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