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Insurance Appeal Rights by State

Every state has its own insurance regulator, appeal deadlines, and external review process. Find your state below for specific guidance on fighting your denied claim.

50 state guides available · 50 states listed

Most-Searched States

Detailed appeal guides with state-specific laws, regulators, and deadlines.

CA

California

Regulator: DMHC / CDI

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FL

Florida

Regulator: Office of Insurance Regulation

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IL

Illinois

Regulator: Dept of Insurance

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NY

New York

Regulator: DFS

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PA

Pennsylvania

Regulator: Insurance Dept

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TX

Texas

Regulator: TDI

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All 50 States

Find your state regulator and appeal resources. States with a guide link have detailed appeal walkthroughs.

AL
Alabama
Dept of Insurance
Guide →
AK
Alaska
Division of Insurance
Guide →
AZ
Arizona
Dept of Insurance (ADOI)
Guide →
AR
Arkansas
Dept of Insurance
Guide →
CA
California
DMHC / CDI
Guide →
CO
Colorado
Division of Insurance
Guide →
CT
Connecticut
Insurance Dept
Guide →
DE
Delaware
Dept of Insurance
Guide →
FL
Florida
Office of Insurance Regulation
Guide →
GA
Georgia
Office of Commissioner of Insurance
Guide →
HI
Hawaii
Dept of Commerce & Consumer Affairs
Guide →
ID
Idaho
Dept of Insurance
Guide →
IL
Illinois
Dept of Insurance
Guide →
IN
Indiana
Dept of Insurance
Guide →
IA
Iowa
Insurance Division
Guide →
KS
Kansas
Dept of Insurance
Guide →
KY
Kentucky
Dept of Insurance
Guide →
LA
Louisiana
Dept of Insurance
Guide →
ME
Maine
Bureau of Insurance
Guide →
MD
Maryland
Insurance Administration
Guide →
MA
Massachusetts
Division of Insurance / OPP
Guide →
MI
Michigan
DIFS
Guide →
MN
Minnesota
Commerce Dept
Guide →
MS
Mississippi
Dept of Insurance
Guide →
MO
Missouri
Dept of Commerce & Insurance
Guide →
MT
Montana
Commissioner of Securities & Insurance
Guide →
NE
Nebraska
Dept of Insurance
Guide →
NV
Nevada
Division of Insurance
Guide →
NH
New Hampshire
Insurance Dept
Guide →
NJ
New Jersey
DOBI
Guide →
NM
New Mexico
Office of Superintendent of Insurance
Guide →
NY
New York
DFS
Guide →
NC
North Carolina
Dept of Insurance
Guide →
ND
North Dakota
Insurance Dept
Guide →
OH
Ohio
Dept of Insurance
Guide →
OK
Oklahoma
Dept of Insurance
Guide →
OR
Oregon
Division of Financial Regulation
Guide →
PA
Pennsylvania
Insurance Dept
Guide →
RI
Rhode Island
Dept of Business Regulation
Guide →
SC
South Carolina
Dept of Insurance
Guide →
SD
South Dakota
Division of Insurance
Guide →
TN
Tennessee
Dept of Commerce & Insurance
Guide →
TX
Texas
TDI
Guide →
UT
Utah
Insurance Dept
Guide →
VT
Vermont
Dept of Financial Regulation
Guide →
VA
Virginia
Bureau of Insurance
Guide →
WA
Washington
OIC
Guide →
WV
West Virginia
Offices of the Insurance Commissioner
Guide →
WI
Wisconsin
Office of the Commissioner of Insurance
Guide →
WY
Wyoming
Insurance Dept
Guide →

Rights That Apply in Every State

ACA Internal Appeal

Under the Affordable Care Act, every insured person has the right to at least one level of internal appeal. Your insurer must respond within 30 days (pre-service) or 60 days (post-service). Urgent cases: 72 hours.

External Review

After exhausting internal appeals, you can request an independent external review. An outside physician reviews your case. The decision is binding on your insurer in most states.

ERISA Protections

If your insurance comes through an employer, ERISA provides federal appeal rights. You get at least one full internal appeal, access to your claim file, and the right to external review.

State Insurance Complaints

Every state has an insurance department that accepts consumer complaints at no cost. Filing a complaint creates a regulatory record and can prompt the insurer to re-review your denial.

Don't Know Where to Start?

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