(Note: This guest blog is by Liberty Ritchie, a Licensed Legal Intern in our Oklahoma City office)
In Washington State, the Office of the Insurance Commissioner (OIC) exists to “oversee Washington’s insurance industry…protect consumers, and make sure companies and producers follow the rules.” One of the ways that the OIC does this is by investigating complaints against agents, agencies, and other insurance licensees. According to their website, the office answers questions and investigates complaints of over 100,000 consumers every year.
If you live in Washington State and feel that your insurance company is not handling your claim correctly or honoring your policy as it should, you can submit a complaint to the OIC. The complaint form can be found on the OIC website under the “For Consumers” tab by selecting “Complaints & Appeals” and then clicking “File a Complaint.” There are three different forms for complaints about your insurance company, your agent or agency, or your healthcare provider. Make sure to select the right one so the OIC knows exactly how to proceed.
Generally, all the forms ask for your contact information and information about your insurance like your policy number, your agent or adjuster, and your date of loss. Then you have space to describe your issue and what you would like the insurance company to do about it. The completed form and any documentation that supports your complaint (like your policy) can be submitted online or mailed to P.O. Box 40255, Olympia, WA 98504-0257. Please note that, under Washington state law, most of the information you provide to OIC will be public record except for social security numbers, driver’s license numbers, financial account numbers, and nonpublic personal health information. The OIC asks that you keep this in mind when providing personal information in your complaint.
Once the OIC receives your complaint, it sends a request to the insurance company, asking it to explain the situation. The insurance company has 15 days to respond to this request and explain its side of the story. After the OIC receives this response, it will evaluate all the information from you and the company to determine if the OIC has the authority to help you or not. If not, it will still try to direct you to other state agencies or resources that might be able to. If so, it may require the insurance company to provide more documentation or investigate the practices that caused your problem. Throughout the whole process, your OIC agent will keep in touch to explain your insurance company’s position and communicate possible next steps and solutions. You can also check your complaint status on the OIC website. If you are not sure the OIC can help you, you can call 800-562-6900 or chat with an agent online.
The OIC’s main purpose is to enforce Washington State insurance law and advocate on behalf of policyholders. When the Office determines that an insurance company or employee has broken state law, it has the power to impose fines or suspend or revoke licenses. Otherwise, it can require insurance companies to respond to your complaint and explain their position regarding your claim, walk you through the claims process, or point you in the direction of other helpful resources. It cannot order companies to pay you, give you legal advice, or make determinations of fact – you need a lawyer or judge for that. The attorneys at Merlin Law Group are available to listen to your problem and see if they can help.