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

You can contact the Montana Department of Insurance at (800) 332-6148 or (406) 444-2040 (in Helena). 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 your complaint is filed, you will receive confirmation and an assigned file number.[14] A copy of the complaint will be sent to your health insurer who must then provide a response within 21 days. A compliance specialist will then review...

How do I file a complaint?

If you are a Montana resident and you still lack 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 telephone number...

How long will the external review process take?

The external review process should take no more than 45 days from when the external review organization receives your request from your health insurer. If you requested an expedited external review, the process should take no longer than 72 hours...

How do I request an external review?

You should file your request for a standard external review with your health insurer within four months from the date your insurer sent you the final decision. You can request assistance from the Montana Department of Insurance (“Department”) with filing...

In what circumstances can I apply for an external review?

During an external review, an independent third party reviews your insurer’s decision.[3] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. Under Montana law, you are entitled to request an external...

How long should the internal appeals process take?

Your insurer should provide you with a notice of its decision to deny or grant your claim within the following timeframes: 30 days if you have not yet received the requested service or treatment; 60 days if you have received...

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 take the following steps...

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