Consumer Protection in Connecticut

Connecticut Insurance Department

Mission

The Connecticut Insurance Department's primary mission is consumer protection. The Department enforces state insurance laws to ensure policyholders are treated fairly.

Contact Information

Filing Consumer Complaints

When to File a Complaint

Consumers should file complaints when:

• Claim is denied without clear explanation
• Excessive delays in claim processing
• Underpayment of claims (significantly less than documented losses)
• Poor communication from insurer
• Unfair policy cancellation
• Pressure to settle for inadequate amount
• Suspected unfair practices by producer or insurer

How to File

Online (Recommended for faster processing):

• Submit through the Connecticut Insurance Department portal
• Assigned to examiner the next business day
• Direct communication via email

By Mail:

• Download and complete the Consumer Complaint Form
• Mail to P.O. Box 816, Hartford, CT 06142-0816

By Phone:

• Call Consumer Helpline at 800-203-3447

What the Department Can Do

What the Department Cannot Do

• Force payment of disputed claims
• Practice law or provide legal advice
• Order specific claim settlements
• Intervene in purely contractual disputes

Connecticut Unfair Insurance Practices Act (CUIPA)

Prohibited Unfair Claim Practices

Under CGS § 38a-816, insurers cannot:

1. Misrepresent policy provisions - Lying about coverage
2. Fail to acknowledge claims promptly - Unreasonable delays
3. Fail to adopt reasonable investigation standards - Inadequate claim review
4. Refuse to pay claims without investigation - Arbitrary denials
5. Fail to affirm or deny coverage promptly - Leaving claims in limbo
6. Attempt to settle for less than reasonable - Lowball offers
7. Delay settlement by requiring excessive documentation - Unnecessary paperwork
8. Refuse settlement under one coverage to influence another - Coercive tactics

Enforcement Powers

The Insurance Commissioner may:

• Hold hearings on suspected violations
• Issue cease and desist orders
• Impose administrative fines
• Suspend or revoke licenses
• Request injunctive relief through the Attorney General

Insurance Fraud

Definition

Insurance fraud involves intentionally deceiving an insurer to obtain benefits or payments not legitimately owed.

Classification and Penalties

Types of Fraud

Hard Fraud (Deliberate):

• Staging accidents
• Arson for insurance proceeds
• Faking theft or injuries
• Billing for services not provided

Soft Fraud (Opportunistic):

• Exaggerating legitimate claims
• Omitting information on applications
• Misrepresenting vehicle usage
• Inflating damage estimates

Producer Involvement Penalties

Producers who participate in or facilitate fraud face:

• Immediate license revocation
• Criminal prosecution
• Civil liability
• Permanent industry bar

Consumer Rights in Connecticut

Policy Rights

• Right to clear policy language
• Right to timely claim processing
• Right to fair settlement offers
• Right to appeal claim denials

Information Rights

• Right to know why claims are denied
• Right to copies of policy documents
• Right to understand coverage limitations
• Right to shop for competitive rates

Complaint Rights

• Right to file complaints without retaliation
• Right to Department assistance
• Right to know complaint status
• Right to appeal Department decisions

Best Practices for Producers

Protecting Consumers

1. Document everything - Keep thorough records
2. Communicate clearly - Explain in plain language
3. Respond promptly - Address concerns quickly
4. Disclose fully - No hidden information
5. Follow up - Ensure needs are met

Protecting Yourself

1. Know the regulations - Stay current on CT laws
2. Get it in writing - Document client decisions
3. Keep copies - Maintain complete files
4. Report concerns - Escalate issues properly
5. Seek guidance - Ask when uncertain

Exam Tip: Remember that the Connecticut Insurance Department's primary mission is consumer protection. Know the complaint filing process and understand that insurance fraud is a Class D felony in Connecticut.