The Criminal Investigations Division of the Department of Insurance closed 413 cases in 2009, totaling more than $10.5 million in restitution and recoveries, according to the Department of Insurance.

The Criminal Investigations Division employs 20 sworn law enforcement officers to investigate claims of insurance fraud around the state.

Last year, in addition to the 413 cases, 89 people were convicted and 175 arrests made.

“I’m proud that through our work at the department we could get money back for consumers across North Carolina,” Insurance Commissioner Wayne Goodwin said. “This year’s numbers are especially eye-opening but certainly great news knowing that so many families have struggled financially this past year. Consumers need to know that the Department of Insurance is here to help them.

The Consumer Services Division, which handles consumer inquiries and complaints about insurance-related issues, handled some 90,000 calls and processed more than 8,500 written complaints from the public.

Through these calls and complaints, more than $9 million was recovered from insurance companies for citizens.

The Health care Review Division returned approximately $175,540 to consumers who received an external review because of a health insurance claim denial.

When health insurance claims are denied, Health care Review works with consumers to complete their appeals and grievances procedures. If a denial is deemed to be for a service that is medically necessary, the consumer can request an external review through the division.

External reviews provide a second look at the denial by a third party expert.

The Market Regulation Division conducts both routine and targeted market conduct examinations on foreign and domestic licensed companies, like insurance companies, premium finance companies, HMOs and PPOs, to ensure compliance with state laws and regulations.

Through these exams, the Division ordered $981,300 to be returned to policyholders.

The Seniors’ Health Insurance Information Program (SHIIP) Division assisted more than 76,000 consumers with general Medicare questions and helped enroll more than 2,600 Medicare recipients in the Low-Income Subsidy program that provides savings for prescription drug costs.

Anyone with questions about insurance can call the Department’s Consumer Services Division at 800-546-5664 to speak with an insurance expert. If your health insurance has denied your claim, you may also contact the Health care Review Division at 1-877-885-0231. Further anyone with insurance fraud suspicions should call the Criminal Investigations Division at 919-807-6840; callers may remain anonymous.