Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. E. Agency Performance Measures

06/01/2000

Staffing

The Consumer Assistance Unit (which does not include the Consumer Advocate position) has nine staff, including the Manager. This represents a 50% increase, up from 6 staff, in 1987. Of the staff, three are employed full-time on life & health complaints, 5 work on property and casualty complaints, while the Manager works across all insurance lines.

Financial Savings to Consumers

The Annual Report noted that in 1998 the Division was responsible for the recovery of $6.9 million in claims for consumers across all insurance lines. However this performance measure is not promoted strongly as there are various definitional issues.

External Audit

The Unit has not been subject to external audit. The Oregon Insurance Code gives the Commissioner overall responsibility for protecting insurance consumers, with the legislation not specifying a requirement for a consumer protection unit per se.

Consumer Satisfaction Surveys

The Unit has not undertaken consumer satisfaction surveys on a regular basis. One previous postcard survey was undertaken with a low response rate, although good outcomes. The Unit largely relies on internal mechanisms of providing explanations to consumers if their complaint cannot be resolved and why.