The Minnesota Department of Commerce regulates the insurance industry to protect consumers and ensure a fair and competitive marketplace. Commerce investigates complaints on behalf of consumers and works to resolve disputes between consumers and insurers.
Commerce is here to help
Health insurance is complex and difficult to navigate for even the most savvy consumer. You will find in this section basic information on buying health insurance and making the most of your coverage.
Learn more about Minnesota's rate review process and explore Medicare options.
Making a complaint
If you have a health insurance claim that has been denied by your health plan, you have the right to appeal that denial. The first thing you should do is contact your health plan and ask for more information on why the claim was denied. This is the first step in the internal appeals process and insurance companies are required to address your complaint within a strict timeline.
If you are still are not satisfied with the health plans's denial of your claim you may be able to request an external review. Review your summary of benefits on the appeals process.
For the external appeals process, Commerce will work with an impartial third party to to determine if the denial was justified. The health plan must follow the decision. However, if you are not satisfied with the result of the decision you have the right to appeal the decision in court.
File an External Appeal