For Consumers

Company complaint outcome descriptions

Outcomes of complaints submitted to our agency are displayed in the Office of the Insurance Commissioner's agent, agency and company lookup tool. The outcome(disposition) of a complaint describes the resolution of the complaint by our office. A single complaint may have up to three outcomes and are defined as:

Company complaint outcome (disposition) descriptions

Company position overturned: Complaint resolved by a regulated entity or individual to ensure compliance with applicable state laws/requirements, via additional payment, restored benefit or policy status and/or other means. In this outcome, the Office of the Insurance Commissioner found the regulated entity or individual to be in violation or otherwise at fault.

Complaint withdrawn: A consumer requested that the complaint be withdrawn.

Compromise settlement/resolution: Complaint resolved voluntarily by a regulated entity or individual via additional payment, restored benefit or policy status and/or other means.

Claim reopened: Regulated entity or individual has reopened claim for further investigation or settlement negotiation. A final resolution of the claim has not been determined.

Claim settled: Claim concluded, in whole or in part, and no other disposition is appropriate.

No action requested/required: The Office of the Insurance Commissioner received only a copy of a complaint that a consumer sent directly to the company or there was no direct request for assistance.

Referred to another state's department of insurance: Complaint falls under the regulatory jurisdiction of another state's insurance department.

Referred to outside agency/department: Complaint referred to other state agency/department.

Fine assessed: The Office of the Insurance Commissioner assessed monetary penalty against the regulated entity or individual.

Referred to other division for possible disciplinary action: Complaint referred elsewhere within the Office of the Insurance Commissioner (Legal, Agent Services, Investigations, etc.) based on apparent or suspected violations of state law, etc.

Question of fact/contract provision/legal issue: Complaint involves a question of fact or a question of law involving a contract provision or interpretation thereof, and therefore falls outside the regulatory authority of the Office of the Insurance Commissioner.

Company position substantiated: The regulated entity or individual upheld its original position and appears to be in compliance with applicable statutes/regulations.

No jurisdiction: Complaint does not fall under the regulatory authority of the state's insurance department and was not referred to any outside agency, department or court system. Includes action suspended for litigation and/or formal arbitration.

Insufficient information: A consumer failed to provide sufficient information/documentation to warrant further investigation.

State specific: The Office of the Insurance Commissioner will use a state-specific code to track data needed for a purpose not shared by other states or the National Association of Insurance Commissioners (NAIC).