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

You can contact the New York Department of Financial Services at (212) 480-6400 or (800) 342-3736. The Department is open from 8:30 a.m. to 4:30 p.m. Monday through Friday.

What happens after the Department receives my complaint?

The Department will review your complaint to determine if the Department can assist you. You will be notified if the Department has decided not to review your case. Otherwise, the Department will attempt to resolve your complaint with your health...

How do I file a complaint?

If you are a New York resident and you believe your insurer did something illegal or unethical, you can file a complaint with the Department. Complaint information. Your complaint should include the following information: The name, address, email address, and telephone...

How long will the external review process take?

The external review process should take no more than 30 days from the date the external appeal agent receives your request. If you requested an expedited external review, the process should take no longer than 72 hours after your request...

How do I request an external review?

You should submit your request for external review to the New York Department of Financial Services (“Department”).[10] You must submit your request within four months from the date of the determination letter from the first level of appeal even if your...

In what circumstances can I apply for an external review?

During an external review, an independent third party reviews your insurer’s decision.[8] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. Under New York law, you are entitled to request an...

How long should the internal appeals process take?

The internal appeal process, including both first level and second level appeals, should take a maximum of 30 days if you have not yet received the requested service or treatment and a maximum of 60 days, including both first level...

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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