If you are a Maine resident, you can file a complaint with the Bureau at any time during the appeals process. 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 your employer if your health insurance is through your employer;
  • The name, address, and telephone number of the insurance company;
  • The policy, certificate, or identification number and claim number; and
  • The details of the complaint.

You can find a copy of the complaint form here. You should also submit the following supporting documents:

  • A signed medical records release form (included in the online application);
  • A copy of your insurance card;
  • Any correspondence, including emails, notices, explanations of benefits, and any other communications between you and your health insurer related to the complaint;
  • Records explaining how claim payments were calculated;
  • 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.[21]

The complaint may be submitted online here, faxed to (207) 624-8599, or mailed to:

Maine Bureau of Insurance
34 State House Station
Augusta, ME 04333