How To Complain To Regulators About An Insurance Company

How to compalin to the regulators if you have a complaint about how you are treated by your health insurance company or HMO DONE

If you have a complaint against an insurance company, contact your state department of insurance. You can find the contact information at www.naic.org or www.consumeraction.gov/insurance.shtml

The federal government has created a website with a list of state and local consumer agencies. The list is arranged by the types of issues they oversee. You can find the appropriate agency in your state at: www.usa.gov/directory/stateconsumer/index.shtml. You can find federal agaencies at: www.usa.gov/directory/federal/index.shtml

If you have a complaint against an HMO: In addition to complaining to the regulators, complain to The Joint Commission on Accreditation of Healthcare Organizations Organizations (JCAHO). You can contact JCAHO by e mail, fax or regular mail.

  • E-Mail: complaint@jcaho.org
  • Fax: Office of Quality Monitoring Tel.: 630.792.5636
  • Mail: Office of Quality Monitoring
    Joint Commission on Accreditation of Healthcare Organizations
    One Renaissance Boulevard
    Oakbrook Terrace, IL 60181
  • Telephone: 800.994.6610

Include in your complaint letter:

  • The name and address of the insurance company or HMO
  • The policy number
  • Your name, address, and daytime telephone number
  • The name of the insured if other than you
  • A brief description of the problem. Attach copies of any relevant documents.

Of course make a copy for your files of everything you send.

Follow-up within a week after mailing or faxing your complaint to be sure it was received and to find out the name of the person who will be handling your complaint. Follow up with that person on a periodic basis - weekly if necessary.