Independent Dispute Resolution (IDR)
If you are an out-of-network provider, an enrollee in a self-insured plan that has opted into Maine’s IDR process, or an uninsured consumer with a bill of $750 or more, AND the dispute involves a claim for emergency services, visit our Independent Dispute Resolution page. All others should use the Bureau’s complaint form.
Instructions for Filing a Complaint
1. Complete the complaint form:
- Tell us what happened, who was involved, and why you think the company or agent is wrong.
- Have you tried to resolve this problem? If so, please provide us with details of your efforts.
- What do you want the company or agent to do?
The signed complaint form authorizes the Bureau to investigate your complaint.
Electronic Option*: You can file the complaint form electronically using one of the two forms below. Select the form that pertains to the type of coverage your complaint concerns.
- Health, Life, Annuity, Long Term Care, Disability, Medicare Supplement Electronic Form (Online Form)
- Property & Casualty Electronic Form (Online Form)
Mailing Option: If you do not wish to submit the complaint form online, you may use the appropriate printable form below. Select the form that pertains to the type of coverage your complaint concerns. If additional space is needed, please use a separate sheet of paper.
- Health, Life, Annuity, Long Term Care, Disability, Medicare Supplement (PDF) (Printable)
- Property & Casualty (PDF) (Printable)
Once completed, send the form to the Bureau's mailing address:
Bureau of Insurance
34 State House Station
Augusta, ME 04333
2. Send supporting documentation:
Examples of documentation that may be relevant to your complaint include:
- Letters, e-mail and other communications, such as notices from the insurance company, explanations of benefits and appeal decisions, between you and the insurance company or agent concerning your complaint;
- Records explaining how claim payments were calculated;
- A copy of your insurance policy or certificate of coverage;
- Property loss forms, vehicle appraisals, police reports;
- Any additional information you feel might be pertinent to the complaint.
Supporting documents can be sent by one of the following methods:
Fax Option: (207) 624-8599 - Please include your name and the words: "Consumer Complaint" on the fax cover page.
Email Option:* firstname.lastname@example.org - Please include your name and the words "Consumer Complaint" on the subject line.
Mailing Option: Use the mailing address above.
- Please include your name and the words "Consumer Complaint" on the envelope, or on its own page as the first page of the contents you are mailing.
- Supporting documentation sent by mail should be copies; PLEASE DO NOT SEND ORIGINALS.
If you need assistance, please call (800)-300-5000 or (207) 624-8475.
*If you choose to send an electronic form, or documents by e-mail, the Bureau cannot guarantee the confidentiality of your complaint during electronic transmission. Once received by the Bureau your file will be confidential.
When we receive your completed complaint form, it will be assigned to an investigator who will contact you by mail at the beginning of the investigation. We will write to the company summarizing your complaint and request a written response to the issues you raised.
By law, any person or company we license must respond to us within 14 days. We allow the company an additional three days for mailing time. If we don’t receive a timely response, we send out a follow-up letter by certified mail; however, the company may ask the Bureau for an extension if the response requires additional investigation.
The length of an investigation will vary; it may require follow-up letters and phone calls. The investigator will advise you of the outcome of the investigation. This usually takes a minimum of thirty days.
The Bureau is committed to doing a thorough investigation on your behalf. Our duty is to enforce the insurance laws and regulations of this state.
- Force the company to satisfy you if no laws have been broken.
- Act as your lawyer or give you legal advice.
- Make medical judgments.
- Make liability decisions.
- Read your policy. Make sure that you understand your coverage and call your insurer or agent if you have any questions.
- Keep a file with all your insurance records.
- If your health plan requires referrals, make sure to get a referral from your Primary Care Provider. Contact your insurance company before you receive the referred services to verify that the company approved the referral.
- Take notes when you talk to the company or agent; write down the date, time, and name of the person you talk to whenever you call with a question or a complaint about your policy or claim.
The Bureau of Insurance has many resources to help educate consumers about dealing with insurance companies, including tips about buying insurance and making claims. For more information, you can call us at 800-300-5000 or 207-624-8475.