Request for investigation
Arkansas Code § 23-61-108; Arkansas Code § 23-66-207; Arkansas Code § 23-76-125
- (a) The provisions of this section shall only apply to persons that are defined as health carriers under 23 CAR § 15-103(b)(8).
(b)
- (1) A health claimant may file a consumer complaint with the Insurance Commissioner relating to a health carrier when there is a reasonable basis for such complaint due to the failure of the health carrier to process claims according to this rule.
- (2) However, if the health claimant is not the actual insured under the policy, nor the enrollee in the plan, the health claimant may file a consumer complaint with the commissioner where there is a reasonable basis to believe that the health carrier has exhibited a practice of not paying that provider's claims according to this rule.
- (c) The commissioner shall investigate such complaint and shall make a report of his or her findings available to the health claimant who filed the complaint.