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File a complaint
Attention: If you have an inquiry or a question relating to insurance, please do not use the online complaint database, as it is for complaints only.
If you have questions relating to insurance, please email us at insurance@nd.gov or call our consumer hotline at 1.800.247.0560.
For complaints involving medical records, such as health and injury claims or life insurance issues, please do not submit the complaint online. In order to process the complaint, a signature is required. Instead, please use the paper forms (SFN 19050 or SFN 18956) available at the bottom of this page.
Before filing a complaint, please make sure you have considered your other options:
- Have you contacted your agent for help?
- Have you written the company for help?
- Have you sent the insurance company the information they requested?
- Have you asked the company to explain the reason for not paying your claim?
- Have you asked to have your claim reviewed by the medical review board (for example, the medical review board of Blue Cross/Blue Shield - Noridian)
How to file the complaint:
For complaints via regular mail, please download, print, and fill out this form.
You may file an online complaint here.
You may also request a form by calling 1.800.247.0560 or by emailing us at insurance@nd.gov.
Your completed complaint form gives us authorization to review your concerns and provides the information necessary to pursue our investigation.
Describing your complaint.
- Provide a factual description of your problem--What happened, who was involved and why you think you have been wronged.
- Describe how you have tried to resolve the problem.
- If the complaint involves a dependent under family coverage, identify the person named on the policy.
- If your complaint is against someone else's insurance company (for example, the other driver's), include his or her name and policy number and your claim number.
- State what you want the company or agent to do (pay claim, make refund, etc.)
Whether you file your complaint online or via mail, to adequately research your complaint, we will need copies of all relevant documents that you may have. Please send us copies (not originals) of the following:
- Letters you have written the insurance company or agent concerning the problem and letters they have written you.
- Your insurance policy or (for group health insurance) the part of your benefits handbook concerning the disputed coverage. Mark the section you think supports your complaint.
- Letters written by other persons (your doctor or lawyer, for example) concerning the problem.
- Sales literature or worksheets (if these are relevant).
- The claim you filed with the insurance company.
- Any other documents that are pertinent to your problem (for example, annual statements, claims, estimates or medical records.
Please DO NOT send doctor or hospital bills, unless there is a specific problem with the bill itself.
What happens after I file the complaint form and how soon will I hear from the Department?
Within a week after we receive your complaint, you will receive an acknowledgement letter from the investigator working on your complaint.
If your complaint does not require us to contact the insurance company or agent, you will receive written answers to questions you may have raised or an explanation of why we cannot handle your complaint.
What contact will be made with the insurance company?
In most cases, the investigator will send the company a copy of your complaint, asking for an explanation of its position.
After the company responds, we should determine within three weeks whether we must take any further actions.
If the company agrees to resolve your problem, the investigator will send you a verification letter.
Should I call to check on the investigation's progress?
You do not need to call. We will keep you informed.
If you have additional information, put it in writing, include your file number, and send the letter to your investigator.
What if the company refuses to correct my problem?
If we see no evidence of violations or if the nature of your complaint exceeds our authority, you will receive a letter explaining that we are closing the investigation and the reason why.
If the investigator is not satisfied with the company's response, we will continue to work on the case. That may involve additional letters and telephone calls to the company.
What does the Insurance Department do?
The Insurance Department makes sure all companies and agents selling insurance in North Dakota obey state insurance laws.
The Department provides consumer information and investigates complaints about companies or agents.
What kinds of problems can the Department handle?
Most insurance problems: home, auto, health, life, credit insurance, annuity plans, dental, etc.
Problems involving insurance coverage or claims, sales misrepresentations, policy cancellations, and refunds.
Things the Department CANNOT do:
- Act as your lawyer or give you legal advice.
- Recommend or rate insurance companies.
- Force the company to satisfy you if no laws have been broken, even if you believe the company or agent has been unfair.
- Handle problems with your employer's health plan, if it is self-funded and does not involve an insurance company.
Complaint checklist
Did you remember to:
- Complete the form?
- Provide full explanation?
- Include names and addresses of agent and company?
- Include your policy number?
- Include copies of documents?
- Include your address and daytime telephone number?
- Mail any and all documents relevant to the complaint?
Send your completed complaint form to:
North Dakota Insurance Department
State Capitol, fifth floor
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
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| Current as of Friday, August 07, 2009 |
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