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

You can contact the South Dakota Office of Attorney General at (800) 300-1986 (in-state) or (605) 773-4400. The Attorney General’s Office is open from 8:00 a.m. to 5:00 p.m., Monday through Friday. You can contact the Division of Insurance at...

What happens after the Office of Attorney General receives my complaint

Once the Office of Attorney General receives your complaint, an investigator will review it and forward a copy to your health insurer. Your health insurer will have 20 days to respond to your complaint. The Division of Consumer Protection may...

How do I file a complaint with the Office of Attorney General?

If you are a South Dakota resident, you can file a complaint with the South Dakota Office of Attorney General, Division of Consumer Protection (“Division of Consumer Protection”). Complaint information. Your complaint should include the following information: The name, address, email...

What happens after the Division of Insurance receives my complaint?

The Division of Insurance will investigate your complaint and notify you of its findings.

How do I file a complaint with the Division of Insurance?

If you are a South Dakota resident and your claim is denied after the external review process, you can file a complaint with the Division. Complaint information. Your complaint should include the following information: The name, address, email address, and telephone...

Should I file my complaint with the Division of Insurance or the Office of Attorney General?

Both the South Dakota Division of Insurance (“Division”) and Office of Attorney General (“Office”) handle complaints involving health insurance companies. If your case involves a claim dispute (denial of service or treatment, payment for already received services), you should file...

How long will the external review process take?

The external review process should take no more than 60 days.[13] If you requested an expedited external review, the process should take no longer than 72 hours after your request is received by the external review organization.[14]

How do I request an external review?

You should submit your request for an external review to the South Dakota Division of Insurance within four months from when your insurer sent you the final decision.[8] Information. You can find a copy of the external review request form here. Your...

In what circumstances can I apply for an external review?

During an external review, an independent third party reviews your insurer’s decision.[5] Your insurer will no longer have the final say over whether to approve a treatment or pay a claim. Under South Dakota law, you are entitled to request an...

How long should the grievance process take?

The grievance 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 reimbursement.[3] If...

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