If you are a Louisiana resident and your insurer denies your 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, and telephone number of the person filing the complaint (“Complainant”);
- The name of the insured individual, if different than the Complainant;
- The name and address of insurance company;
- The name of the employer, if it’s a group policy;
- The policy number, group number, claim number, and date of loss or date of claim;
- The reason for your complaint and a description of the problem; and
- What you consider to be a fair resolution.
Supporting documents. 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 correspondence between you and the insurance company;
- 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.[19]
How to submit. The complaint may be submitted online here or mailed to the following address:
Louisiana Department of Insurance
P.O. Box 94214
Baton Rouge, LA 70804-9214[20]