What are private rating firms?
Several private firms specialize in evaluating the
finances and services of insurance or managed care
carriers. Each of these agencies has its own methods and
standards and gives grades to the companies based on
their judgment of how well the company is doing.
- The phone numbers and web site addresses below
will connect you with some of the most popular
rating firms.
- You may be charged for insurance company reports
you get.
- Before you rely on any report, make sure you
understand the rating system because each firm has
its own grading system. For example, one firm may
use “A+” as its top grade, while another may go all
the way up to “A+++.”
A.M. Best Company
Phone: (908) 439-2200
Web site:
www.ambest.com
Fitch Investor's Service
Phone: 1-800-853-4824
Web site:
www.fitchibca.com
Moody's Investor Service
Phone: (212) 553-0377
Web site:
www.moodys.com
Standard & Poor’s
Phone: (212) 438-1000
Web site:
www.standardandpoors.com
Several of these rating firms publish books with
their ratings, so you may also be able to find what you
need at your local library.
What should I do if I have a dispute with my
health insurance carrier?
You do not need a lawyer to resolve most disputes with
an insurance agent or a health carrier. Start with
contacting your health carrier’s customer services
office. Most companies have toll-free telephone numbers
for quick service. If you do not receive satisfaction,
ask about the health carrier’s procedures for appealing
decisions. For information on appeals go here:
http://www.michigan.gov/cis/0,1607,7-154-10555_12902_35510_35694---,00.html
What if my self-help efforts fail?
If working directly with the health carrier doesn’t
satisfy your concerns, you should contact the Office of
Financial and Insurance Services at 1-877-999-6442.
How do I file a complaint with OFIS?
You can obtain a complaint form and instructions for
filing a written complaint from our web site at
http://www.michigan.gov/documents/cis_ofis_comp_all_25074_7.pdf
or by calling OFIS toll free at 1-877-999-6442. We will
send the health carrier a copy of your complaint and ask
them to explain its position. • Health carriers are
required by law to respond to OFIS and most health
carriers are very cooperative in resolving complaints.
We will review all of the facts to make sure the health
carrier has followed its contract with you, and that it
has also complied with insurance rules and laws.
Does OFIS keep track of consumer complaints?
Yes. In 2003, OFIS received more than 4,000 complaints
regarding health coverage. If your complaint raises
questions requiring us to contact the health carrier, we
will record it as a "complaint." A complaint represents
a consumer who has been unhappy with the health carrier.
It does not necessarily mean the health carrier has
broken the law or done anything wrong.
What are the most frequent consumer
complaints about health coverage?
- Claim denial
- Claim handling delay
- Unsatisfactory settlement offer
- Coverage question
Complaint comparisons
To obtain complaint information on individual health
insurance carriers and BCBSM, visit the ofis web site at
http://www.michigan.gov/cis/0,1607,7-154-10555_12902_12916---,00.html.
The “Complaint Ratio” column is designed to help make
“apples-to-apples” comparisons easier.
To obtain complaint information on HMOs, visit the
ofis web site at
http://www.michigan.gov/documents/cis_ofis_compinfo_28032_7.html
Please visit the following pages on the OFIS web site
to obtain specific complaint information:
Health Insurance Company Complaint Ratios -
http://www.michigan.gov/cis/0,1607,7-154-10555_12902_12916---,00.html
Health Insurance Company Complaint Statistics -
http://www.michigan.gov/cis/0,1607,7-154-10555_12902_12912---,00.html
Health Insurance Company Financial Information -
http://www.naic.org/cis/
(NAIC web site, see financial information section)
HMO Complaint Information -
http://www.michigan.gov/documents/cis_ofis_compinfo_28032_7.html
HMO Financial Information -
http://www.michigan.gov/cis/0,1607,7-154-10555_12902_18956-93711--,00.html
BCBSM Complaint Ratios -
http://www.michigan.gov/cis/0,1607,7-154-10555_12902_12916-100476--,00.html
You'll find additional information for consumers at
the Office of Financial and Insurance Services Insurance
web site:
www.michigan.gov/ofis