How To

How to File a Complaint Against a Health Insurance Company

Contributor
By Sidney
eHow Contributing Writer
(0 Ratings)

Having an issue with a health insurance company can be stressful. But every state has a department of insurance that is designed to mediate these issues. The process typically starts with filing a claim. But there are a few details that are helpful to know.

From Quick Guide: Health Insurance
Difficulty: Moderate
Instructions
  1. Step 1

    Gather supporting documentation. Before filing a complaint you will need to gather relevant documents, including letters of denial, termination papers or anything else of interest. Take copies of these documents and place in a new folder.

  2. Step 2

    Fill out a complaint form with your state's department of insurance. Each state has a separate department of insurance. This agency is responsible for handling complaints against insurance companies. When submitting a complaint, make sure to attach the supporting documentation you prepared.

  3. Step 3

    Understand procedures if you have an attorney. If you are attorney-represented, the state department of insurance may not be able to mediate the issue. They can resolve any compliance issues, but your attorney will be responsible for settling the issue.

  4. Step 4

    Indicate if you want the information you submit to be confidential. When you fill out a complaint form, the insurance company may receive a copy unless you indicate otherwise. If you want your paperwork to be kept confidential, make sure to indicate this.

  5. Step 5

    Be prepared to wait for resolution. Depending on your individual state, the time to process a complaint may be lengthy. Check on the status every 30 days to evaluate the progress.

Tips & Warnings
  • Put any overdue accounts in dispute. If the complaint is the result of the health insurance company denying a medical claim, contact the hospital or doctor. They can often put your account in dispute while awaiting resolution so your credit won't suffer.
  • Make sure not to send original documents. When sending supporting documentation, make sure not to send the originals. Most state agencies will not be held liable for lost documents.

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