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How To File A Complaint

We review complaints to gather information on compliance with law and to detect patterns of wrongdoing and/or fraud. We cannot attempt to resolve or otherwise handle every individual complaint. We will notify you if your complaint is not being individually reviewed. Be aware that we may share a copy of your complaint with the company or individual you are complaining about.

CONSUMERS

PROVIDERS

Consumer Complaint:

Use our Consumer Complaint Form to file a complaint about a financial product or service, or add additional information to an existing complaint.

Prior Approval:

Use our Prior Approval Form to file a Comment about a Health Insurance Rate Increase.

Provider Complaint:

Log in to the DFS Portal and use our Provider Complaint Form if you are a health care provider or representative filing a complaint regarding payment of health insurance, no fault or workers compensation claims, or to add additional information to an existing complaint.

General Questions about Financial Services

If you are unable to find the answer to your questions on our website, submit inquiries and complaints via the following options:

External Appeals

Consumers have the right to an external appeal when health care services are denied by an HMO or insurer as not medically necessary, experimental/investigational, a clinical trial, a rare disease treatment, or, in certain cases, as out-of-network. Your insurer is required to notify you if your denial is eligible for the process. Providers have their own right to an external appeal when these health care services are denied concurrently or retrospectively. External appeal requests must be submitted to the DFS and we will assign independent medical experts to review the appeal. Learn more about External Appeals...

No-Fault Claims and Arbitration

If your case was submitted to the American Arbitration Association (AAA) for arbitration, you should contact them:

American Arbitration Association
Email: nysinsurance@adr.org
Customer Support: (917) 438-1660

If you have won a judgment in a No-Fault Arbitration, you should not normally have any difficulty in collecting from the respondent. If you have not received payment within 30 days of the date of mailing of the No-Fault arbitration award, we suggest that you follow-up with the respondent in writing to advise of the specific elements of the award which remain unpaid and outstanding. If you do not receive a timely response from the respondent, you should seek assistance from the Department of Financial Services. Learn More About No-Fault Arbitration...

Complaint Forms in Other Languages

Updated 07/11/2017

 

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