If you are a Montana resident and you still lack 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 names of other parties involved in the claim;
  • The name of insurance company, agency, and/or agent, adjuster, or appraiser, if applicable;
  • Policy number, certificate number, claim number, date of loss or service;
  • The reason for the complaint; and
  • The details of the complaint.[11]

Supporting documents. You should also submit the following supporting documents with your complaint:[12]

  • 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 health care provider;
  • A copy of your insurance policy; and
  • All responses from your insurer.

How to submit. The complaint may be submitted online here, faxed to (406) 444-1980, or mailed to the following address:[13]

Commissioner of Securities and Insurance
Montana Department of Insurance
840 Helena Avenue
Helena, MT 59601