The Division of Insurance in South Dakota’s Department of Labor and Regulation (“SDDOI”) seeks to “protect the public and make insurance available and affordable.”1 One of its main functions is to answer consumer questions and investigate consumer complaints. If you think that your claim has been delayed, unfairly denied, or otherwise poorly handled, you can file a complaint with SDDOI requesting an investigation.
Before you file a complaint, SDDOI encourages consumers to contact the entity involved first, as that may be your best chance of getting the issue resolved in a satisfactory manner. SDDOI cannot act as your legal representative, make determinations of fact regarding your claim, or order an insurance company to pay you. It can answer questions you have about your policy or the claims process. If you submit a complaint, it can investigate to ensure that your company, adjuster, or agent is complying with all the applicable laws, regulations, and policy provisions.
The South Dakota Department of Labor and Regulation website is a bit confusing. To make a formal complaint, click “Insurance” and then “File a Complaint” under the “Resources for Consumers” section on the Division of Insurance’s home page. This will direct you to a web page outlining the complaint process. To actually access the complaint form, you must click the “File a Complaint” button on the SDDOI home page again. This will take you to the SDDOI Consumer Portal Login. To submit a complaint online, you must create a Consumer Portal account by providing a valid home and e-mail address, your name and contact information, and creating a password. You can also print out a complaint form and mail it to the SDDOI at 124 Euclid Ave., 2nd Floor, Pierre, SD 57501.
The complaint form itself is fairly simple. It requests your contact information, the name of the insurance company, agency, or agent involved, and the applicable policy or claim number. It then asks for the reason for your complaint (e.g., claim denial, misrepresentation, or an unsatisfactory settlement) with a brief explanation. You should also describe the desired solution so the SDDOI can determine how best to help you.
After receiving your complaint, the SDDOI will assign your case a problem report identification number and send you a letter of acknowledgement. If the Department needs more information to begin its investigation, the acknowledgement letter will request additional documentation. The SDDOI will then reach out to your insurance company requesting a written explanation within 20 days. Once the SDDOI receives the insurance company’s response, the Department will review all the available information to determine if there has been a violation of South Dakota law. If so, the department has the power to impose sanctions or disciplinary action against the offending company or agent. If not, the Department can still answer your questions and discuss other possible solutions. Either way, the Department will send you a letter informing you of its findings.
If you want to know more about the complaint process or find out if the South Dakota Division of Insurance can help you, you can call (605) 773-3563 or e-mail insurance@state.sd.us with your questions. If you have other questions or concerns about your insurance claim, please do not hesitate to contact Merlin Law Group for a free case evaluation.
(Note: This guest blog is by Liberty Ritchie, a Licensed Legal Intern in our Oklahoma City office)
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1 South Dakota Dept. of Labor and Regulation, Division of Insurance; Our Mission, (n.d.), https://dlr.sd.gov/insurance/default.aspx, (retrieved Nov. 4, 2021).