In 2007, the Oregon Insurance Division reports that, "Only about 39 percent of Oregonians have individual or group health insurance purchased from commercial health carriers. Another 26 percent receive coverage through government programs (Medicare and Medicaid), while 18 percent receive employer-based coverage through large employers that are self insured. Approximately 617,000 Oregonians, or 17 percent of the population, are uninsured."
The Oregon Insurance Division - Consumer Advocacy Unit
The Consumer Advocacy Unit (CAU) will advocate on your behalf! The CAU resolves thousands of consumer complaints each year.
There is free help available
There is free help available to consumers with insurance questions and complaints. The Oregon Insurance Division's Consumer Advocacy Unit responds to general insurance questions and assists consumers with complaints about insurance companies or insurance agents.
Consumer Advocacy will:
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Investigate your complaint.
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Help you get a clear response to your questions
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Advocate on your behalf to resolve issues.
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Mediate misunderstandings.
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Explain laws and rules.
Consumer Advocacy cannot:
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Recommend a particular insurance company, agent or product.
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Provide legal advice that sometimes is required to settle complicated issues.
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Force an insurance company to pay claims.
File a complaint
You should file a complaint with the Oregon Insurance Division as soon as you receive a denial from your insurance company. You should also file a complaint if you believe you are being treated unfairly by your insurance company at any time. As soon as you file a complaint, the consumer advocates can investigate the problem and help you.
The Insurance Division keeps track of all complaints. This is important when SB1, Mental Health Parity and HB 2918 are reviewed. Complaints will show areas of these laws that need to be improved and point the direction for further legislation.
Contact the Oregon Insurance Division
The Oregon Insurance Division
Consumer Advocacy Hotline
1-888-877-4894 (toll-free)
(503) 947-7984 (Salem)
Self-Insured Employer Plans
If you have a self-insured employer plan, most state benefit mandates will not apply to you. However, the Insurance Division can still attempt to advocate on your behalf with the insurance company administering your employer's plan. Please understand that CAU has less leverage in the case of self insured plans. In particular, they will not be able to advocate on your behalf with your employer. If your health care plan is through a self-insured employer, it is best to contact the Insurance Division to find out how they can assist you. For more information on self-insured employer plans, please go to this page. If you do not know what kind of plan you have, please ask your insurance company or your employer.