The Utah Insurance Department has a staff of insurance experts available to help you understand your insurance coverage and answer your questions. If you have been unable to resolve a problem with your insurance company or agent, you may contact our staff for assistance, or file a written complaint. Most types of complaints can be filed through the GO TO COMPLAINT PORTAL link at the bottom of the page, including:
- Health insurance (see additional information below regarding health insurance complaints
- Life insurance
- Property & casualty insurance
HOW TO FILE A COMPLAINT
- The online process requires that you open an account. When creating your account it is important to MAKE NOTE OF THE PASSWORD you select, it will be required to access the status of your complaint. Once your account has been created, you will be able to access the complaint form and submit your complaint. The purpose of a password-protected account is to provide secure transmission of the complaint and communication to and from the Insurance Department.
- If you are not able to complete your complaint online please contact our office for a printed complaint form to be sent to you.
- Once we receive your complaint:
- Your complaint will be forwarded to the party that you are complaining against for a response.
- We will review the response and provide you with our findings.
- The complaint process usually takes three to four weeks.
HEALTH INSURANCE COMPLAINTSBefore submitting a complaint you will need to know some additional information. If you need to get it from your insurance company, check your insurance identification card for the company's contact information.
- Are you covered under an individual plan or an employer plan?
- What state is the policy written in?
- If you have an employer plan, what type of policy are you covered under — fully-insured (state-regulated) or employer self-funded?
- Your coverage identification card may say whether the policy is a fully-insured or an employer self-funded plan. An employer self-funded plan identification card usually has the words "administered by" along with the company, while a fully-insured plan should have the words "state regulated." Please contact us at 801-957-9280 if you need help determining the type of plan you have.
- If your policy is fully-insured and the policy was issued in Utah, you can file a complaint with our office using our complaint portal.
- If your policy is fully-insured and the policy was issued in a different state, you will need to file a complaint with the Department of Insurance in that state. You can find links to other states at https://content.naic.org/state_web_map.htm.
- If your policy is a self-funded plan, you will need to contact the US Department of Labor (DOL) for assistance with your complaint. The state does not have any authority over employer self-funded plans. The DOL can be reached at:
- If your policy is a Medicare Advantage Plan you will need to contact Medicare at the Centers for Medicare & Medicaid Service (CMS).
- 1-800-MEDICARE (1-800-633-4227)
- Medicare information statewide in Utah 1-877-424-4640
- If your policy is a Medicaid plan you will need to contact Utah Medicaid at 1-800-662-9651 or 801-538-6155.
CLAIM HANDLING LAWS AND RULES
- For information regarding Claim Settlement Practices click here.