Regulator Showcase: Complaint Hearings at the Maryland Insurance Administration
Joy Hatchette (Maryland Insurance Administration) explains the appeals process for consumer complaints as provided in state law.
“Everything but the locusts,” is how Joy Hatchette, associate commissioner of the Maryland Insurance Administration, described the many disasters Maryland has experienced in the past year. Hatchette took the stage to discuss Maryland’s state-mandated appeals process established by law for consumers.
The process
In Maryland, any aggrieved consumer can request a hearing, but that request must be in writing. (Any form of written communication can—and has been—used.) The demand for hearing must meet certain minimal thresholds, one being the time threshold of 30 days from grievance occurrence to request the hearing. After all concerned entities are notified, documents are gathered for the complaint file.
As with any hearing, the Maryland administrative hearing provides for a fair, impartial and independent opportunity for all parties to be heard on the issues in question. Cases are assigned either within the department OR within the Office of Administrative Hearings. In either case, the Hearing Officer determines facts and reviews the evidence and ultimately issues a decision on the issues presented.
Regarding representation, consumers may have an attorney if they choose to do so, but it is not a requirement. Corporations may have qualified individuals represent the company, but those individuals must have clear decision-making authority.
Hatchette provides details of Maryland’s hearing process.
Hearing Procedure
Proceedings, witnesses and concerned parties may appear in person, by telephone, or via video conference. However, just as with any hearing, swearing-in is required. The party with the burden of proof starts the proceedings, meaning the company has the burden of proof in cancellation and non-renewal cases. Then, procedure follows usual court protocol of direct questioning and cross examination. Unlike usual court proceedings, these hearings require a lesser standard of proof than beyond reasonable doubt.
The numbers
Many attending, while recognizing this appeal process may provide significant consumer safeguards, wondered about how time-intensive or laborious this process could become. Hatchette replied with specific numbers. The Maryland numbers track almost the same for 2009-2011 (to date) with little variance, so the 2010 numbers for request of hearings are shown here:
- Auto protests: 112 for 5,328 complaints (although Hatchette noted auto protests are the one protest where a fee is required to file a hearing request)
- Property and casualty, general: 123 requests out of 2,163 complaints received
- Life and health: 65 protests of 3,995 complaints received
- Appeals and grievances for medical necessity cases: 20 requests out of 816 decisions
Consumer benefits
Maryland is noted for having a general assembly that works hard to protect the consumer and, because of this appeal process, Maryland’s insurance regulators work to fully notify all stakeholders—especially the consumer—about all protection options available. That being said, Hatchette explained that consumer protections really only accomplish so much in terms of protecting the consumer. She opined that consumer and agent education is truly the key to ensuring all consumers know exactly what their policy is and what they can expect—which is the ultimate form of consumer protection.
CONTACT INFO
Joy Hatchette
Associate Commissioner, CEAU
Maryland Insurance Administration
200 Saint Paul Place, Suite 2700
Baltimore, MD 21202
410.468.2029
jhatchette@mdinsurance.state.md.us
www.mdinsurance.state.md.us
PRESENTATION
Click here to view Hatchette’s presentation
