If you are experiencing issues with your health insurance company and feel your concerns are not being adequately addressed, you have the right to report your concerns to the Massachusetts Division of Insurance (DOI). Information about this process can be found here: https://www.mass.gov/doi.
When Should You File a Complaint?
You may file a complaint if you believe your insurance company is:
- Denying a legitimate claim.
- Delaying processing of claims or pre-approvals.
- Not adhering to its policy terms and conditions.
- Providing poor customer service or lack of response.
Steps to File a Complaint:
- Gather Documentation: Collect all relevant documents, including your insurance policy, correspondence with your insurer, claim denials, or other related materials.
- Complete the DOI Complaint Form: Visit the Massachusetts DOI website and complete their complaint form here: https://www.mass.gov/how-to/filing-an-insurance-complaint. You may also call their Consumer Services Unit at 617.521.7794 for guidance.
- Submit Your Complaint: Online through the DOI website or by email or postal mail using the contact details provided on the website.
What Happens Next?
Once your complaint is submitted, the Division of Insurance will review your case and may contact you for additional information. They will also communicate with your insurance company to seek resolution.