Maine policyholders who disagree with insurers who delay, refuse and recalcitrant might search help within the claims course of by submitting a criticism with the Maine Bureau of Insurance coverage.
An insurance coverage criticism with the Maine Bureau of Insurance coverage could also be filed by mail or electronically. Policyholders who file claims electronically can discover digital varieties on the division's web site. Digital varieties can be found for property and casualty insurance coverage, well being, life, annuity, long run care, incapacity and medical health insurance.
For those who select to ship an digital type, the Bureau cannot assure the confidentiality of your criticism throughout its digital transmission. Nonetheless, as soon as obtained by the Bureau, your file shall be confidential.
The Workplace wants the next data to course of a declare:
Particulars. You have to to supply particulars about what has occurred, concerning the individuals concerned and why you assume the corporate or agent is incorrect. Clarify you probably have tried to resolve the issue and the small print of your efforts to resolve it.
Aid. Inform the division what you need the insurance coverage firm to do.
Paperwork. Connect copies (not originals) of relevant paperwork, resembling letters, e-mails, and different communications, resembling insurance coverage firm notices, profit explanations, and enchantment choices, between you and the insurance coverage firm or its agent relating to your criticism; information explaining how declare funds had been calculated; a duplicate of your insurance coverage coverage or certificates of protection; Property loss varieties, car evaluations, police stories; and any extra data that you just really feel is related to the criticism.
Be aware: Within the case of on-line submitting, all arduous copies listed above will be faxed to (207) 624-8599 or mailed to the Workplace of Insurance coverage, 34 State Home Station, Augusta, ME 04333. Don’t forget not embody your title and the phrases "Shopper Consumption." "For assist, name (207) 624-8475 (in Maine, name toll-free 1-800-300-5000).
For some forms of complaints, it’s possible you’ll want to supply a signed launch type to permit the Bureau to research your criticism. If so, a member of the Bureau workers will contact you to offer you the mandatory type.
Policyholders who want to submit a criticism by mail should print and full one of many printable varieties obtainable on the web site talked about above. The signed criticism type authorizes the Bureau to research your criticism. For those who want extra space to supply declare data, use a separate sheet of paper. As soon as accomplished, detach the criticism type and ship it to the Workplace of Insurance coverage, 34 State Home Station, Augusta, ME 04333.
As soon as your criticism is obtained, it will likely be assigned to an investigator from the Workplace who will contact you by mail at first of the investigation. The Workplace writes to the insurance coverage firm to summarize your criticism and request a written response to the problems you raised.
Below the regulation, any particular person or firm licensed in Maine should reply to the workplace inside 14 days, plus an extra three (three) days for mailing. If the Workplace doesn’t obtain a solution in time, a follow-up letter is distributed by licensed mail. Nonetheless, the corporate might request an extension from the Bureau if the response requires additional investigation.
The Bureau notes that the period of an investigation will range; this may increasingly require follow-up letters and telephone calls. The investigator will inform you of the end result of the investigation, which often takes at the least thirty days.
Please word that the Bureau cannot oblige the corporate to fulfill you if no regulation has been damaged. act as a lawyer or provide you with authorized recommendation; to make medical judgments; or make choices of accountability.
The Maine web site incorporates the next sensible ideas for customers:
Learn your coverage. Be sure you perceive your protection and name your insurer or agent you probably have any questions.
Maintain a file with all of your insurance coverage information.
In case your well being plan requires referrals, remember to get a referral out of your major care supplier. Contact your insurance coverage firm earlier than receiving the referred providers to confirm that they’ve been permitted.
Take notes when speaking to the corporate. write down the date, time and title of the particular person you’re speaking to each time you name for a query or criticism about your coverage or declare.
If extra issues happen or if you happen to want authorized recommendation, please contact our legal professionals.