Maryland Insurance Denial Appeal Law at a Glance
Unfair Claims Practices
Md. Code, Ins. §27-303 — Unfair Claim Settlement Practices
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
Maryland allows bad faith insurance claims — compensatory damages available; private cause of action under Md. Code, Cts. & Jud. Proc. §3-1701
External Review
Maryland Insurance Administration external review / Grievance process for health plan denials
Md. Code, Ins. §15-10A-01 et seq.
Where to File Complaints
- Maryland Insurance Administration Consumer Complaints
- Maryland Attorney General Consumer Protection Division
Small claims limit: $5,000
Additional Protections
- Bad faith denial action available with private cause of action
- External review and grievance process for health insurance denials
- Insurer must acknowledge claims within 15 working days
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Maryland Insurance Denial Appeal FAQ
How do I appeal an insurance claim denial in Maryland?
To appeal an insurance denial in Maryland: (1) Review the denial letter for the specific reason and deadline, (2) Send a formal appeal letter citing Md. Code, Ins. §27-303 (Unfair Claim Settlement Practices), (3) Demand a complete explanation of the denial and copies of all documents considered, (4) Reference your right to file a complaint with the Maryland Insurance Administration. Send via certified mail, return receipt requested.
How long do I have to appeal an insurance denial in Maryland?
In Maryland, 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 Maryland?
Yes. Maryland recognizes insurance bad faith claims. Maryland allows bad faith insurance claims — compensatory damages available; private cause of action under Md. Code, Cts. & Jud. Proc. §3-1701. 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 Maryland?
Maryland's unfair claims settlement practices are governed by Md. Code, Ins. §27-303 (Unfair Claim Settlement Practices). 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 Maryland have an external review process for insurance denials?
Yes. Maryland Insurance Administration external review / Grievance process for health plan denials (Md. Code, Ins. §15-10A-01 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 Maryland?
In Maryland, file complaints with: (1) Maryland Insurance Administration Consumer Complaints, (2) Maryland 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 Maryland small claims court.
Insurance Denial Appeal Letters by State
Select your state to see your specific protections.