Colorado Division’s complaint reconciliation system helps companies know where they stand anytime
Dayle Axman, supervisor, Life & Health Consumer Affairs Section, Colorado Division of Insurance, presents the division’s complaint reconciliation system during the regulator’s showcase.
The Colorado Division of Insurance is an adherent of Market Analysis Core Competency Standard 5, which requires that “each department of insurance shall have a system for recording and tracking complaints in a database using a coding system to facilitate analysis and trending.” In other words, a department should have a procedure in place to monitor the accuracy of complaint data. A laudable goal, but not always easy to achieve, as the experience of the Colorado Division can attest.
“The reconciliation process used to be a very staff-time intensive process,” she said. So intensive, in fact, that for two years running (2002-03) Colorado didn’t even do it. Why so time intensive? Simply because twice a year paper reports were mailed to each company for review, with each company returning paper reports with any information regarding identified problem issues. Those returns had to be reviewed again by department staff members, eating up more time, postage costs and paper – a decidedly “un-green,” paper-intensive process.
Saving trees
That began to change in 2004, when Colorado introduced a new online, real-time, Web-based application that marked the beginning of the end of the old, paper process.
“The online system captures all the same data that we used to report on paper, but now it is available for access on line as soon as a complaint is closed.” Axman said.
Companies can access and verify data and statistics for closed complaints anytime during the year, an important feature since such information is used in calculating and publishing the complaint indices regarding company performance on the Division’s Website.
If a company agrees with the data, it is moved from “open” status to “agreed.” If the company disagrees, it can mark the file “disagree” in a text box and resubmit it. The Division staff then reviews the disagreement, retaining the authority to determine whether the disagreement is valid and whether the entry needs to be changed. If changed, the Division will review the data elements again.
Those data elements include:
- The Division’s assigned number
- The “incident” date (if applicable)
- Date the Division “opened” its complaint investigation
- Date the Division “closed” its complaint investigation
- Complainant’s name
- Short description of the product line
Data elements not provided include complaint “reason” codes, “disposition” codes and the “confirmed” or “non-confirmed” status of the complaint.
Timely company reviews critical
The deadline for review of all data is January 30. Axman stressed that companies need to register for a user ID and access that data well enough in advance to allow time for a meaningful review.
“I would recommend that companies don’t wait until January 29 to look at their data,” Axman said. “If you have questions or issues with anything on the site, you need to give our people enough time to review your concerns before the indices are calculated.”
The Division does have some ability to remind companies that have not responded in a timely fashion, such as sending emails with complaint lists to those who have not reported in. Sometimes the Division will make calls to companies that may have had staff turnovers leaving gaps in the review process.
“It’s important for companies to review and comment on closed complaint data on a timely basis,” Axman said. “The fact is, as of February 1 all that data is gone, so asking for a user ID on January 29 is not going to cut it. The best approach is to go into our closed complaint database on a regular basis throughout the year. Remember, this is a voluntary process. If you don’t reconcile your data, that’s what gets reported.”
Axman recommended that companies refer to Colorado Insurance Bulletin B-1.13 for information about the basic parameters of the complaint reconciliation process. The information can be found at www.dora.state.co.us/insurance/regs/bulletin.htm.
Axman concluded with a clear and unambiguous statement about the mission of the Colorado Division of Insurance.
“We are dedicated to preserving the integrity of the marketplace and are committed to the promotion of a fair and competitive business environment in Colorado,” she said. “We truly believe that effective regulation creates a level playing field where consumers are safe and businesses can flourish.”
Click here to view Axman’s presentation.
Contact Info:
Dayle Axman
Supervisor – L&H Consumer Affairs Section
CO Division of Insurance
303.894.7881
dayle.axman@dora.state.co.us
www.dora.state.co.us
