NORTH CAROLINA, USA — Who helps you if you have a dispute with your insurance company? What if you need help with Medicare? What about reporting insurance fraud? That's when you contact the North Carolina Department of Insurance.
Commissioner Mike Causey joins us on 2 Wants to Know today to talk about what his department does for you.
Q. What if someone has a dispute with their insurance company? They’re haggling over a price on car or auto insurance, or the health insurance company doesn’t want to pay for something that you think should be covered.
A. Call 855-408-1212 between 8 a.m. and 5 p.m. Monday through Friday. The department has consumer experts ready to help you understand your benefits and to work on your behalf with the insurance company.
They can help you understand what is covered and what is not covered. Standard homeowners’ insurance policies do not cover damages from floods or earthquakes. You have to get flood insurance from the National Flood Insurance Program. You can get an earthquake rider on your homeowners’ policy. It’s not that expensive.
Q. What if my doctors say I need a procedure, device, or drug that my insurance company won’t cover?
A. Call the same number, 855-408-1212, and ask for Smart NC. The department has a staff that will work with you, your doctors, and the insurance company. They have a peer-review system set up to determine if your procedure, device, or drug is medically necessary.
Q. For our senior citizens, Medicare open enrollment is coming up, beginning in October. Do you have any way to help them navigate the maze of different Medicare supplement and drug programs?
A. The department has what’s called SHIIP. That stands for Seniors’ Health Insurance Information Program. SHIIP has set up a network of trained volunteers across the state to help Medicare beneficiaries to decide which supplemental programs and which prescription programs will be most beneficial to them. Call the same toll-free number, 855-408-1212.
Q. I had a relative who died, but I can’t find any life insurance policies. Can you help me with that?
A. The department has a lost life insurance policy database. Call 855-408-1212, and they can help you.
Q. I think I might have been scammed. How do I report insurance fraud?
A. You can report fraud at 888-680-7684. The department encourages a point of contact in case they need more information. However, you can report it anonymously.
Email: reportfraud@ncdoi.gov
Mail: Criminal Investigations Division, N.C. Department of Insurance, 1201 Mail Service Center, Raleigh, N.C. 27699-1201
Report online: North Carolina Department of Insurance (sas.com)
