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