If you are an Arkansas resident and your insurer denies your coverage after the external review process, you can file a complaint with the Arkansas Insurance Department (“Department”).
Your complaint should include the following information:
- The name, address, email address, and telephone number of the person filing the complaint (i.e., complainant);
- The name of the insured individual, if different from the complainant;
- The names of any other parties involved (for example, the plan administrator);
- The name of insurance company and the type of insurance;
- Claim information, including the policy number, certificate number, and claim number, date of denial, and amount in dispute;
- The reason for and details of the complaint; and
- What you consider to be a fair resolution.[10]
You should also submit the following documents as supporting information:
- 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.[11]
The complaint may be submitted online here, faxed to (501) 371-2749, or mailed to the following address:[12]
Arkansas Insurance Department
Consumer Services Division
1200 West Third Street
Little Rock, AR 72201-1904