BALTIMORE – The Maryland Insurance Administration (MIA) recovered nearly $16.5 million in 2021 for Marylanders by helping resolve insurance-related issues and complaints.
“The core mission of the Maryland Insurance Administration is making sure that consumers are protected and that insurance business in our state is conducted fairly and in compliance with all Maryland insurance laws and regulations,” said Maryland Insurance Commissioner Kathleen A. Birrane. “The MIA is a free resource available to all Marylanders who need help resolving insurance disputes.”
The money was recovered through the Administration’s Rapid Response Program, the Property and Casualty Division’s Complaints Unit, the Life and Health Division’s Complaints Unit, the Appeals & Grievances Unit, the Insurance Fraud and Producer Enforcement Division, and the Market Regulation and Professional Licensing Division.
The Maryland Insurance Administration’s innovative Rapid Response Program helps many consumers resolve property and casualty claims, such as auto and homeowners claims, quickly and without having to file a formal written complaint. Participation in the Rapid Response Program is voluntary and does not affect the consumer’s right to file a formal complaint. The program closed 1,448 complaints in 2021 and recovered $3.45 million for consumers.
The Property and Casualty Complaints Unit is responsible for investigating formal property and casualty insurance complaints filed by consumers. The unit closed 4,605 complaints in 2021 and recovered about $4.4 million for consumers.
The Life and Health Complaints Unit is responsible for investigating life and health insurance complaints filed by consumers and providers. The unit closed 1,751 complaints in 2021 and recovered $3.1 million for consumers and providers.
Maryland law gives consumers the right to appeal a decision that denies coverage for medically necessary treatment. If a doctor has determined that certain medical treatment is needed, but an HMO or health insurer does not agree, this law allows a consumer to appeal. The Administration’s Appeals & Grievances Unit responded to 847 such complaints in 2021 and recovered $883,460 for consumers.
The Administration’s Market Regulation and Professional Licensing Division is responsible for regulatory oversight of domestic and foreign insurance companies and title producers. Oversight is performed through a variety of methods, including comprehensive and target market conduct examinations and investigations. The division’s Market Conduct Unit closed 178 investigations and eight examinations in 2021, assessed more than $1.01 million in penalties and recovered more than $4.5 million for consumers. The Title Unit closed 1,239 investigations, assessed penalties of $500, and recovered $3,416 for consumers.
The Insurance Fraud and Producer Enforcement Division investigates and prosecutes civil and criminal insurance fraud committed by insurance companies, producers (agents or brokers), consumers and the general public. The division closed 202 fraud investigations in 2021, levied $125,000 in fines and recovered $106,023 in restitution for Maryland consumers and businesses. The Division’s Producer Enforcement Unit is responsible for investigating misconduct by insurance producers (agents), public adjusters and bail bonds producers. During 2021, the Producer Enforcement Unit closed 305 investigations, resulting in $100,200 in administrative penalties.
Recovering money for consumers and business owners is one of many ways the Maryland Insurance Administration serves the state’s citizens. The Administration licenses and regulates insurers, insurance agents, and brokers who conduct business in the State, and monitors the financial solvency of licensed insurers. The Administration educates consumers about insurance issues, investigates consumer complaints and questions concerning insurance companies operating in Maryland and resolves insurance appeals and grievances about coverage decisions or claims denials.