Florida’s Insurance Consumer Helpline Recovers $16.6M During First Half of 2017

Jul 19 • 173 Views • View Comments

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Chief Financial Officer Jimmy Patronis today announced that assistance provided by insurance experts working Florida’s Insurance Consumer Helpline led to the recovery of more than $16.6 million during the first half of 2017. Helpline experts answered more than 141,000 calls from Floridians and aided in the recovery of funds that included insurance claim payments and premium refunds that consumers sought the Department of Financial Services’ help collecting.

The Insurance Consumer Helpline is a free service offered to all Floridians that assists callers with financial and insurance-related matters including disaster preparation and insurance fraud, as well as questions and complaints regarding auto, home, health, life, and small business insurance.

“The claims-filing process can be a stressful affair, especially during times of serious illness or after a disastrous event,” said CFO Jimmy Patronis. “I applaud the efforts of our experts who work tirelessly to provide Floridians with the tools and resources they need to easily navigate through their insurance-related issues.”

Recent examples of how consumers were helped by helpline experts include:

  • A Leon County consumer contacted the Helpline after insurance claims related to her son’s month-long stay in intensive care were denied. The company denied the claims on the basis of a pre-existing condition, yet the consumer felt the policy did cover her son’s pre-existing illness. Helpline experts contacted the company on her behalf and learned that the insurance agent who sold the policy may have misrepresented what the policy would cover. Helpline staff questioned the pre-existing condition determination, the claims were reprocessed, and a maximum benefit payout of $100,000 was made to the consumer.
  • After filing a homeowner’s claim and receiving payment following Hurricane Matthew, a Pinellas County consumer contacted the Helpline when her insurance company denied coverage for additional damage that had been discovered. Even after sending in additional documentation, she was unable to resolve the issue. Upon calling the company, Helpline experts were told that a simple processing error was to blame, not a denial. The company promptly processed the claim, paying out an additional $4,700 to the consumer.
  • A Brevard County consumer contacted the Helpline when medical claims payments related to treatment for her son never arrived. The company explained to Helpline experts that the payments had been processed but the company could not explain why they had not been received. A widespread system error was discovered and the company realized that payment checks for 53 consumers had never been mailed. In total, more than $24,000 in unmailed payments went out to the 53 consumers, including the original caller.

Floridians can contact the Insurance Consumer Helpline toll-free by calling 1-877-693-5236.

 

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