The grievance process should take a maximum of 30 business days, regardless of how many internal levels of review your health insurer requires.^[7]

An expedited grievance review should take no longer than 48 hours once your physician certifies that there is a substantial risk of immediate harm if you are not provided the service or treatment or within five days if you are terminally ill.^[8] If you are in the hospital, your health insurer must provide you with a decision about inpatient care prior to your discharge from the hospital.^[9]

Under Massachusetts law, if your insurer fails to provide a decision within the allotted time periods, the insurer must cover the service or treatment you requested.^[10]