Author: Mike Causey, Insurance Commissioner
During the year, our staff at the Department of Insurance is busy licensing insurance agents and combing through insurance company financial statements to make sure they’re solvent and have enough money on hand to pay claims.
Last year, our dedicated employees also helped North Carolina consumers and policyholders recover $142 million. That figure includes money senior citizens saved on their Medicare plans, dollars saved by patents receiving medical services or drugs originally declined by insurance companies and monies consumers saved after our specialists intervened in claims disputes. It also includes money recovered for fraudulent payments.
Protecting consumers is a top priority for me and the dedicated employees at the Department of Insurance.
The bulk of the savings -- $65.9 million – came about through our lost life insurance policy tool. If you have a loved one who passed away and haven’t been able to locate his or her life insurance information, you may be able to find it by using our online tool at www.ncdoi.gov. When you get to the page, scroll down to where you see the “Getting help is easy…” title and then click on “Locate a lost life insurance policy. You may also call our toll-free number at 855-408-1212 weekdays from 8 a.m. to 5 p.m. for more information about this service.
The Department’s Seniors’ Health Insurance Information Program, also known as SHIIP, assisted more than 64,000 Medicare beneficiaries last year, saving them $41.7 million.
SHIIP counselors help North Carolinians navigate the maze of Medicare Advantage and Part D prescription drug programs so they can get the best deal available. This is a free service. Our SHIIP counselors provide unbiased information helping people understand their options so they can make an educated decision.
Our Consumer Services Division also helped North Carolina policyholders facing hurdles with insurance companies receive $25.9 million.
Our Smart NC Division saved North Carolinians originally denied necessary medical procedures or prescription drugs receive $1.9 million through appeals and independent reviews. In these external reviews, an independent provider reviews information provided by the patient’s doctor and the insurance company to make a binding determination on the dispute.
The Department’s Criminal Investigations Division recovered $6.4 million in fraudulent expenditures. Special agents also made 380 arrests and obtained 199 convictions in 2025.
The Market Regulation Division, which routinely monitors the conduct of insurance companies in North Carolina, was able to provide nearly $336,000 to consumers last year.
Our staff is dedicated to not only regulating the insurance industry but also making sure consumers obtain benefits for their premium dollar. Consumers who have questions about their insurance can visit www.ncdoi.gov or call 855-408-1212.