11 NCAC 04 .0115             DIVISION PROCEDURES

(a)  Complaint Handling Procedure.  Complaints will be processed in the following manner:

(1)        Analyst will request explanation from company, agent or adjuster;

(2)        If he finds that the complaint has been improperly handled, then he will recommend that proper action be taken;

(3)        If the issue is not resolved, the deputy commissioner may arrange a conference with company representatives to resolve the problem.

(b)  Hearings.  If a conference does not resolve a disputed issue, the deputy commissioner may recommend to the commissioner that appropriate legal action be taken to insure compliance with the statutes, rules and regulations administered by the department.  Such legal action may include the convening of a public hearing to review, in light of the conduct which occasioned the complaint, the necessity of entering an order against the party complained of.

(c)  Complaints Represented by Counsel.  The Division will not investigate a complaint which is also the subject matter of a pending lawsuit filed by an attorney representing the complainant.  If a lawsuit has not been filed but the complainant has retained an attorney, the Division will investigate the complaint according to its normal procedures provided it has first obtained the attorney's consent.


History Note:        Authority G.S. 58-2-40; 58-2-50; 58-2-155; 58-2-185; 58-2-190; 58-2-195; 58-2-200; 58-3-100; 58‑33-45; 58-65-1; 58-65-40; 58-67-20; 58-67-150;

Eff. December 15, 1979;

Amended Eff. April 1, 1989.