If you are a Tennessee resident and your insurer still denies your claim after the external review process, you can file a complaint with the Tennessee Department of Commerce and Insurance, Division of Insurance (“Division”).

Complaint information. 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 than the Complainant;
  • The names of other parties involved;
  • The name of the insurance company, insurance agency, and agent/adjuster/appraiser;
  • The state in which you purchased the plan;
  • The policy number, certificate number, claim number, and date of loss;
  • The type of insurance and reason for the complaint;
  • The details of the complaint; and
  • What you consider to be a fair resolution.[25]

Supporting documents. You should submit the following supporting documents with your complaint:

  • A copy of your insurance card;
  • Copies of determination letters 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.[26]

How to submit. The complaint may be submitted online here, faxed to (615) 532-7389, or mailed to the following address:

Consumer Insurance Services
500 James Robertson Parkway, 6th Floor
Nashville, TN 37243-0574[27]