External Review – COLORADO

Who should I call if I have any questions about filing a complaint?

You can contact the Colorado Division of Insurance at (303) 894-7490 if you are inside the Denver metro area or (800) 930-3745 if you are outside the Denver metro area to speak with a consumer affairs representative.

What happens after the Division receives my complaint?

The Division will assign an analyst to review your complaint and conduct an investigation.[17] The analyst will provide a copy of your complaint to your insurer, and your insurer will have approximately 20 days to respond.[18] The analyst will then conduct an...

How do I file a complaint?

If you are a Colorado resident and your insurer denies your coverage after the external review process, you can file a complaint with the Colorado Division of Insurance (“Division”). Your complaint should include the following information: The name, address, email...

How long with the external review process take?

The external review process should take no more than 45 days.[14] If you request an expedited external review, the process should take no longer than 72 hours after your request is received.[15]

How do I request an external review?

If your insurer still denies you coverage after you requested a first and, if applicable, second level review, you can request an external review of the insurer’s decision.[7] If your situation is urgent, you can request an expedited external review. Your...

What if I can’t wait for a first level review because my situation is urgent?

The first and second level review processes should each take a maximum of 30 days.[5] You can skip the first and second level review processes and request an expedited external review in urgent situations.[6] Your situation is urgent if waiting 30 to...

Do I need to request a second level of review?

If you have a group plan and your insurer denies you coverage after you requested a first level voluntary review, you must then request a second level voluntary review.[3] During the second level voluntary review, you will have the opportunity to...

How do I appeal the decision?

If your health insurer denies your claim, you have the right to a first level review (also known as an internal appeal).[1] This means you can ask your insurer to conduct a full and fair review of its decision. To appeal...

Donations

Lorem ipsum dolor sit amet, consec tetur adipiscing elit ultrices felis eget laoreet dolore magna.

Donate Now