Commissioner Causey: Department Of Insurance Saves Or Recovers $142 Million For North Carolinians in 2025

RALEIGH — Insurance Commissioner Mike Causey announced Tuesday that the North Carolina Department of Insurance saved or recovered $142 million for North Carolina consumers in 2025, reflecting continued efforts to protect policyholders and combat insurance fraud across the state.

The recovered funds stemmed from a wide range of consumer protection activities, including insurance fraud restitution, consumer assistance interventions, market monitoring, and external medical reviews. Department employees also helped consumers gain access to needed medical procedures and prescription medications that were initially denied.

“Protecting consumers is a top priority for me and the dedicated employees at the Department of Insurance,” Commissioner Causey said. “Every dollar we save or recover represents real help for North Carolinians who depend on fair treatment from their insurance providers.”

Throughout 2025, the Department assisted residents in recovering $65.9 million from lost or unclaimed life insurance policies and helped policyholders overcome disputes with insurers, resulting in $25.9 million paid to consumers after intervention by Department experts. The Department also provided assistance to more than 64,000 Medicare beneficiaries, saving seniors and people with disabilities $41.7 million.

Efforts to combat insurance fraud resulted in the recovery of $6.4 million in fraudulent expenditures. Insurance fraud remains a significant issue nationwide, costing Americans an estimated $308.6 billion annually, according to a study conducted for the Coalition Against Insurance Fraud. In 2025 alone, the Department’s Criminal Investigations Division announced 380 arrests and 199 convictions related to insurance fraud.

Through the Department’s SmartNC program, patients who were originally denied medically necessary procedures or prescription drugs received $1.9 million in assistance through appeals and independent external reviews. Additionally, routine oversight by the Department’s Market Regulation Division helped consumers recover more than $336,000 as a result of monitoring insurance company conduct in North Carolina.

“As we enter 2026, employees at the Department will continue to put forth efforts to make sure insurance companies are providing the benefits that North Carolina consumers deserve,” Commissioner Causey said.

Consumers with questions about their insurance coverage or who wish to report suspected insurance fraud can visit www.ncdoi.gov, call the Department toll free at 855-408-1212, or contact the Criminal Investigations Division at 919-807-7940 or 888-680-7684.