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‘Consumer Protection Week’ Good Time to Familiarize Yourself With The External Review Law

Superintendent of Insurance Gregory V. Serio today reminded all New York State consumers of their health insurance rights and how to exercise these rights and ensure proper access to critical care under the State's External Review Law. This landmark reform has been so successful that more New Yorkers are exercising their rights under this Law than consumers in any of the other 41 states with External Review Laws.

"Consumers in New York State, now more than ever, have power in determining their medical treatments," said Serio. "’Consumer Protection Week’, which runs from February 3rd- 9th prompts us to remind consumers of their health insurance rights and their ability to utilize the power to ensure proper medical treatment."

The External Appeal Law which went into effect in July 1999 empowered consumers by giving them the right to an independent review of a health plan’s decision to deny coverage on the grounds that the service is not medically necessary or is experimental.

"Our priority as insurance regulators is to protect consumers in New York State and the external appeal process means that treatment decisions for patients will be made because they are smart medical choices and not simply sound financial decisions," added Serio. "I am pleased that New Yorkers are exercising their health insurance rights and during this important week I hope more even New Yorkers will become educated about the External Review Law."

As a consumer if you are denied health insurance coverage based on the grounds that the procedure is not medically necessary or is experimental here is how to utilize this Law:

  • Your insurer should provide written notification to patients of their right to an external appeal and how to proceed in filing an external appeal; or
  • Call the Insurance Department’s a toll-free hotline to answer consumer questions about the External Appeal Law. The toll-free number is 1-800-400-8882. The hotline provides consumers with information about their rights under this law. Consumers can also lodge their complaints on the hotline about their insurer’s compliance with the external review law.

In addition to the hotline telephone number, consumers can obtain information about the External Review Law from the Department’s Web site at

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