A consumer watchdog group says Indiana is one of the worst states when it comes to approving health insurers' requests for premium increases.As state officials scramble to comply with federal mandates and increased regulation of the health insurance industry, consumerwatchdog.org contends Hoosiers are essentially powerless over changes in their premiums.Indiana is one of 36 states that must approve insurance rate hikes before they go into effect. The Indiana Department of Insurance has the legal authority to approve or disapprove rate increase applications. 6News' Joanna Massee's review of 600 applications found more than 95 percent of increases were approved. Carmen Balber, of consumerwatchdog.org, said Hoosiers don't really have a voice in the regulatory process."I know that Indiana's standards fall on the low end of state protections across the country," Balber said. "Indiana consumers really have no role to play in commenting on or challenging rates that are too high."IDOI Chief Deputy Commissioner Robyn Crosson countered that the department sometimes approves a lower rate increase than an insurance company originally requested."We are here to serve the citizens of Indiana. One way to do that is to make sure there are products out there," Crosson said. "The primary concern is to make sure there's a robust market so that people have access to health insurance coverage."Some companies have gotten double-digit premium increases year after year. Prudential asked for a 35 percent increase in 2009 after increasing rates by 35 percent in 2005, 35 percent in 2006 and 20 percent in 2008."It's a function of not only medical costs, but utilization," Crosson said, meaning that consumers are visiting the doctor more often. "We get calls on a regular basis. You know people, times are tough. This affects people's bottom line and their pocketbook. We basically spend a lot of time looking into alternatives."Barbara Parks and Shari Obermeyer now work in the basement of Obermeyer's home after insurance premiums pushed the small paralegal service company out of its downtown office."They've gone up at least three times, 300 percent, in less than 10 years," Parks said of insurance premiums. "My pay hasn't gone up nearly that much.""It's pitiful," Obermeyer said. "They should do more investigation into why the premiums are going up."Parks' alternative is to simply drop coverage, but she is a diabetic and has already suffered one heart attack."I'll keep going as long as I can, and when I can't go anymore, I won't," she said.Indiana has begun toughening its stance with insurance companies by checking to make sure a high percentage is being spent on medical costs instead of executives' salaries.The Department of Insurance is also building a website where the public will be able to see and comment on rate hike applications before they are approved.