Date: June 18, 2002
For more information contact: Kyle Richmond (608) 267-9336 or kyle.richmond@oci.state.wi.us

Madison, WI--The Office of the Commissioner of Insurance (OCI) has just published yearly data concerning:

• complaints against insurance companies
• disciplinary actions taken against insurance companies and agents
• grievances filed with companies

"We compile grievance and complaint statistics to keep an eye on how insurers are responding to consumers, and to get an early view of emerging trends," said Commissioner of Insurance Connie L. O'Connell. "Over time, these reports are one tool consumers can use to make informed decisions when they choose their insurance."

"2001 Insurance Complaints & Administrative Actions" is a report that lists insurance companies with above average complaint statistics for the year, and summarizes disciplinary actions taken by the OCI against insurers and insurance agents. It's available to the public on paper and on the Internet.

The report covers five major areas of insurance:

• Homeowner's and Tenant's Insurance
• Auto Insurance
• Life Insurance and Annuities
• Individual Accident and Health Insurance
• Group Accident and Health Insurance

Also released were 2001 grievance statistics for the 23 managed health care plans in Wisconsin. While managed care plans have long been required to file grievance statistics with the OCI, 2001 is the first year all health plans must have grievance processes in place. State health insurance consumers are encouraged to appeal adverse decisions by their insurers directly to the insurer through the grievance process before filing complaints with the OCI.

The managed care grievance statistics are posted on the OCI Web site as part of its brochure, "Consumer's Guide to Managed Care Health Plans in Wisconsin." That brochure includes both raw numbers of grievances filed with insurers in the past three years and the number of grievances per 10,000 enrollees, which gives policyholders a way to compare between companies of different sizes.

Some Wisconsin plans had large percentage increases or decreases in grievances, often due to changes in business. Mergers, acquisitions, termination of blocks of business, and dissolutions all affected the 2001 statistics for various plans.

On a related topic, Wisconsin consumers have an added level of appeal for health insurance claim denials as the state's new Independent Review process took effect on Saturday, June 15. Health insurance policyholders can now request review of claims denials from a third party. The OCI Web site has an Independent Review fact sheet available at http://oci.wi.gov/pub_list/pi-203.htm.

For more information about the annual complaints report, read it on-line on the OCI Web site under Publications at http://oci.wi.us, or order it by writing to OCI, P.O. Box 7873, Madison, WI 53707-7873. Contact the OCI toll-free at 1-800-236-8517 or by electronic mail at ociinformation@wisconsin.gov.