Denied by Anthem Blue Cross Blue Shield CT, ConnectiCare, Aetna, Cigna, or UnitedHealthcare? Connecticut gives you binding external review and powerful prompt pay protections with 12% interest penalties. ClaimBack writes your appeal in 3 minutes.
Check My Claim Free →Takes 3 minutes · No login required · CID-ready letters
Connecticut offers strong consumer protections through the Insurance Department, binding external review, the Prompt Pay Law with 12% interest penalties, and the landmark Chronic Condition Coverage Act for ongoing treatment.
The Connecticut Insurance Department regulates all insurance companies in the state and is committed to consumer protection. CID's Consumer Affairs Division investigates complaints, enforces regulations, and recovers money for consumers — $23 million recovered in 2024 alone. CID also administers the External Review Program for health insurance denials. Connecticut additionally has an Office of the Healthcare Advocate (OHA) that provides free assistance with disputes.
Under Conn. Gen. Stat. §38a-591g, after exhausting internal appeals, you can request an independent external review through CID. Eligible denials include medical necessity, experimental/investigational treatment, eligibility disputes, and rescission of coverage. The CID Commissioner assigns an independent review organization to your case. Standard reviews are completed within 45 days. Expedited reviews for urgent cases resolve within 4 business days. For urgent care, internal appeal requirements can be waived.
Internal appeal: 72 hours for urgently needed care, 30 days for pending treatment, 60 days for treatment already received. For chronic conditions under the CCCA: extended to 120 days. External review through CID: standard 45 days, expedited 4 business days. Prompt Pay Law: insurers must resolve claims within 30 days (electronic) or 45 days (paper) — failure triggers 12% annual interest plus attorney fees.
The Chronic Condition Coverage Act (CCCA, effective July 2024) extends appeal deadlines to 120 days for chronic conditions and requires insurers to continue coverage during appeals for treatments received for 90+ days. The Prompt Pay Law (§38a-478) imposes 12% interest penalties on delayed claim payments. Connecticut also mandates mental health parity under §38a-488a/514, autism coverage including ABA therapy with no age cap, and has strong network adequacy requirements.
Three steps. No jargon. No legal degree required.
In Connecticut, first complete your insurer's internal appeal process. Your insurer must respond within 72 hours for urgent care, 30 days for pending treatment, or 60 days for treatment already received. For chronic conditions under the CCCA, appeals have 120 days. If the internal appeal is denied, you can request an external review through the Connecticut Insurance Department (CID). An independent review organization will issue a binding decision.
The Connecticut Insurance Department's External Review Program under Conn. Gen. Stat. section 38a-591g provides independent review for denials based on medical necessity, experimental/investigational treatment, eligibility, and rescission of coverage. The CID Commissioner assigns your case to an independent review organization. Standard reviews are completed within 45 days. Expedited reviews for urgent cases are resolved within 4 business days. CID recovered $23 million for consumers in 2024.
The Chronic Condition Coverage Act (CCCA), effective July 2024, created specialized appeal pathways for patients with chronic conditions. It extends the appeal deadline to 120 days (from 60 days) for chronic condition patients and requires insurers to continue coverage during the appeal process for any treatment the patient has been receiving for more than 90 days, preventing dangerous disruptions in ongoing care.
Connecticut's Prompt Pay Law (Conn. Gen. Stat. section 38a-478) requires insurers to resolve claims within 30 days for electronic submissions or 45 days for paper submissions. If an insurer fails to meet these deadlines, they must pay 12% annual interest on the overdue amount plus attorney fees. This law ensures insurers cannot use delay tactics to avoid paying legitimate claims.
ClaimBack provides AI-assisted document drafting. We are not a law firm and do not provide legal advice.