If your insurer still denies your 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 name and address of insurance company;
  • The employer name, if a group policy;
  • Group or certificate number, policy or identification number, effective date, claim number, and date of loss;
  • The reason for the complaint; and
  • The details of the complaint.[21]

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

  • 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 grievances and complaints;
  • Supporting documentation from your doctor;
  • A copy of your insurance policy; and
  • All responses from your insurer.[22]

How to submit. The complaint may be submitted online here, faxed to (573) 526-4898, or mailed to the following address:[23]

Missouri Department of Insurance
P.O. Box 690
Jefferson City, MO 65102-0690