Connecticut Insurance Denial Appeal Law at a Glance
Unfair Claims Practices
Conn. Gen. Stat. §38a-816(6) — Unfair Insurance Practices Act — Claims Settlement
Appeal Deadlines
- General claims: 60 days from denial
- Health insurance (ACA): 180 days internal appeal
- Prompt pay: Insurer must pay within 30 days
Bad Faith Remedies
Connecticut allows bad faith claims under CUIPA/CUTPA — treble damages possible for unfair claim practices
External Review
Connecticut Insurance Department external review for health plan denials
Conn. Gen. Stat. §38a-478n et seq.
Where to File Complaints
- Connecticut Insurance Department Consumer Affairs Division
- Connecticut Attorney General Consumer Protection Division
Small claims limit: $5,000
Additional Protections
- Bad faith claims under CUIPA/CUTPA — treble damages possible
- External review for health insurance denials
- Insurer must acknowledge claim within 15 business days
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Connecticut Insurance Denial Appeal FAQ
How do I appeal an insurance claim denial in Connecticut?
To appeal an insurance denial in Connecticut: (1) Review the denial letter for the specific reason and deadline, (2) Send a formal appeal letter citing Conn. Gen. Stat. §38a-816(6) (Unfair Insurance Practices Act — Claims Settlement), (3) Demand a complete explanation of the denial and copies of all documents considered, (4) Reference your right to file a complaint with the Connecticut Insurance Department. Send via certified mail, return receipt requested.
How long do I have to appeal an insurance denial in Connecticut?
In Connecticut, the general appeal deadline for insurance claim denials is 60 days from the date of the denial letter. For health insurance claims, the ACA provides at least 180 days for internal appeals. Acting quickly is critical — missing the deadline can forfeit your right to appeal.
Can I sue my insurance company for bad faith denial in Connecticut?
Yes. Connecticut recognizes insurance bad faith claims. Connecticut allows bad faith claims under CUIPA/CUTPA — treble damages possible for unfair claim practices. If your insurer unreasonably denied a valid claim, you may be entitled to damages beyond the claim amount.
What is the unfair claims settlement practices act in Connecticut?
Connecticut's unfair claims settlement practices are governed by Conn. Gen. Stat. §38a-816(6) (Unfair Insurance Practices Act — Claims Settlement). This law prohibits insurance companies from failing to promptly investigate claims, denying claims without conducting a reasonable investigation, failing to provide clear explanations for denials, and other unfair practices.
Does Connecticut have an external review process for insurance denials?
Yes. Connecticut Insurance Department external review for health plan denials (Conn. Gen. Stat. §38a-478n et seq.). External review allows an independent third party to review the insurer's denial decision. For health insurance, the ACA also provides federal external review rights.
Where do I file a complaint about an insurance denial in Connecticut?
In Connecticut, file complaints with: (1) Connecticut Insurance Department Consumer Affairs Division, (2) Connecticut Attorney General Consumer Protection Division. For health insurance, you can also contact the U.S. Department of Labor (ERISA plans) or HHS (ACA plans). For claims up to $5,000, you can file in Connecticut small claims court.
Insurance Denial Appeal Letters by State
Select your state to see your specific protections.