Now that I've filed a complaint, what can I expect?
Once you submit your complaint electronically, we’ll immediately send you a confirmation email with instructions on how to log in and view your case.
It takes an average of 30 days from the time we receive your complaint until we finish our investigation. If your complaint involves a unique or complex problem, it could take longer. Once we receive your complaint, we’ll contact the insurance company and present your complaint.
Once we hear back from the company, we’ll review their response and make sure they’re following the law and the terms of your policy. If we’re not satisfied with their response, we’ll advocate on your behalf. We also can help you understand what your policy covers and may suggest steps you can take to resolve your issue.
We’ll contact you when the investigation is closed, and your complaint will become a permanent part of the company’s public record with our office. Unfortunately, we do not have authority over all insurance plans and we can’t help in every case.
Can anyone else see my personal information through the Consumer Complaint Center?
Yes. Our consumer protection staff working on your case can view your information while your case is open. After your case is closed it becomes part of our public records. See our confidentiality statement.
If you can't help me, where else can I go for help?
There are some limitations on what we can do. We may not be able to help if your complaint is against a third-party administrator (someone who manages health care or liability claims on behalf of an employer) or if it involves provider networks or a self-funded health or liability plan.
We cannot give you legal advice, recommend or rate an insurance company, or make medical judgments. We also cannot identify someone else’s insurance company or resolve disputes of fact between you and an insurance company, such as the amount of money owed to you or who is at fault.
If your complaint involves any of the health plans or issues listed below, the following agencies may be able to help you:
- If your complaint involves the Washington Healthplanfinder (the Exchange): Washington Healthplanfinder (www.wahealthplanfinder), 855-923-4633
- If your complaint involves a workers’ compensation claim: Washington State Department of Labor and Industries (www.lni.wa.gov), 360-902-5800
- If your complaint involves a federal health or life insurance plan: U.S. Office of Personnel Management (www.opm.gov), 202-606-1800
- If you’re insured through the U.S. military: TRICARE (www.tricare.mil)
- You bought your policy in another state, find that state's insurance commissioner’s office using this list of all the insurance commissioners' websites (www.naic.org)
- You're covered by Washington Apple Health: contact the Washington State Health Care Authority at 800-660-9840
- If you are covered by the Uniform Medical Plan, contact the Washington State Health Care Authority at 800-762-6004