The West Virginia Offices of the Insurance Commissioner regulate the state’s insurance industry. One way the OIC does this is by investigating consumer complaints against insurance companies, agents, and adjusters. If you think that your insurance claim or policy has been delayed, wrongly denied, deliberately underpaid, or improperly managed, you can file a complaint with OIC and request an investigation.

To file a complaint, visit the OIC website and select “Consumers.” This will take you a webpage listing various Consumer Services and helpful links provided by the OID. Under the “File a Complaint” or “Popular Forms and Links” headings, you can select “Online Consumer Complaint Form” to submit a complaint online or “Consumer Complaint – Paper Form” to print and mail to the OID. If you select the online option, you will be directed to an online portal where you can provide your name, address, policy information, and details about your complaint. After you complete the online form, you will be prompted to attach supporting documents to your submission, like a copy of your policy and correspondence with your company.

You can also submit a complaint via mail by downloading and printing the paper form. The paper complaint form requests the same information as the online version. Once you complete the form, you must sign, date, and mail it, with copies of any supporting documentation, to the Consumer Services Division of the OIC at P.O. Box 50540, Charleston, West Virginia 25305-0540. If you need any help filling out the form, you can call the OID for assistance at (888) 879-9842.

When the OIC receives your complaint, a Consumer Services employee will review it and any supporting documentation, and then reach out to your insurance company requesting an explanation. The employee will review the company’s response, along with all the information you provided, to determine if there has been a violation of state law, regulations, or your policy. Once a determination is reached, the OIC will contact you with a summary of its findings and make a recommendation for resolution of the issue. The OIC notes that some resolutions “result in the refunding of premiums, the restoration of a cancelled contract, claims payments being made, or a contract being rescinded.” If it appears that the insurance company may be violating state law, Consumer Services will refer the case to the Legal Section for further investigation and possible sanctions.

Navigating your insurance claim or policy can be frustrating and confusing. West Virginia’s OIC is there to answer your questions, advocate for your rights, and ensure that insurance companies are following the rules. If you have questions about the complaint process or want to know if the OIC can help you, call at (888) 879-9842 or e-mail OICConsumerServices@wv.gov. If you have other questions or concerns about your insurance claim, do not hesitate to contact Merlin Law Group for a free case evaluation.