Insurance companies and their representatives (agents or producers) are regulated by the Maryland Insurance Administration (MIA). All insurance companies and their agents or producers are required to follow Maryland insurance laws. Consumers experiencing a problem with their insurance company can file a complaint with MIA and the matter will be investigated. At the conclusion of the investigation, the consumer will receive a letter from MIA. To file a complaint with MIA against your insurance company, click HERE.
BEFORE YOU FILE AN INSURANCE COMPLAINT READ THIS ESSENTIAL INFORMATION FOR CONSUMERS WITH DISPUTES WITH THEIR INSURANCE COMPANY
1. Complaints filed with the Maryland Insurance Administration (MIA) are reviewed to decide whether a Maryland insurance law has been violated. Click Here to find Maryland Insurance Laws.
2. Before you file a complaint with the Maryland Insurance Administration, gather up documents to support your claim or position and submit them with the complaint form. Examples of documents are contractor estimates detailing the work that needs to be done or an estimate from a plumber or other document stating what work was done and what the problem was. 3. After receiving a complaint, MIA assigns an investigator who may contact you and the insurance company and send the company a copy of your complaint. Consumers should expect the complaint process to take several weeks. Complex matters may take longer. MIA will determine whether the actions or inactions of the insurance company or its representative violated the Maryland insurance laws.
4. The investigator assigned to your complaint may decide your complaint without contacting you. You may want to call your investigator to request copies of any documents that your insurance company provides to the investigator to justify their position in the matter. Otherwise, the correspondence from the insurance company will not be provided to you. But see, the Maryland Public Information Act and requests to MIA can be made at: https://insurance.maryland.gov/Pages/how-to-submit-public-information-act-request.aspx. 5. The MIA will not tell the insurance company to pay a claim unless a violation of the law is found. For example, in the case of a claim complaint, the MIA investigator will generally decide whether the insurer violated the law prohibiting denial of a claim for an "arbitrary or capricious" reason. If the insurer provides an engineer's report supporting a claim denial and the homeowner has a plumber's report supporting a claim payment, the claim denial most likely will not be found to be arbitrary or capricious. That is because the engineer's report gives the insurer a valid reason to deny the claim. The fact that the homeowner's report disagrees with the report of the engineer does not make the claim denial arbitrary or capricious. In such a case, the complaining consumer will usually receive a letter from MIA advising them that the insurance company did not violate the law. 6. Since 2006 when the Division began reviewing complaint letters issued by the Maryland Insurance Administration, there have been a few claim-related complaints where the investigator concluded that the insurance company violated the insurance laws. Most of them involved a delay in paying the claim and the insurance company was ordered to pay interest to the homeowner, in addition to the claim payment, for the period of the delay. In a few cases, a claim denial was found to be a violation and the insurer was ordered to pay the claim plus interest on the claim settlement amount. 7. Another option for resolution of your dispute with your insurance company is to file an action against the insurance company in the Maryland District Court. This is not difficult, and a case may be commenced with the completion of a form and payment of a fee. The Court will look at the facts of the claim and the insurance policy language to decide whether the claim should have been paid. Click here for more information.
8. If you believe your insurance company did not act in good faith, a second type of complaint process is available to consumers. A complaint can be filed under section 27-1001 of the Insurance Laws. More information about this type of complaint is available from the Maryland Insurance Administration website: A Guide for Consumers Filing a 27-1001 Civil Complaint.
Advisory Notice
The brochures provided on PICD's website are updated annually, as needed. Therefore, the following websites contain information from the Maryland courts at https://www.courts.state.md.us and MIA at https://insurance.maryland.gov/Pages/default.aspx.
Maryland Attorney General's OfficePeople's Insurance Counsel Division200 St. Paul StreetBaltimore, Maryland, 21202410-576-64321 (888) 743-0023email: PIC@oag.state.md.us
1-888-373-7888
233733
