If you are a South Dakota resident and your claim is denied after the external review process, you can file a complaint with the Division.

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;
  • The name of the insurance company;
  • The type of insurance, policy number, and claim number; and
  • A description of the complaint.

Supporting documents. You should submit the following supporting documents with your complaint:

  • A copy of your insurance card;
  • Copies of determination letters from your insurer;
  • Copies of any determinations made by internal and external reviewers;
  • Any materials submitted with prior grievances and complaints;
  • Supporting documentation from your doctor;
  • A copy of your insurance policy; and
  • All responses from your insurer.[15]

How to submit. The complaint may be submitted online here, faxed to (605) 773-5369, or mailed to the following address:

South Dakota Division of Insurance
124 S. Euclid Avenue, 2nd Floor
Pierre, SD 57501[16]