Policyholder Help

The Insurance Complaint Division provides the public with insurance information and assistance and examines consumer complaints.

Before filing a complaint:

Important: If you did not live in Nebraska when you purchased the policy, please contact the state in which you lived at the time of purchase.

• Contact your insurance company and request an explanation.
• Make sure you have provided all information requested by the company.
• If you are concerned about the handling of a health insurance claim, ask what appeal and external review procedures are available to you. (Appealing a Health Plan Decision)

If you are not satisfied with the company’s response to your concerns, you may consider filing a complaint. Be prepared to summarize your complaint, so people who are not familiar with your issue will be able to understand.

What the Nebraska Department of Insurance cannot do:

• Order the company to pay your claim or refund premium
• Decide who was at fault in an accident
• Act as a court of law or provide legal advice
• Recommend an agent, company, or products
• Identify an insurance company with whom a particular person may hold a policy
• Establish the facts surrounding a claim (for example: who is being truthful when there are conflicting reports of a situation)
• Determine the cause of loss, the value of a claim, the amount owed to you, or act as your adjuster
• Address issues the Department can’t legally enforce

How filing a complaint with the Nebraska Department of insurance can help:

• A complaint provides a fresh objective evaluation by individuals with the insurance expertise and usually prompts a new review at the insurance entity
• The process allows an opportunity to provide additional understanding and documentation if it was missing
• Complaints allow the Department of Insurance to evaluate whether an insurance company has complied with Nebraska law

For assistance with other entities not regulated by the Department, please refer to the following list of resources:

• Policies Purchased in Another State - Map to States & Jurisdictions
• Billing Disputes with Hospitals or Medical Providers – Nebraska Attorney General Consumer Mediation Center
• Federal Employee Health Benefits Program –Healthcare & Insurance, Office of Personnel Management
• Health Plans for Military Personnel – Appeals Fact Sheet
• Workers' Compensation – Nebraska Workers' Compensation Court
• Self-funded Benefit Plans – Employee Benefits Security Administration, US Department of Labor
• Medicaid – Department of Health and Human Services
• For federal employees: https://www.opm.gov/healthcare-insurance/healthcare/
• Medicaid and Long-term care: http://dhhs.ne.gov/Pages/medicaid-and-long-term-care.aspx
• EBSA: https://www.dol.gov/agencies/ebsa
• Tricare: https://www.tricare.mil/

File an online complaint:

Please read our Filing An Insurance Complaint brochure for additional information.

Downloadable Complaint Form

After you file a complaint:

• Once received, your complaint will be assigned to an Insurance Complaint Examiner who will send you an acknowledgment letter with a case tracking ID number. Please reference this tracking ID number for all case inquiries with the Insurance Complaint Division.
• We will send a copy of your complaint to the company and/or agent and request a detailed explanation.
• Companies and agents are allowed 15 business days to respond to the Department’s request for information. Some examinations may take longer depending on complexity.
• After reviewing the company/agent response, the examiner will advise you of the case outcome.

Pre-Need Complaint Questionnaire
Use this form if your complaint concerns the handling of a pre-need trust. A pre-need trust is the purchasing of burial or funeral merchandise (casket, vault, monument, etc.) or services prior to the time of death.

Contact Insurance Complaint Division:

Phone: 877-564-7323 (toll-free in Nebraska) or 402-471-0888 Fax:402-471-4610

Nebraska Department of Insurance