Please review the following information before filing a complaint.

or Call 1-800-332-6148

How to file a complaint

• Click the ‘File an Insurance Complaint’ tab on either the Home page or the Consumer page. 
• When your complaint is received, a file number will be assigned and you will be sent written notification of that number. Please refer to the complaint file number when you call or write to the Department.
• When a response to the complaint is received from the company or producer, a Compliance Specialist will review the complaint and response.
  
  This review will result in one of the following actions:
• If the complaint has been resolved, the complaint will be closed and you will be sent a letter;
• If an insurance law has been violated, the Department will request corrective action;
• If the company is not abiding by the policy, the Department will request corrective action;
• If the insurer or producer has not responded to all questions or has not investigated the complaint thoroughly, the Department will require them to do so;
• If no violation of Montana insurance law is found, a letter will be sent to you with an explanation of the finding and notice that the investigation is being closed.
• In each instance, you will receive a written response from the Department explaining the results of our investigation.

Before filing a complaint

1. Contact the insurance company or agent and bring the problem to their attention. Document your phone calls by noting the name of the person you speak to, the date of the call and a brief summary of the conversation. Keep copies of all written communications.
2. If you are not satisfied with the results you receive, contact the Department of Insurance for assistance. Compliance Specialists are available to answer general questions by phone at our toll-free Consumer Assistance Hotline (800) 332-6148 or in Helena 444-2040.
   However complaints must be submitted in writing.

What types of complaints does the Department of Insurance handle?

We handle most insurance problems involving home, business, auto, health, life, etc. Those problems may include coverage issues, claim disputes, premium problems, sales misrepresentations, policy cancellations, and refunds, just to name a few.  We will also investigate complaints against insurance agents, adjusters and consultants.

Where else can I go for help?

For more help with specific issues, check the list of organizations below. They may be able to assist you, if we can't:

• If you are covered under a Medicare, Medicare Advantage, or Medicare Part D drug plan, contact the Centers for Medicaid and Medicare Services at 1-800-MEDICARE          1-800-633-4227.
• If your complaint involves a workers’ compensation claim, contact the Workers’ Compensation Claims Assistance Bureau (406) 444-1574.   
• If your complaint involves a federal health or life insurance plan, contact the U.S. Office of Personnel Management at (202) 606-1800.
• If you’re insured through the U.S. military and a Montana resident, contact TRICARE at 1-888-874-9378.    
• If you bought your policy in another state, contact that state’s insurance commissioner’s office.
• If you are covered by a self-funded employer health plan, contact the U.S. Department of Labor at 1-866-444-3272 or your employer.

The Department of Insurance cannot:

• Act as your legal representative or give you legal advice;
• Intervene in a pending lawsuit, on your behalf;
• Consult with you if you are represented by an attorney unless we have your attorney’s written permission;
• Recommend an insurance company, producer or policy;
• Identify an insurance company with whom a particular person may have a policy;
• Resolve a dispute between you and your insurance agent or company when the only evidence is your word against the word of the producer or company;
• Make medical judgments;
• Cannot determine the value of damaged or stolen property or conclude who was at fault for an accident;
• Establish the facts surrounding a claim (such as who is being truthful when there are differing accounts of what happened);
• Address plans or companies that are not subject to the insurance laws of Montana or that are governed by other state or federal agencies.  For example, we have no regulatory authority over MMIA (Montana Municipal Insurance Authority) as they are not an insurance company. Also, we do not have regulatory authority over rental car agencies as they are usually self insured. 

The Department of Insurance does not have jurisdiction over the following plans:

• State Sponsored Self-Insured Health Plan for Teachers and State Employees;
• Self-Funded Employee Health Benefit Plans.  Many large employers provide health benefits for their employees through self-insured plans. Although self-insured plans are frequently administered by an insurance company, it is the employer and not the insurance company that bears the risk for paying claims.
• Federal Employees’ Health Plan and Life Insurance
• Medicare Advantage or Medicare Part D
• Medicaid
• State Fund Workers Compensation
• Any governmental plans