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NEW Online Insurance Complaint Process for Providers and Patients
By the FCA   
Thursday, 05 May 2016

In response to FCA advocacy, the Department of Financial Services, Division of Consumer Services, has made recent changes to their Insurance Complaint form to make it easier for you and your patients to file a complaint for any insurance claim denials, reductions, or delays. 

 
Appearing below are the easy steps for you and your patients to file an Online Insurance Complaint for your health insurance and all other forms of insurance complaints.  You can also download a PDF file of these instructions.
 
In preparation, please make sure you have the following:
Full name of the insurance company involved
Your patient's name and contact information 
Your patient’s Policy number and Claim number (if any)

Under Florida law, an insurance company is required to respond within 20 days to your complaint.1   However, if the company information is incorrect, it may extend that response date.
 
 
complaint form revised 600
  
  
 
   
   120.121(2)(h)2, Florida Statutes:  Any person licensed or issued a certificate of authority by the department or by the Office of Insurance Regulation shall respond, in writing, to the Division of Consumer Services within 20 days after receipt of a written request for information from the division concerning a consumer complaint. The response must address the issues and allegations raised in the complaint. The division may impose an administrative penalty for failure to comply with this subparagraph of up to $2,500 per violation upon any entity licensed by the department or the office and $250 for the first violation, $500 for the second violation, and up to $1,000 per violation thereafter upon any individual licensed by the department or the office.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

  120.121(2)(h)2, Florida Statutes:  Any person licensed or issued a certificate of authority by the department or by the Office of Insurance Regulation shall respond, in writing, to the Division of Consumer Services within 20 days after receipt of a written request for information from the division concerning a consumer complaint. The response must address the issues and allegations raised in the complaint. The division may impose an administrative penalty for failure to comply with this subparagraph of up to $2,500 per violation upon any entity licensed by the department or the office and $250 for the first violation, $500 for the second violation, and up to $1,000 per violation thereafter upon any individual licensed by the department or the office.