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

You can contact the North Dakota Department of Insurance at (800) 247-0560. 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?

The Department will review your complaint and attempt to resolve the issue with your health insurer. Within a week of receiving your complaint, you will receive a written acknowledgment. In most cases, an investigator will send a copy of your...

How do I file a complaint?

If you are a North Dakota resident and your insurer denies your coverage after the external review process, you can file a complaint with the Department. You can find a copy of the complaint form here. Complaint information. Your complaint should include...

How long will the external review process take?

The external review process should take no more than 45 days from the date your request is accepted by the external review organization for review.[9] If you request an expedited external review, the process should take no longer than 72 hours...

How do I request an external review?

You should submit your request for an external review to either your health insurer or the North Dakota Department of Insurance (“Department”) by mail to the following address:[6] North Dakota Department of Insurance 600 E. Boulevard Ave., #401 Bismarck, ND...

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 North Dakota law, you are entitled to request an...

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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