Ill. Admin. Code tit. 50, § 926.40 - Complaint Handling Procedure

Current through Register Vol. 46, No. 15, April 8, 2022

a) Notification and Response Requirements

When a complaint is received by the Department against an insurer, insurance producer, or other entity identified in Section 926.20 (respondent), the respondent shall be notified of the complaint. The Department will, in its notification, specify the date when a report is to be received from the respondent, which, in most instances, will be 21 calendar days after notification is sent to the respondent.

b) Contents of Response or Report or Both

1) Each respondent shall supply adequate documentation that explains all actions taken or not taken and that were the basis for the complaint;

2) Documents necessary to support the respondent's position, or information requested by the Department, shall be furnished with the respondent's reply; and

3) The Department will respect the confidentiality of medical reports and other documents that, by law, are confidential. Any other information furnished by a respondent shall be marked "confidential" if the respondent does not wish it to be released to the complainant.

c) Follow-up or Conclusion

Upon receipt of the respondent's report, the Department will evaluate the material submitted and:

1) Advise the complainant of the action taken and disposition of the complaint;

2) Pursue further investigation with the respondent or complainant; or

3) Refer the complaint file to the appropriate Division within the Department for further regulatory action.

d) The Department deems complaint files to be confidential records and will not release them to persons other than the complainant and the respondent.

Notes

Ill. Admin. Code tit. 50, § 926.40

Amended at 23 Ill. Reg. 5695, effective May 3, 1999

Amended at 43 Ill. Reg. 3246, effective 2/25/2019