Online Insurance Guide

Grievances & Complaints

pillsFile a grievance within your insurance company if:

  • You have a claim denial due to specific benefits exclusions or restrictions.
  • You want to file a formal complaint regarding any aspect of the services provided by your healthcare plan. 

As with the appeals processes, the process for filing a grievance will vary from health plan to health plan. Be sure to call your health plan's customer service department to obtain the specific details on how to file a grievance.

Tips for Communicating with Your Insurance Company

File a complaint with your state’s Department of Insurance if:

  • Your insurance company has denied you medical service(s) or treatment that is covered or that you feel should be covered in your plan.

How to File a Department of Insurance Complaint




Contact us with insurance questions, success stories or suggestions.
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The information provided on the PHA website is provided for general information only. It is not intended as legal, medical or other professional advice, and should not be relied upon as a substitute for consultations with qualified professionals who are familiar with your individual needs. PHA does not endorse or recommend any commercial products or services.

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