Indiana Code
Chapter 10. Comprehensive Health Insurance
27-8-10-2.6. Member and Health Care Provider Grievances

Sec. 2.6. (a) If a:
(1) member is aggrieved by an act of the association; or
(2) health care provider is aggrieved by an act of the association with respect to reimbursement to the provider under an association policy;
the member or health care provider shall, not more than ninety (90) days after the act occurs, appeal to the board of directors for review of the act.
(b) If:
(1) within thirty (30) days after an appeal is filed under subsection (a), the board of directors has not acted on the appeal; or
(2) a member or health care provider is aggrieved by a final action or decision of the board of directors;
the member or health care provider may appeal to the commissioner.
(c) An appeal to the commissioner under subsection (b) must be filed less than thirty (30) days after the:
(1) expiration of the thirty (30) day period specified in subsection (b)(1); or
(2) action or decision specified in subsection (b)(2).
(d) The commissioner shall, not more than forty-five (45) days after an appeal is filed under subsection (c), take a final action or issue an order regarding the appeal.
(e) A final action or order of the commissioner on an appeal filed under this section is subject to judicial review.
(f) If a member or health care provider sues the association, the court shall not award to the member or health care provider:
(1) attorney's fees or costs; or
(2) punitive damages.
As added by P.L.51-2004, SEC.6.