The Wisconsin Office of the Commissioner of Insurance regulates the state’s insurance industry by investigating consumer complaints against insurance companies, agents, and adjusters. If you think that your insurance claim or policy has been delayed, wrongly denied, deliberately underpaid, or improperly managed, you can file a complaint with OCI and request an investigation.
To file a complaint, visit the OCI website and select the “Complaints” tab. This will take you a webpage detailing types of complaints you can file. You will then click “File an Insurance Complaint,” which will take you to a page with information about the complaint process and links to complaint forms. Before you file a complaint, OCI encourages you to first try to resolve your dispute directly with your insurance company. The OCI 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 about your policy or the claims process and, if you submit a complaint, investigate to ensure that your company, adjuster, or agent is complying with all state laws, regulations, and policy provisions. It can also recommend possible resolutions or direct you to other helpful resources.
If you decide that filing a complaint is the next step for you, you can do so online by selecting the “Online Complaint” option, which will take you to an portal where you can fill out your name, address, policy information, and details about your complaint. You will also be prompted to describe what you think fair resolution of the issue would look like. Once you complete the form, you will be asked to upload and attach copies of any supporting documentation like invoices, denial letters, or correspondence with your agent. Please note that any documentation you provide may become public record. You have 90 minutes to complete and submit your online from before your session times-out.
You can also download a printable form by selecting “Mail Complaint,” which requests the same information as the online one. You can send your completed, signed form, along with copies of any supporting documents to P.O. Box 7873, Madison, WI 53707-7873. If you are sending your complaint via FedEx, UPS, or overnight mail, OCI requests that you send it to the physical address at 125 South Webster Street Madison, WI 53703-3474. You can also e-mail your completed complaint form to ocicomplaints@wisconsin.gov or fax it to (608) 264-8115. You can also request that the OCI send you a paper complaint form to complete by e-mailing ocicomplaints@wisconsin.gov. The website mentions that the OCI follows a “no wrong door” policy, meaning that it will work to make sure your complaint goes to the correct place even if you submit it incorrectly. However, it notes that incomplete or improper submission will slow down the process and likely delay resolution.
The OCI will review your complaint and any supporting documentation and then reach out to your insurance company requesting an explanation. OCI will then review the company’s response, along with all the information you provided, to determine if there has been a violation of state law, regulations, or your policy. Once a determination is reached, the OCI will contact you with a summary of its findings and make a recommendation for resolution of the issue. It notes that, if the OCI is unable to help you with your issue, you may want to contact an attorney for further guidance.
Navigating your insurance claim or policy can be frustrating and confusing. Wisconsin’s OCI is there to answer your questions, advocate for your rights, and ensure that insurance companies are following the rules. If you have questions about the process or need help filling out the form, you can call OCI at (800) 236-8517 (within Wisconsin) or (888) 879-9842 (out of state). If you have other questions or concerns about your insurance claim, do not hesitate to contact Merlin Law Group for a free case evaluation.