For Immediate Release: February 3, 2014
Commissioner Goodwin Announces $27.2 Million in Recoveries and Savings for North Carolinians
RALEIGH -- Insurance Commissioner Wayne Goodwin today announced that the North Carolina Department of Insurance saved or recovered more than $27.2 million for North Carolinians in 2013.
"The Department of Insurance is committed to fighting fraud, assisting North Carolinians with insurance questions or complaints, and holding members of the insurance industry to the highest professional standards," said Goodwin. "I am very proud of our track record of recovering and saving money for our citizens."
Several divisions of the Department of Insurance contributed to the total recoveries and savings:
- The Consumer Services Division, which receives consumer inquiries and complaints about homeowners, auto, life and other insurance-related issues, handled approximately 59,900 calls and 6,800 written complaints from the public. Through these calls and complaints, the division was able to help consumers recover more than $8.77 million in benefits from insurance companies.
- Health Insurance Smart NC returned $3,493,417 to consumers as a result of services provided. Health Insurance Smart NC, the department's newest consumer assistance program, assists people with questions about health insurance and helps consumers file complaints or appeals with their health insurance companies, identify enrollment opportunities and request external reviews for denied claims. In 2013, Smart NC specialists took more than 15,000 calls, responded to 1,599 consumer complaints and handled 247 external review requests.
- SHIIP, the Seniors' Health Insurance Information Program, assisted 99,813 consumers with general Medicare questions and helped more than 3,249 Medicare recipients apply for the Low-Income Subsidy program that provides savings for Medicare prescription drug costs. The estimated cost savings for Medicare beneficiaries was approximately $10.8 million. SHIIP offers free, unbiased information about Medicare, Medicare prescription drug coverage, Medicare Advantage, long-term care insurance and other health insurance issues. SHIIP's trained volunteers provide one-on-one counseling in all 100 counties of North Carolina.
- The Criminal Investigations Division employs 20 sworn law enforcement officers dedicated to investigating claims of insurance fraud and criminal concerns associated with bail bonding, motor clubs, collection agencies and premium finance companies. In 2013, the work of these criminal investigators led to 231 arrests, 85 criminal convictions and more than $3.9 million in restitution and recoveries. Another 152 cases are currently pending in court.
- The Agent Services Division regulates all licensed agents, brokers, limited representatives, appraisers, adjusters, premium finance companies, collection agencies, motor clubs, bail bondsmen, surety bondsmen and bail bond runners authorized to do business in North Carolina. Oversight includes licensure qualification, pre-licensing education, continuing education, telephone inquiries, complaint investigations and agency examinations. In 2013, the Agent Services Division investigated more than 1,466 complaints and recovered $7,229 in premium funds for consumers.
- The Market Regulation Division conducts both routine and targeted market conduct examinations on foreign and domestic licensed companies (insurance companies, premium finance companies, HMOs, PPOs and more) to ensure compliance with state laws and regulations. Through these exams, the Division ordered $293,654 returned to policyholders.
More information, downloadable publications and an online suggestion box are available at www.ncdoi.com.