07 Aug 2018

How To File A Complaint Against A Health Insurance Company?

How To File A Complaint Against A Health Insurance Company?

Do you believe you’re being mistreated by an insurance company? If the answer is yes, there are several steps you can take to file a formal complaint with the U.S. Department of Health and Human Services. Today we’re going to break things down an explain everything in detail.

What does the department do?

The U.S. Department of Health and Human Services was established in 1960. As the name suggests, this bureau aims to oversee the health and wellness of all Americans. It also investigates grievances between consumers and health insurance companies. So when you file a complaint against an insurance company, the department creates a file and starts leading the investigation.

How to submit a claim?

You can either submit a claim electronically or physically to the department. In most cases, you’ll have to provide evidence, so taking screenshots of your emails and send in all letters you’ve written and received from the insurance company.

Americans have exactly 180 days to file a complaint to the department. If you fail to abide by this deadline, then the department won’t investigate the incidence, and you’ll be forced to go through the court system. This can result in a lengthy and costly legal battle that can last for years.

The process

Once you submit a claim to the U.S. Department of Health and Human Services, you’ll be assigned an investigator who will begin establishing a case. Don’t expect this process to take a week though, as it can last anywhere from a few months up to a year. During this period, the investigator may conduct interviews and gather additional evidence.

The outcome

Once the investigation is complete, the head investigator will notify the citizen regarding the outcome. The decision of the department can force the insurance company to do the following:

  • Change policy details
  • Provide a service
  • Reinstate an individual to a job
  • Restore lost benefits

If the insurance company does not comply with the decision, the department can take legal action. If you don’t agree with the final decision, you can always file an appeal and have the case re-examined by another investigator.


You can also file a complaint with your state bureau, which can lead a separate independent investigation. For example, in the state of Texas, residents can pursue a claim with the Texas Department of Insurance. For more details, you can always call HealthQuoteInfo at 1-855-614-5057

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