Insurance
Long Term Care Insurance

How do you file a complaint about a company that sells long term care insurance?

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Wiki User
2017-01-01 23:12:54

If you're in the U.S., go to the state agency that regulates

insurance companies. Each state has very specific laws and

regulations.

All state insurance regulatory agencies have Consumer Services

departments (although they may use different nomenclature). Their

function is to be the gatekeeper for consumers and intercede on

their behalf through investigation of complaints. Generally, you

will need to complete a request for assistance (which in some

states may be electronic), and specify the nature of your

complaint. Be as specific as possible, including policy number,

claim number, and of course the identity of the insurer; the

complaint form may request that you submit a copy of your policy

(never send your only copy).

Upon receipt of your material, the Consumer Services authority

will request the insurer for its side of the story, and will

attempt to facilitate a middle ground. Keep in mind that one side

or the other is not always correct. Therefore, to better the

chances that you will get the resolution that you seek, be sure to

keep full documentation so that it is available for use in a

dispute. Also remember to stay flexible, because it is usually the

sign of a fair settlement when one side feels that they did not get

quite enough and the other feels that they gave a little too

much.

For those of you who want to do research on a company before you

purchase a plan, many states will report the number of consumer

complaints per company for their state. Many state insurance

websites will report the numbers. Search using your state name plus

"department of insurance."

As an agent, here is how I tell clients to interpret the

complaint numbers. If a consumer reports a complaint to the state's

insurance department it's probably a big complaint. Over a cup of

coffee consumers may complain to each other about their insurance

company, but when they report it to the state it's big. If you see

a company with a large number of complaints, versus other

companies, or greater than their share versus sales, I think there

is good reason to possibly avoid the company. (Ratings, complaints,

years in the business, history of rate increases, etc. are criteria

used to compare companies).


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