Governor Polis’s Division of Insurance Actions Recover Over $1 Million for Colorado Consumers

Wednesday, August 26, 2020

DENVER - Over $1 million has been recently recovered for Colorado consumers due to a series of regulatory actions by the Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA). Three companies will be returning $1,081,987 to Coloradans as a result of DOI actions: Kaiser Permanente of Colorado, Loya Insurance Company and Young America Insurance Company. 

“This recovered money means people are finally being paid or reimbursed, helping them financially during these challenging times. Especially in these challenging times, protecting consumers and holding insurers accountable is critical. The money they are returning will make a positive difference for Coloradans,” said Governor Jared Polis.

“Making sure that insurance companies are abiding by the rules is absolutely crucial to our job of protecting consumers,” said Insurance Commissioner Michael Conway. “If the companies are not processing claims correctly, not giving people notices in a timely manner or are simply not following state and federal regulations appropriately, we will step in to make sure that consumers are treated fairly.”

The Division’s Market Regulation Team recently concluded an action involving Kaiser Permanente of Colorado and found that the insurer was not providing sufficient notice prior to  cancelling members for non-payment of premium. As a result of the Division’s actions, Kaiser has corrected their notification systems and reprocessed the health claims for people impacted by this situation. This resulted in 675 claims being reprocessed for 383 consumers, leading to $725,408 being paid back to Colorado members and health care providers (plus any applicable penalties and interest). 

The Market Regulation Team also completed market conduct exams of Loya Insurance Company and Young America Insurance Company (a subsidiary of Loya). Market conduct exams are akin to an audit in the world of insurance regulation. These companies offer private passenger automobile insurance, automobile liability coverage and physical damage insurance . The team found that these companies had a number of issues primarily with claim handling. As a result, they are required to pay restitution to consumers, which includes their policyholders, people who were involved in an accident with their policyholders, and repair shops. Loya Insurance will pay $177,796 in restitution, and Young America will pay $178,783.

These recent actions bring the total amount of money that the DOI has recovered for Colorado consumers in 2020 to over $5 million ($5,012,694). This year-to-date total includes $1,610,688 from the Market Regulation Team, $1,441,912 from the Division’s Consumer Services Team and their investigations of consumer complaints, and $1,960,094 matched to Colorado beneficiaries from the Life Insurance Policy Locator (a tool to match beneficiaries with lost or misplaced life insurance and annuity policies of deceased loved ones). 

“This is what we do - this work is part of the Division’s role as an insurance regulator and a resource for consumers,” said Insurance Commissioner Michael Conway. “Our efforts not only result in money going back to Coloradans, but can help in other ways - help reinstate coverage, answer questions and better inform people about their insurance. I encourage anyone who has any kind of issue with their insurance to contact the DOI.”

Find more information about the money the DOI recovers for Colorado consumers at our webpage “Money Recovered for Coloradans by the Division of Insurance.”

Consumers with insurance questions, concerns and complaints can contact the Consumer Services section of the Division of Insurance, a dedicated resource to work with consumers to answer their questions and investigate their complaints - 303-894-7490 / 800-930-3745 / DORA_Insurance@state.co.us - or visit the Question / Complaint page of the DOI’s website.

 

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