(Note: This guest blog is by Liberty Ritchie, a Licensed Legal Intern in our Oklahoma City office)
Insurance companies took over $6 billion in premiums from Oklahomans last year.1 That money should be working for you, but too often it feels like you are being ignored or strung along by your company instead. The process of submitting an insurance claim is a daunting maze of bureaucracy, fine print, adjuster shuffling, and endless “on hold” phone calls. The claims system seems designed to be confusing, leaving policyholders frustrated and, all too often, underpaid.
The Oklahoma Insurance Department was created to help consumers navigate this system and hold insurance companies accountable for their business practices. The OID mission is to “protect Oklahoma consumers by monitoring the financial stability and market conduct of Oklahoma insurers.” One of the ways it does this is by investigating complaints from Oklahomans about insurance companies, agents, and adjusters. In 2020 alone, OID received 2,391 complaints from frustrated consumers who felt that their claims were being mishandled or deliberately underpaid.
To submit a complaint, visit the OID website. Under the “Consumer Assistance” tab, click “File a Complaint.” This will take you to a portal where you can fill out a confidential online form or print out a paper copy to send via mail to the OID offices at 400 NE 50th St., Oklahoma City, OK. The form can be used for complaints about auto, home, commercial, life and health, service warranty, title insurance, or workers’ compensation claims.
The OID complaint form outlines all the information the Department needs to process your complaint and begin an investigation. First, you fill out your name, address, and the best way to contact you once your complaint has been received. Next, you provide general information about your insurer, policy, and loss. Finally, you detail why you are submitting a complaint: Did you request information only to be ignored? Was your claim wrongfully denied or underpaid? Do you feel that your agent made a misrepresentation when you purchased the policy? The complaint form has a section for you to describe what happened in detail, why you think the OID should investigate, and what you want the insurance company to do. Copies of policies, letters, phone logs, or other documents related to your complaint should be sent to the OID Claims division via fax at (405) 521-6652 or mail. None of the information you provide will be publicly available, so feel free to disclose everything you think would be help the OID investigate your complaint. Most importantly, keep a complete copy of your complaint and all documentation submitted because once the complaint is submitted no one, including the policyholder submitting the complaint, can get a copy from the OID. The OID is not required to provide a copy of complaints through an Open Records Request and it is immune from subpoenas seeking copies of complaints.2
Once your complaint and all its supporting documentation is submitted, the OID will assign your file to a Claims Analyst. Your analyst will send a letter to your insurance company to let it know a complaint has been lodged and ask for its side of the story. Under Oklahoma law, the insurance company must respond to the Claims Analyst within 20 days of receiving the letter. The analyst will then evaluate all the provided information to determine if the insurance company has violated state or federal law or contravened industry standards. When the analyst decides if and how the OID can help you, he or she will send you a letter outlining how that decision was reached and possible next steps.
The OID is not a court – it cannot make findings of fact or order an insurance company to pay you. The purpose of the OID is to investigate, make recommendations, and, if your complaint stems from insurance law violations, move forward with appropriate sanctions against the violating company. If you have questions or concerns about your insurance claim, please do not hesitate to also contact Merlin Law Group.
1 Oklahoma Insurance Department, 2020 Annual Report, (2021), https://www.oid.ok.gov/wp-content/uploads/2021/01/2020-Annual-Report-Full-Version.pdf.
2 Section 306 of the Insurance Code states that files of the Consumer Assistance/Claims Division, including complaints and requests for assistance from insureds, and insurance agency and company records, shall not be public records and shall not be disclosed except in connection with disciplinary proceedings by the Commissioner.