Sec. 13. (a) An insurer shall provide, at the request of the insured, covered individual, or legal representative of the insured or covered individual, and upon policy issuance, at each policy renewal, and with any notice of denial of a claim, timely, adequate, and appropriate notice to each insured, covered individual, or legal representative, of:
(1) the grievance procedure required under this chapter;
(2) the external grievance procedure required under IC 27-8-29;
(3) information on how to file:
(A) a grievance under this chapter; and
(B) a request for an external grievance review under IC 27-8-29;
(4) a toll free telephone number through which a covered individual may contact the insurer at no cost to the covered individual to obtain information and to file grievances; and
(5) the address for the Internet web site established by the department under IC 27-1-3-33.
(b) An insurer shall prominently display on all notices to covered individuals the toll free telephone number and the address at which a grievance or request for external grievance review may be filed.
As added by P.L.66-2001, SEC.2 and P.L.203-2001, SEC.13. Amended by P.L.18-2016, SEC.2.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 28. Internal Grievance Procedures
27-8-28-1. "Accident and Sickness Insurance Policy"
27-8-28-3. "Covered Individual"
27-8-28-5. "External Grievance"
27-8-28-7. "Grievance Procedure"
27-8-28-10. Grievance Procedure to Comply With Chapter Requirements
27-8-28-11. Commissioner May Examine Procedure
27-8-28-13. Notice of Grievance Related Information
27-8-28-14. Filing Grievance; Toll Free Number
27-8-28-15. Assistance in Filing Grievance; Designation of Representative
27-8-28-16. Policies and Procedures for Timely Resolution of Grievances
27-8-28-18. Insurer Prohibited From Taking Action
27-8-28-19. Grievance Procedure Filing; Complaint Analysis and Reporting