Direct answer
To appeal, you must formally request a review through your insurer’s internal grievance department by submitting additional medical documentation that proves the necessity of care. It depends on the specific appeal window stipulated in your policy contract and the documentation of your functional impairment.
National Association of Insurance Commissioners (NAIC) consumer complaint and appeal guidelines. For additional information about the formal appeals process and consumer rights, see the National Association of Insurance Commissioners‘ consumer guide.
What this means for you
To appeal, you must formally request a review through your insurer’s internal grievance department by submitting additional medical documentation that proves the necessity of care. It depends on the specific appeal window stipulated in your policy contract and the documentation of your functional impairment.
FARMER STOCKMAN
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