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