If you are a Virginia resident and have completed the internal and external review processes, you can file a complaint with the Bureau.

Complaint information. Your complaint should include the following information:

  • The type of insurance;
  • The name, address, email address, and telephone number of the patient;
  • The name, address, email address, telephone number, and relationship to patient of the person filing the complaint (“Complainant”);
  • The name of the insurance company;
  • Policy number, certificate number, or identification number; and
  • A description of the issue.

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

  • 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 doctor;
  • A copy of your insurance policy; and
  • All responses from your insurer.[18]

How to submit. The complaint may be submitted by fax to (804) 371-9944, or by mail to the following address:

State Corporation Commission
Bureau of Insurance
Life and Health Division
P.O. Box 1157
Richmond, VA 23218[19]