If you are a Michigan resident and your insurer still 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, email address, and telephone number of the person filing the complaint (“Complainant”);
  • The name of the insured individual, if different than the Complainant;
  • The date of the healthcare service;
  • The name of insurance company and name of agent or agency, if applicable;
  • The policy number, group contract number, and name of group/employer, if applicable;
  • The reason for the complaint;
  • The details of the complaint; and
  • What you consider to be a fair resolution.

Supporting documents. You should also 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 grievances and complaints;
  • Supporting documentation from your doctor;
  • A copy of your insurance policy; and
  • All responses from your insurer.[15]

How to submit. You can submit the complaint online here, faxed to (517) 284-8837, emailed to [email protected], or mailed to the following address:[16]

DIFS – Office of Consumer Services
P.O. Box 30220
Lansing, MI 48909-7720