Insurance Issues Topped Complaints to Oregon Financial Regulator Last Year

Insurance issues were the most frequent complaint fielded by the Oregon Division of Financial Regulation last year.

In the final quarter of 2025, the DFR received 935 insurance complaints, bringing the total of 3,700 insurance complaints for last year. Insurance complaints led the way for all quarters of 2025. Consumer advocates also received 254 insurance complaints that were not regulated by DFR.

The division helped recover $1.1 million in the last three months of 2025, bringing the total to more than $7 million.

Credit union complaints were the second most frequent complaint, with 59 complaints coming in during the final quarter, and 212 for the year.

Examples of consumer complaints resolved by DFR advocates in the final quarter of 2025 include:

• A consumer reported a hail loss in July 2025. The insurance company’s estimate and the contractor’s estimate were significantly different, with the two areas of concern being skylights and roofing materials. The consumer lived in a homeowner association that set requirements for the quality of materials used for building or repairs. Some differences appeared associated with those requirements, and based on the insurance contract, were not owed by the insurer. However, through the complaint process, the company reassessed these two areas of the repair estimate and made adjustments to reflect like kind and quality of the repair materials. Additional payments totaling $4,389.17 were issued.
• Following a dental trauma, a consumer visited an in-network emergency room and was referred to an out-of-network specialist for follow-up care. Even though the in-network doctor submitted a prior authorization, the consumer wasn’t aware that the out-of-network would be responsible for the $12,000 bill. The insurers denied the consumer’s appeal to pay and waive the charges. The consumer filed a complaint with DFR, after review the consumer was only responsible for the in-network cost share.
• While traveling to Cleveland for a rare cancer treatment, a consumer required hospitalization for a month and multiple procedures. Unaware their employer had recently changed to different insurers, the provider was now out-of-network. After getting back to Oregon, the consumer noticed a $40,000 bill. After corresponding with the insurers, four claims were reprocessed saving the consumer 38,800.75