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

You can contact the Louisiana Department of Insurance at (225) 342-5900 (local) or (800) 259-5300.  The Department is open from 8:00 a.m. to 5:00 p.m. Monday through Friday.

What happens after the Department receives my complaint

After receiving your complaint, the Department will send you an acknowledgement letter, which will include your file number and the name of the compliance officer in charge of investigating your complaint.[21] The compliance officer will send a copy of the complaint...

How do I file a complaint?

If you are a Louisiana resident and your insurer denies your coverage after the external review process, you can file a complaint with the Department. Complaint information. Your complaint should include the following information: The name, address, and telephone number of...

How long will the external review process take?

Once an independent review organization receives notice that it will conduct your appeal, it will select one or more clinical peers to conduct the standard or expedited review.[14] A clinical peer is a licensed physician or other health care professional in...

How do I request an external review?

You must submit a written request for a standard external review directly to your health insurer within four months of your insurer’s last decision.[10] However, if you are requesting an expedited external review, you should submit your request to your health...

In what circumstances can I apply for an external review?

During an external review, an independent third party reviews your insurer’s decision.[6] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. Under Louisiana law, you are entitled to request an external...

How long should the internal appeals process take?

The internal appeals process should take a maximum of 30 days if you have not yet received the requested service or treatment and a maximum of 60 days if you have received the service or treatment but are waiting for...

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 do the following: Review...

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