Is it permitted that an insurer can give verbal notice of an internal appeal decision, with no written follow-up?
Incorrect!
At the end of the internal appeal process, your insurance company must provide you with a written decision. For certain types of claim denials, if your insurance company still denies a service or payment for a claim, you can ask for an external review. The insurance company’s final determination must tell you how to ask for an external review.
When you receive the final adverse determination for your internal appeal your Insurer is required to provide the Nebraska Department of Insurance’s external review request forms.
Correct!
At the end of the internal appeal process, your insurance company must provide you with a written decision. For certain types of claim denials, if your insurance company still denies a service or payment for a claim, you can ask for an external review. The insurance company’s final determination must tell you how to ask for an external review.
When you receive the final adverse determination for your internal appeal your Insurer is required to provide the Nebraska Department of Insurance’s external review request forms.
