Consumer advocates recover over $1 million in fourth quarter 2025 to put last year’s total at more than $7 million

In the fourth quarter of 2025, Oregon Division of Financial Regulation (DFR) consumer advocates helped recover more than $1 million for Oregon consumers. The fourth quarter consists of the last three months of the year. The $1,118,375 recovered brings the 2025 total to $7,039,774 – money that goes directly back to Oregonians.

Consumer advocates have extensive knowledge across many areas of regulation, including helping those experiencing difficulties with insurance, mortgages, banking products, securities, student loans, and a variety of other financial services regulated by DFR.

“The agency’s work to protect consumers by holding companies accountable to their customers helps to make Oregon more affordable for all of us,” Gov. Tina Kotek said.

The final quarter of last year saw 1,454 complaints come through DFR’s consumer advocates for a total of 5,663 complaints in 2025. Insurance complaints led the way in each quarter, with 935 in the last three months of 2025, while more than 3,700 insurance complaints came in throughout the year. Credit union complaints were the next highest of areas DFR regulated with 59 complaints for the quarter and 212 for the entire year. Advocates also received 254 insurance complaints that were not regulated by DFR.

Examples of consumer complaints successfully resolved by DFR advocates in the last three months of 2025 include:

• Following a dental trauma, a consumer was seen at an in-network emergency room and referred to an out-of-network specialist for follow-up care. The in-network doctor submitted a prior authorization for the specialist’s services, but the consumer did not understand that since the specialist was out-of-network, they would be responsible for the full bill, which totaled $12,000. The insurer denied the consumer’s appeal to pay the claim and waive the charges, so the consumer filed a complaint with DFR. During the insurer’s review, because the in-network emergency room provider requested prior authorization from an out-of-network provider instead of an in-network provider, the insurance company agreed to negotiate a single case agreement, which means the consumer will be responsible only for their in-network cost share.

• A consumer filed a complaint indicating a debt management service provider charged for services while he resided in Oregon when the provider was not licensed in the state. The service provider credited the consumer $3,176.48 for fees earned while he lived in Oregon.

• A consumer reported a hail loss in July 2025. The company’s estimate and the contractor’s estimate were significantly different. The two areas of concern were 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 properly reflect like kind and quality of the repair materials. Additional payments totaling $4,389.17 were issued.

• A consumer traveled to Cleveland, Ohio, to see a specialist for a rare type of cancer and ongoing treatment. During travel, an emergency occurred requiring the consumer to be hospitalized for a full month and to undergo multiple procedures. The provider had previously been in-network. However, the consumer’s employer recently changed insurers, and the provider was now out-of-network. The consumer was not aware there would be such a drastic difference in benefits. The consumer returned to Oregon as soon as they were able, but now had significant bills due of about $40,000. After corresponding with the insurer, the insurer agreed to retroactively approve continuity of care for the consumer, which allowed several large claims to be reprocessed as in-network. Partnering with the consumer and the insurer to verify outstanding balances and claim statuses, four separate previously out-of-network claims were able to be reprocessed, saving the consumer $38,800.75.

“Last year saw over 5,000 complaints come in to our consumer advocates, and they handled them professionally,” said Sean O’Day, director of the Department of Consumer and Business Services. “We have a dedicated group of employees who have a common goal of helping Oregonians navigate the often complicated world of insurance and financial services.”

Oregon Insurance Commissioner TK Keen said consumer advocates have a tough job and handle it professionally.

“I am very proud of our team of industry experts, who continue to put their knowledge to work for the benefit of Oregonians,” said Keen, who is also the DFR administrator. “Many of the cases they deal with are highly complex and take a lot of time to navigate. I am happy to see their hard work benefitting so many people in our state.”

Anyone who may need a consumer advocate can call 888-877-4894 (toll-free) or email dfr.insurancehelp@dcbs.oregon.gov for insurance-related issues and dfr.finanicialserviceshelp@dcbs.oregon.gov for financial-related issues.

Here is the list of complaints through 2025:

Contact information
Jason Horton, public information officer
503-798-6376
Jason.A.Horton@dcbs.oregon.gov