How can we help you with formal insurance complaints?

This is what we CAN do:

• Forward a copy of your complaint to the insurance company, agent, or broker
• Obtain information and explanations from the insurance company or their representatives. This may involve written or verbal contact.
• Review the information obtained from the company, agent, or broker in detail for compliance with statues, regulations, and policy contracts
• Explain the provisions of your insurance policy
• Suggest actions that you may take which could aid in resolving your insurance problems
• If it is determined that the actions of an insurance company are in violation of a statute, regulation, or policy that the Division enforces, we may take corrective action against that company.

This is what we CANNOT do, but can offer guidance for:

• Assume the role as your legal representative in or out of court, including intervening in a pending lawsuit on your behalf.
• In the case of disability insurance complaints, make a medical decision as to the extent of an individual's disability. We will investigate complaints involving disability insurance to determine (1) whether or not the denial decision is arbitrary or capricious, and (2) whether or not the denial decision was rendered in accordance with the terms of the insurance contract and State insurance laws and regulations.
• Address complaints or inquiries involving insurance contracts that are not subject to the jurisdiction of the insurance laws of the State or matters governed by other State or Federal agencies. We will be able to refer to other agencies that can assist, including:
• Self-funded or self-insured plans (U.S. Dept of Labor)
• Medical Assistance (Medicaid) (NH DHHS)
• Medicare and Medicare HMO's (Medicare.gov) (ServiceLink)\
• Federal Employee Health Benefit Programs (US Office of Personnel Management)
• Workers' Compensation (NH Dept of Labor)
• Contracts issued and delivered to the policy holder in another state (find that state’s insurance department)

What should I do before contacting the NH Insurance Department?

Before you file a complaint with the NHID, you should first contact the insurance company, agent, or broker to resolve the issue(s). If you do not receive a satisfactory response, then you may file a complaint with us. When filing a complaint, please provide as much information as possible. Failure to provide this information may delay or even prevent our ability to be of assistance. Please be aware that a copy of your Complaint will be provided to the insurance company.

In order to effectively begin our investigation, you will need to provide supporting documentation with your complaint. Failure to provide supporting documentation may delay your request. Supporting documentation includes any documents (copies) related to your problems, such as the declaration page of your insurance policy or certificate, cancelled checks, letters of claim denial, or other correspondence. Do not send us originals of any documents, photographs, or other evidence, as we are not responsible for lost records or other items. The more complete the information we receive, the quicker we can identify the issues and begin our review.