Procedures and Forms for Filing

Pursuant to the Federal Health Care Reform, the Delaware legislature has amended Title 18, Section 6416 relating to Independent Health Care Appeals Program (IHCAP). This section allows for a covered person or their representative to file a request for an external appeal within 4 months from receiving an adverse claim decision. Any carrier seeking to submit a request for this appeal type is required to complete the below application and send it electronically.

• Title 18, § 6416 . Independent health care appeals program.
• Regulation 1301 Internal Review, Arbitration and Independent Utilization Review of Health Insurance Claims
• Procedure for IHCAP Application
• Insurer’s Petition for External Appeals Program

The goal of the Insurance Commissioner’s Consumer Services Division is to protect, advocate for and inform consumers of their rights and options when it comes to insurance. Please feel free to contact the Consumer Services Division with general questions you have about insurance or if you have problems or complaints by email, or call 1-800-282-8611 in Delaware or (302) 674-7310.