Rhode Island policyholders at loggerheads with their delaying, denying and recalcitrant insurers may seek help in the claims process by filing a complaint with the Rhode Island Insurance Division.
An individual who believes there has been a violation of insurance statute(s) and/or regulation(s) may file a written complaint with the Insurance Division. All complaints must be in writing and signed by the Claimant.
Electronic forms can be found on the Division website.
A completed insurance complaint form and copies of supporting documents should be sent to the Insurance Division by e-mail (DBR.Insurance@dbr.ri.gov) or by mail to:
State of Rhode Island and Providence Plantations
Department of Business Regulation – Insurance Division
1511 Pontiac Avenue, Building 69-2
Cranston, RI 02920
FAX No. (401) 462-9602
Phone No. (401) 462-9520
All complaints filed will be processed in accordance with the Insurance Division’s internal complaint review process. Upon receipt of the written complaint, the Insurance Division will make an initial determination with respect to standing and jurisdiction. The Insurance Division will then send an acknowledgement letter to the complainant advising that the Division is reviewing the matter and will contact the complainant when the situation warrants. The letter of complaint together with any attachments will be sent to the insurer named in the complaint for reply. Once the Insurance Division has concluded its review, a letter will be sent to the complainant stating the Division’s findings.
The Insurance Division will only accept complaints filed by the individual claimant, the claimant’s designated immediate family member (spouse, parent, sibling or off-spring) on behalf of the claimant, the claimant’s attorney admitted to practice law in Rhode Island, or an executor and/or administrator or other court-approved legal representative of the claimant’s estate.
All disputes regarding the terms and provisions of the policy must be resolved between the insurer and the claimant if the dispute is not covered by statute or regulation. The Division’s authority is limited to jurisdictional matters pursuant to Rhode Island General Laws.
The Division cautions that it does not have the authority to settle or arbitrate claims or to determine liability or that an insurer should pay a claim. Nothing in the complaint process shall be deemed to prohibit either the insurer or the claimant from seeking redress in the appropriate judicial forum.
Before filing a complaint, the Division recommends that policyholders first contact the insurer named in the complaint to resolve the issues. If the response is unsatisfactory, then the complaint form should be filed with copies of any important papers that relate to your complaint, such as letters, e-mail and other communications, such as notices from the insurance company, explanations of benefits and appeal decisions, between you and the insurance company or agent concerning your complaint; records explaining how claim payments were calculated; a copy of your insurance policy or certificate of coverage; Property loss forms, vehicle appraisals, police reports; and any additional information you feel might be pertinent to the complaint. Do not send original documents.
Should additional issues arise or if you need legal advice, please contact our attorneys.
