From a certain point of view, insurers are in the business of denying claims. Finding a way to limit the scope of benefits a claimant can receive is how insurance adjusters make their living. Naturally, an insurer is legally permitted to aggressively defend itself against the possibility of fraud or inflated damages claims. But an insurer’s aggressive posture can and often does cross the line into the realm of bad faith or, even worse, fraud on the part of the insurer. When an insurance dispute arises the insured has the option of submitting a complaint to the Nevada Division of Insurance.
What does the Nevada Division of Insurance do?
The Division of Insurance has a number of important functions, with consumer protection being among time. The Division has staff dedicated to helping resolve disputes between consumers and insurers. They will investigate cases and offer mediation services to bring the dispute to amicable resolution without involving the relatively slow and expensive court system. The Division oversees state licensing of insurance professionals, which means that it has the authority to revoke the license of a professional or even a business if it has committed serious violations.
The complaint process begins by submitting a form online, or alternatively by mail. A consumer must provide all the information the Division needs to evaluate the claim, including a signed release form to permit the Division to seek medical information from the claimant’s doctors, if necessary. The Division considers cases involving potentially improper denials of claims, improper cancellations of policies, and disputes related to the necessity or efficacy of medical treatments. Once the Division receives the complaint and provides a notice to the insurer, the insurer has a short time to respond to the complaint.
The Division of Insurance has limited power to resolve disputes
Although the Division can help a consumer in a number of important ways, its authority in disputes is limited to a mediator role. Among other things, it cannot handle complaints brought by consumers who are represented by an attorney. Essentially, the Division offers no-cost assistance to consumers who otherwise cannot find or afford the help of an attorney. The Division also cannot order an insurer to provide coverage or alter a decision.
A consumer who feels that an insurance company is acting in bad faith or unethically may find that pursuing recourse through litigation offers a greater chance of a favorable outcome. This is especially true when a case involves complicated issues that make it difficult to compile a comprehensive complaint without an attorney’s help. Speaking to an attorney needn’t foreclose submitting a complaint to the Division of Insurance. The consumer can’t be represented by an attorney in a matter that is submitted to the Division, but an attorney may be able to help the consumer determine whether it makes sense to pursue a remedy through the Division complaint process or through litigation.
GGRM is a Las Vegas personal injury law firm
For more than 45 years the law firm of Greenman Goldberg Raby Martinez has represented injured clients in cases involving personal injury, workers’ compensation, and insurance disputes. If you aren’t sure whether filing a complaint with the Division of Insurance is the right move for you, call us today for a free attorney consultation at 702-388-4476 or reach us through our contact page.