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

You can contact the Kentucky Department of Insurance at (800) 595-6053 (for Kentucky residents only) or (502) 564-6034 and ask to speak with a Consumer Complaint Investigator. The Department is open from 8:00 a.m. to 4:30 p.m. Monday through Friday.

What happens after the Department receives my complaint?

Once the Department receives your complaint, it will send a copy to your insurer who then has 15 calendar days to respond. A typical case should be resolved within 30 days.[18]

How do I file a complaint?

If you are a Kentucky resident and your insurer denies your coverage after the impartial appeal process, you can file a complaint with the Kentucky Department of Insurance (“Department”). Complaint information. Your complaint should include the following information: The name, address,...

How long will the impartial review process take?

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

How do I request an impartial appeal?

Request to Insurer for Impartial Appeal. You should send your request for an additional impartial appeal to your insurer if your insurer denied your claim because it deemed your requested treatment or services not medically necessary or experimental/investigational.[8] The appeal...

In what circumstances can I apply for an impartial review?

During an impartial review (also known as an external review), an independent third party reviews your insurer’s decision.[4] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. You are entitled to...

How long should the internal appeals process take?

The internal appeals process should take a maximum of 30 days.[2] If your health care practitioner requests an expedited appeal, the process should take no more than 72 hours.[3]

How do I request an internal appeal?

If your insurer denies your claim, you have the right to an internal appeal.[1] This means you can ask your insurer to conduct a full and fair review of its decision. To appeal the denial, you should complete the following steps...

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