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

Your complaint should include the following information:

  • The name, address, email address, and telephone number of the person filing the complaint (e., complainant);
  • The name of the insured individual, if different from the complainant;
  • The name of insurance company and the type of insurance;
  • Claim information, including the policy number, certificate number, and claim number, date of denial, and amount in dispute;
  • The reason for and details of the complaint.

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.[14]

The complaint and supporting documents may be submitted online here. Alternatively, the complaint and supporting documents can be faxed to (404) 657-8542 or mailed to:[15]

Georgia Department of Insurance
2 Martin Luther King Jr. Drive, Suite 716, West Tower
Atlanta, Georgia 30334