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How an Agent Should Respond to a Department of Insurance Complaint

It happens to every agent and broker at some point in their career. Eventually, a customer will file a department of insurance complaint against you or your agency. While not desirable, complaints don’t need to be stressful.

Learn ways to handle department of insurance complaints while still running your agency and providing excellent service to your policyholders.

Managing Insurance Department Complaints

When you first receive a department of insurance complaint or request for assistance letter, you’ll likely feel a rush of emotions. It is normal to question yourself and doubt your abilities. Many agents worry about the investigation or outcome of the complaint.

But remember to breathe and take your time reading the complaint letter before reacting. Letters from the insurance department, requests for assistance, and even complaints are common. Consumers are able to easily file a complaint in every state, which means every agent will face one at some point in their career.

Follow these steps to respond to a request for assistance or a complaint:

Read the complaint thoroughly.

Take the time to read the complaint letter and understand the allegations. Some complaints are simple, but others will invariably be more complex. Note the issues alleged and important dates. Understand what the letter is asking you to do next — and pay close attention to dates.

Review your file.

Read your notes and look back through your documentation. Pay attention to letters and notices you sent and any calls that took place. Look in your file for supporting information about the allegations in the complaint.

Thoroughly investigate the complaint.

Be sure to comply with deadlines in the complaint but perform a thorough investigation. Review your notes, talk with others in your agency who worked with the customer, and investigate every complaint thoroughly — even if you think it is without merit.

Draft your response to the insurance department.

You will need to respond to the complaint in writing, although you may be able to respond digitally. Make sure you address every point in the complaint. Follow your agency’s template for complaint responses. Use clear, concise language and reread your draft for errors. Stick to the facts in your response. Ask someone else in your agency to read your response before you send it.

Work with another agent or manager to review complaints.

A best practice is to work together with someone else to review, investigate, and respond to complaints. A team approach can help ensure you don’t miss anything critical.

Respond on time.

Request an extension or respond to the complaint by the due date. Fines and other penalties can accrue if you miss deadlines. If you cannot respond in time or need more time for your investigation, you may be able to request an extension.

Ways to Reduce Policyholder Complaints

Not every complaint is avoidable. But you can proactively manage your policyholders and work with them to resolve issues before they file a complaint. Try these best practices:

  • Communicate openly and transparently. Tell your policyholders what to expect. Return their calls and answer questions timely.
  • Don’t avoid sharing bad news. If you need to share rate increases, claim challenges, or other bad news, don’t avoid it. Talk openly with your policyholder to tackle problems together.
  • Document your files. Document every conversation and action taken on your files. Remember, if it is not documented, you cannot prove it happened.
  • Keep your E&O insurance current. Don’t let your E&O coverage lapse. Having sufficient coverage for your exposures is critical as an agent.
  • Train your agency staff. Make complaint resolution a part of your regular agency training sessions so everyone knows how to help avoid complaints and manage them when they happen.

Purchase E&O Insurance Coverage Through the American Agents Alliance

Follow our tips and best practices to help your agency avoid department of insurance complaints — and protect against thse risks with E&O coverage. Get your free quote today from the American Agents Alliance and make sure your limits are sufficient to match your risk.

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