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;

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Terms Used In Indiana Code 27-8-28-13

  • covered individual: means an individual who is covered under an accident and sickness insurance policy. See Indiana Code 27-8-28-3
  • department: refers to the department of insurance. See Indiana Code 27-8-28-4
  • external grievance: means the independent review under IC 27-8-29 of a grievance filed under this chapter. See Indiana Code 27-8-28-5
  • grievance: means any dissatisfaction expressed by or on behalf of a covered individual regarding:

    Indiana Code 27-8-28-6

  • insured: means :

    Indiana Code 27-8-28-8

  • insurer: means any person who delivers or issues for delivery an accident and sickness insurance policy or certificate in Indiana. See Indiana Code 27-8-28-9
(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.