If complaints to the Insurance Commissioner’s Office about an auto, homeowner or health insurance policy do not provide a suitable solution to your issue, you may take part in a formal process called “arbitration”. In arbitration, you file a formal complaint against a company, somewhat like a lawsuit, but instead of a judge and jury, the case is decided by independent experts. For cases involving home or auto insurance, the matter is decided by a three-person panel made up of an attorney and two insurance adjusters who have no interest or stake in the case. For health insurance, it is a single expert.
Arbitration is available only after several attempts to resolve the matter informally have failed and will require a $50 filing fee for home and auto cases or a $75 filing fee for health insurance matters. Arbitration is not available to contest health insurance policy denials based on medical necessity.
Attorneys wishing to be considered as arbitration panel members may submit a resume to the Department of Insurance. Please direct your communication by email to: DOI-Legal@state.de.us.
Provider Health Care Reimbursement Arbitration (Regulation 1313):
Primary Care and Chronic Care Management Services (Regulation 1319):