You should submit your request for external review to the Hawaii Division of Insurance (“Division”) within 130 days from of your insurer’s last determination letter.[9] To request an external review, you should take the following steps:

  • Request documents from your insurer. Ask your insurer for a copy of the final determination letter from the internal appeal, a signed consent to release your medical records, and a conflict of interest disclosure form.[10]
  • Prepare a cover letter. Prepare a cover letter to the Division. The cover letter should contain the following information:
  • Whether you are requesting a standard or an expedited external review;
  • An explanation, in detail, why you believe you are entitled to the coverage or reimbursement that you are seeking;[11] and
  • An explanation of why you believe the denial of coverage in your case was wrong.[12]
  • Send a filing fee. You should send a check for $15, made payable to the “Department of Commerce and Consumer Affairs” along with your applicable. The filing fee is refundable if the Division determines that your insurer should have covered your claim.[13]
  • Submit your request. Send your request for an external review and supporting documents to the Division at the following address:
  • Division of Insurance
    P.O. Box 3614
    Honolulu, HI 96811