Internal and External Grievance Procedures
An Indiana consumer who is enrolled under a health maintenance organization contract or is insured under an accident/sickness insurance policy has the right to file a grievance and an appeal of a grievance decision with the insurance company. Each company is required to develop procedures and file them with the Department of Insurance.
When you receive a denial, your Explanation of Benefits (EOB) form will include details on how to file a grievance. It is important to follow the deadlines stated in your EOB or your policy or certificate, which will also include a toll free number and mailing address.
The filing procedures as provided by the insurance companies can also be found by clicking on the insurance company name below. Your insurance company’s customer service number is the best place to start with questions regarding the grievance process. If they are unable to help, you may contact the IDOI’s Dawn Parry at 317-232-2396 or toll free 800-622-4461.