent years.

Commissioner Wade said among the many cases the Department worked on during 2016 was a dispute that involved nearly $170,000 in hospital bills for a victim of a car accident. The patient had health care coverage under two plans – through his employer and as a dependent on his parent’s health insurance. When a dispute arose over which plan was the primary payer, the Department stepped in and determined it was the employer’s plan, which then covered the claims.  Another case involved a motorist whose car was totaled in an accident. When motorist’s insurer initially denied her claim, the Department required that the insurer review the case further. The insurer subsequently paid 100 percent of the motorist’s claims.

The Department’s Consumer Affairs Unit (CAU) fielded more than 5,800 complaints and inquiries and helped policyholders recoup nearly $6 million from January 1 to December 31, 2016, according to officials. Also in 2016, the Department’s Market Conduct division levied approximately $1.6 million in fines against carriers and returned that money to the state’s General Fund. The fines resulted from a variety of violations and settlements ranging from untimely claim payments to improper licensing, the department said.

The majority of the funds recovered for policyholders stemmed from complaints over health, accident, homeowners and life and annuities policies. The  breakdown of funds recovered in 2016:

  • Accident, Health - $3.63 million
  • Auto - $432,000
  • General Liability - $33,710
  • Homeowners and Commercial Property - $874,250
  • Life, Annuities - $820,000
  • Miscellaneous - $160,000

The department announced this month that licensing renewal notices for casualty adjusters and motor vehicle property damage appraisers will now be handled online, with an anticipated savings of nearly $40,000 in processing and mailing costs.The renewals also are now processed online through the National Insurance Producer Registry (NIPR). The licenses expire on June 30, 2017 and are good for two years. The casualty adjuster renewals are expect to generate approximately $6 million for the General Fund.

“The Department is now emailing renewal notices to the 73,000 casualty adjusters and motor vehicle property damage appraisers in Connecticut improving efficiency by saving time and shedding thousands of dollars in mailing and postage costs,” Wade said.

The Department calculates its consumer recoveries based on what the policyholder received as a result of the Department’s intervention. The inquiries and complaints also help the Department identify industry trends that may adversely affect consumers and trigger investigation by the Market Conduct division.  Complaint data also help determine topics for consumer education and serve as tools to help the Department monitor the industry.  The Market Conduct enforcement actions are posted on the Department’s Web site at