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July 31, 2001   (217) 782-0673
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2000 Insurance Complaint Ratios Released

Springfield, IL - The Illinois Department of Insurance investigated 15,304 written consumer complaints in 2000, according to complaint statistics released today by Director Nat Shapo. This complaint total represents a three percent increase over the 1999 total of 14,867 cases.

The most significant increases involved health insurance, indicating a growing public awareness of the Department's Office of Consumer Health Insurance toll-free number (877-527-9431). HMO complaints increased by 16 percent and group health insurance complaints by 23 percent. Individual annuity complaints rose by 41 percent. Coverages recording fewer complaints in 2000 than in 1999 were: individual accident and health, down by 2 percent; auto, by 3 percent; homeowners, by 7 percent; individual life, by 12 percent; and group credit accident and health, by 28 percent. The most common reason for all complaints was claim handling.

Shapo attributed the surge in health insurance complaints in part to improved consumer awareness of Department services. "Our efforts to promote the resources of our Office of Consumer Health Insurance have paid off," he said. "OCHI is an important avenue of both information and redress for consumers. During its first year of operation, OCHI staff fielded 10,750 calls, mailed 2,489 complaint forms, and distributed thousands of educational materials to Illinois consumers. Some of this activity spilled over into our complaint investigation program," Shapo said.

The Insurance Director also noted that nearly one-third of all HMO complaints made to the Department of Insurance in 2000 were against American Health Care Providers, which was placed in liquidation in May 2000. "Prior to liquidation, we were averaging 30 complaints a week about American," Shapo said.

Other factors contributing to higher levels of complaints included problems with continuation of group insurance coverage and fluctuating interest rates in the annuity market.

The Department of Insurance calculates complaint ratios for all licensed HMOs regardless of the number of complaints and for auto, homeowners, life and accident and health insurance companies that receive ten or more complaints in a calendar year. Ratios measure the number of written grievances in relation to Illinois premium volume, policies or certificates in force, or membership. A rank of 1 is the lowest ratio of all companies listed for a line of coverage.


Composite of Insurance Complaints

Total Complaints Investigated in Year 2000

HMO Complaints 1,761
Insurance Company Complaints 10,781
12,542
Not Categorized   2,762
Totals: 15,304

Complaints by Line of Coverage

Auto 3,499 (23%)
Homeowners 792 ( 5%)
Individual Life 870 ( 6%)
Individual Accident & Health 1,128 ( 7%)
Group Accident & Health 3,486 (23%)
HMOs 1,761 (11%)
Group Credit Accident & Health 82 ( 1%)
Individual Annuity 180 ( 1%)
All Other Coverages 744 ( 5%)
Not Categorized 2,762 (18%)
Totals: 15,304 (100%)

Major Reasons for Complaints

Insurance Companies
HMOs
Claim Handling
7,746
(72%)
1,715
(97%)
Underwriting
1,523
(14%)
20
( 1%)
Policyholder Service
1,196
(11%)
23
( 1%)
Marketing and Sales
    316
   ( 3%)
      3
   ( 1%)
Totals:
10,781
(100%)
1,761
(100%)

Distribution of Complaints by Zip Code

Insurance Companies
HMOs
Metro Cook County (600-605)
4,089
(38%)
905
(51%)
Chicago (606)
2,176
(20%)
261
(15%)
Downstate (607-629)
3,549
(33%)
544
(31%)
Outside Illinois
     967
   ( 9%)
     51
   ( 3%)
Totals:
10,781
(100%)
1,761
(100%)

Comparison of Complaints by Coverage & Reason 1999 -- 2000

Coverage
Underwriting
Marketing & Sales
Claim Handling
Policyholder Service
Total
% Change
Auto (1999)
537
136
2,818
110
3,601
Auto (2000)
492
78
2,809
120
3,499
- 3%
Homeowners (1999)
308
29
481
33
851
Homeowners (2000)
275
18
473
26
792
- 7%
Individual Life (1999)
103
130
173
580
986
Individual Life (2000)
99
110
159
460
870
- 12%
Individual Annuity (1999)
0
23
20
79
122
Individual Annuity (2000)
3
44
16
109
172
+41%
Individual A&H (1999)
215
28
742
154
1,139
Individual A&H (2000)
268
28
660
156
1,112
- 2%
Group A&H (1999)
147
11
2,479
169
2,806
Group A&H (2000)
236
16
3,010
184
3,446
+23%
Group Credit A&H (1999)
6
5
61
39
111
Group Credit A&H (2000)
4
1
55
20
80
- 28%
HMOs (1999)
42
3
1,441
35
1,521
HMOs (2000)
20
3
1,715
23
1,761
+16%

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