General Inquiries

For general questions or inquiries only, please use our Contact Us form.

File a Complaint

To submit a complaint, please use one of the following Request for Assistance (RFA) forms:

Internet RFA                        

1. If you have supporting documents, please use the Printable RFA.
2. Print and keep a copy for your records. You may wish to make a note of your complaint number for future reference.

Printable RFA   (Imprimir Solicitud De Asistencia)

1. Print hard copy of the completed form. If you wish to give authority to someone to assist you in filing a complaint, please complete the Authorization and Designation of Agent form in addition to the Request for Assistance Form.
2. Attach supporting documents.
3. Mail all documents to the address listed on the RFA form.

Examples of Complaints Addressed by the California Department of Insurance

• Improper denial or delay in settlement of a claim
• Alleged illegal cancellation or nonrenewal of an insurance policy
• Problems concerning insurance premiums and rates
• Alleged misconduct by an agent or broker (misrepresentation, theft of premiums, etc.)
• Problems relating to medical necessity of a treatment, an experimental or investigational therapy for certain medical conditions, or a claim denial for emergency or urgent medical services.

Independent Medical Review Program and Related Documents

• Information and Instructions Regarding Your Application for Independent Medical Review
• Physician Certification Experimental/Investigational Denials
• Authorization for Release of Medical Records and Designation of IMR Agent

Privacy statement: If you are submitting information through the Internet, please review our privacy statement regarding information we obtain from you.