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How to File a Health Insurance Complaint in Pennsylvania
The Pennsylvania Insurance Department handles consumer complaints — here's how to file one.
If you have a dispute with your health insurance company in Pennsylvania, the Pennsylvania Insurance Department (PID) is the state agency that regulates insurers and handles consumer complaints.
Pennsylvania Insurance Department
The Pennsylvania Insurance Department licenses and regulates insurance companies doing business in Pennsylvania and investigates consumer complaints. Filing a complaint is free and requires your insurer to formally respond to the issue.
How to File a Complaint in Pennsylvania
- Online: insurance.pa.gov — use the Consumer Services complaint portal
- Phone: 1-877-881-6388
- Mail: Pennsylvania Insurance Department, Consumer Services Bureau, 1326 Strawberry Square, Harrisburg, PA 17120
What to Include in Your Complaint
- Your policy number and insurance company name
- A clear description of the problem with dates and relevant details
- Copies of denial notices, EOBs, and correspondence with your insurer
- The specific resolution you are requesting
What Happens After You File
The PID will review your complaint and contact your insurer for a formal response within a specified timeframe. You will be notified of the outcome. The PID tracks complaint patterns and uses this data in carrier oversight and market conduct examinations.
External Review in Pennsylvania
Pennsylvania offers independent external review for denied claims after internal appeals are exhausted. You can request external review through the Pennsylvania Insurance Department. The external reviewer's decision is binding on the insurer.
BenZen is licensed in Pennsylvania. If you need help navigating a complaint or appeal, reach out directly.