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Current as of January 02, 2024 | Updated by Findlaw Staff
Sec. 6. As used in this chapter, “grievance” means any dissatisfaction expressed by or on behalf of a covered individual regarding:
(1) a determination that a service or proposed service is not appropriate or medically necessary;
(2) a determination that a service or proposed service is experimental or investigational;
(3) the availability of participating providers;
(4) the handling or payment of claims for health care services;
(5) matters pertaining to the contractual relationship between:
(A) a covered individual and an insurer; or
(B) a group policyholder and an insurer;
(6) an insurer's decision to rescind an accident and sickness insurance policy; or
(7) a determination concerning a prior authorization request under IC 27-1-37.5;
and for which the covered individual has a reasonable expectation that action will be taken to resolve or reconsider the matter that is the subject of dissatisfaction.
Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-8-28-6 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-8-28-6/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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