External Review – INDIANA

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

You can contact the Indiana Department of Insurance at (800) 622-4461 or (317) 232-2426. The Department if open from 8:00 a.m. to 4:15 p.m. Monday through Friday.

What happens after the Department receives my complaint?

The Department will process your complaint within 72 hours.[17] You will receive a confirmation letter that includes your problem report number and the name of the Consumer Consultant handling your case. The Consultant will send a copy of the complaint to...

How do I file a complaint?

If you are an Indiana resident and you have completed the internal appeal and external review processes but still lack access to a treatment, you can file a complaint with the Indiana Department of Insurance (“Department”). Your complaint should include...

How long will the external grievance review process take?

The external grievance review process should take no more than 15 days after the external grievance is filed.[11] If you request an expedited external grievance review, the process should take no longer than 72 hours after your request is received.[12]

How do I request an external grievance review?

If your insurer still denies you coverage after you filed an internal grievance, you can request an external grievance review of your insurer’s decision. If your situation is urgent, you can request an expedited external grievance review.[5] During an external grievance...

What if I can’t wait for an internal grievance because my situation is urgent?

The internal grievance process should take a maximum of 45 days.[3] You can skip the internal grievance process and request an expedited external grievance review in urgent situations.[4] Your situation is urgent if waiting 45 days would seriously jeopardize your life or...

How do I request an internal grievance?

If your insurer denies your claim, you have the right to an internal appeal, known in Indiana as an “internal grievance.”[1] This means you can ask your insurer to conduct a full and fair review of its decision. To file an...

Donations

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

Donate Now