STATE OF CONNECTICUT
Thomas B. Leonardi
Insurance Department – On The Road to Health Care Reform:
Free Help For Consumers Over Claims/Coverage Disputes
With fewer than two weeks remaining until individuals and small businesses can enroll for health insurance at Access Health CT
, in the state-sponsored health insurance exchange, the Department will provide regular updates to help consumers understand their options and rights under the new federal law.
Health Insurance Tip – Use CID ‘Road Map’ To Navigate Claims Process
When your car breaks down on the side of the road you call for roadside assistance to get you going again. The Insurance Department offers its own free “roadside assistance” when policyholders get bogged down in the complexities of health insurance claims and denials.
The Department’s “Appeals and External Review Guide”
is now updated to reflect changes in state and federal laws governing health insurance and health care reform. The new guide is a user-friendly “road map” to help consumer navigate the claims process and file appeals when disputes arise. Consumers have rights when it comes to insurance and the Department will ensure those rights are upheld. They include:
The right to appeal denials directly to insurance companies
The right to ask for an independent review on medical determinations through the Insurance Department
The right to ask for a 24-hour expedited review of a behavior health services denial
For more information, visit the Department’s External Review
page for a copy of the Guide and appeals applications. Consumers with questions or complaints about health insurance or any insurance issue can contact the Insurance Department either online
or call 800-203-3447
About the Connecticut Insurance Department: The mission of the Connecticut Insurance Department is to protect consumers through regulation of the industry, outreach, education and advocacy. The Department recovers an average of $4 million yearly on behalf of consumers and regulates the industry by ensuring carriers adhere to state insurance laws and regulations and are financially solvent to pay claims. The Department’s annual budget is funded through assessments from the insurance industry. Each year, the Department returns an average of $100 million a year to the state General Fund in license fees, premium taxes, fines and other revenue sources to support various state programs, including childhood immunization.
For help with all your insurance issues: