If you are a Colorado resident and your insurer denies your coverage after the external review process, you can file a complaint with the Colorado Division of Insurance (“Division”).

Your complaint should include the following information:

• The name, address, email address, and telephone number of the person filing the complaint (“Complainant”);
• The name of the insured individual, if different from the Complainant;
• The names of any other parties involved in the claim (for example, the plan administrator);
• The name of insurance company and the type of insurance;
• The state where the insurance plan was purchased;
• Claim information, including the policy number, certificate number, claim number, dates of denial, and amount in dispute;
• The reason for and details of the complaint; and
• What you consider to be a fair resolution.

You should also submit the following documents as supporting information:

• A copy of your insurance card; copies of coverage denials or adverse benefit determinations from your insurer;
• Copies of any determinations made by internal and external reviewers;
• Any materials submitted with prior appeals and complaints;
• Supporting documentation from your health care provider;
• A copy of your insurance policy; and
• All responses from your insurer.^[16]

You can locate and submit the complaint online here.