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

You can contact the Michigan Department of Insurance and Financial Services at (877) 999-6442. 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?

Once the Department receives your complaint, it will forward a copy to your health insurer and ask for a response. For policies issued before July 1, 2016, the insurer has 35 days to respond to the complaint. For policies issued...

How do I file a complaint?

If you are a Michigan resident and your insurer still 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, email address, and...

How long will the external review process take?

Issue with your policy. If your case involves a decision regarding part of your insurance contract or policy, the Department has 14 calendar days to give you a decision. Question of medical necessity. If the medical necessity of your treatment is at...

How do I request an external review?

You should submit your request for external review to the Michigan Department of Insurance and Financial Services (“Department”) within 60 days from the date that your insurer sent you the final decision. If you are requesting an expedited external review,...

What if my insurer denies my coverage after an internal grievance?

You are entitled by law to request an external review from an independent third party, which means your insurer no longer has the final say over whether to approve a treatment or pay a claim. Under Michigan law, you are...

How long should the internal grievance process take?

The internal grievance process should take a maximum of 30 calendar days plus an additional ten business days if your insurer has not received requested information from a health care provider or health care facility.[3] The expedited grievance process should take...

How do I file an internal grievance?

If your insurer denies your claim, you have the right to submit an internal grievance.[1] This means you can ask your insurer to conduct a full and fair review of its decision. To file a grievance, you should do the following:...

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