Official local service finder

Insurance complaints & medical review

Find CDI or DMHC help with an insurance or health plan complaint, denied care, billing problems and eligible independent medical reviews.

File an insurance complaint Request an independent medical review

Before you start

Check which regulator oversees your actual policy or health plan. A company name alone does not establish jurisdiction.
Keep the insurer’s decision, your grievance record and supporting documents. IMR has specific eligibility and filing deadlines.
If there is an immediate serious threat to your health, contact the regulator for urgent assistance; ordinary grievance waiting rules have exceptions. County maps help you browse and do not determine plan eligibility.

2 guides with reviewed service links · Alameda · “City of Industry”

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California58 counties

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U.S. Census boundaries via U.S. Atlas · 2017 edition, simplified for display.

California state agency · Statewide

California CDI — Insurance Complaints & Medical Review

California CDI-regulated insurance; jurisdiction depends on the policy and complaint.

File a consumer insurance complaintOfficial instructions

Use CDI’s Consumer Complaint Center for an insurer or licensee complaint within CDI jurisdiction. Paper health and non-health forms are separate.

Service area: CDI-regulated insurance only; confirm policy and issue jurisdiction. Area details & sources

File a consumer insurance complaint

An account supports complaint status, additional documents and new complaints. The public entry page also offers “Continue as a Guest”.

Official information checked October 16, 2026 · Details & sources

File a consumer insurance complaint

CDI recommends electronic filing; paper complaint forms may take longer.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Insurance · CDI — File an insurance complaint (opens in a new tab)

Main content — service cdi consumer

File a Complaint - Consumers

Saved evidence: 24adc00932b4d5bb · Agent source review

Get help with a CDI-regulated health insurance complaintOfficial instructions

Check health-insurer jurisdiction and use the consumer route. Healthcare providers have a different complaint portal.

Service area: CDI-regulated insurance only; confirm policy and issue jurisdiction. Area details & sources

Get help with a CDI-regulated health insurance complaint

The form’s demographic/statistical questions are optional and do not affect complaint processing.

Official information checked October 16, 2026 · Details & sources

Get help with a CDI-regulated health insurance complaint

Consumers and healthcare providers have separate complaint links. Do not use the provider portal for a patient complaint.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Insurance · CDI — Getting Health Insurance Help (opens in a new tab)

Main content — service cdi health

Consumer & Provider Health Inquiries & Complaints

Saved evidence: 12b482c81914543f · Agent source review

Request a CDI independent medical reviewOfficial instructions

For eligible medical-necessity, experimental/investigational or emergency-care disputes involving CDI-regulated health insurance. Check grievance and filing deadlines.

Service area: CDI-regulated insurance only; confirm policy and issue jurisdiction. Area details & sources

Request a CDI independent medical review

If a request does not qualify for IMR, CDI’s guide says it is referred to the department’s complaint/mediation programme.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Insurance · CDI — Independent Medical Review Program (opens in a new tab)

Main content — service cdi imr

Independent Medical Review Program (IMR)

Saved evidence: b49b5bcea57ca0e5 · Agent source review

Ask CDI an insurance questionOfficial instructions

Use the official inquiry form or consumer hotline for help choosing the right route. An inquiry is separate from filing a complaint.

Service area: CDI-regulated insurance only; confirm policy and issue jurisdiction. Area details & sources

Source checked October 16, 2026

California Department of Insurance · CDI — More contact info (opens in a new tab)

Main content — service cdi question

E-mail general question or concerns?

Saved evidence: 009ed28286f4c1cb · Agent source review

Full guide, contact details & sources →

California state agency · Statewide

California DMHC — Health Plan Complaints & Medical Review

California DMHC-regulated health plans; plan jurisdiction and IMR eligibility must be confirmed.

File a DMHC health plan complaintOfficial instructions

For billing, cancellation, access, appointments, translation and other issues with a DMHC-regulated plan. Start with the plan’s grievance process unless an exception applies.

Service area: DMHC-regulated plans only; check the plan and issue before filing. Area details & sources

File a DMHC health plan complaint

Consumer complaints can address bills, cancellation, claims/copays, appointment or authorization delays, translation, network access and continuity of care.

Official information checked October 16, 2026 · Details & sources

File a DMHC health plan complaint

Print and preview your copy before submission; the application says you cannot print a copy after submitting.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Managed Health Care · DMHC — How to File a Complaint (opens in a new tab)

Main content — service dmhc complaint

You can also file a Consumer Complaint when you have other issues with your Health Plan.

Saved evidence: cf22574902ba5f14 · Agent source review

Request a DMHC independent medical reviewOfficial instructions

DMHC screens the issue for IMR eligibility. Consumer complaints and IMR use one application; medical review has its own conditions and deadline.

Service area: DMHC-regulated plans only; check the plan and issue before filing. Area details & sources

Request a DMHC independent medical review

If the problem does not qualify for IMR, DMHC says it will review it through the consumer complaint process without a second application.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Managed Health Care · DMHC — How to File a Complaint (opens in a new tab)

Main content — service dmhc imr

If your Health Plan denies, changes or delays your request for medical services, denies payment for emergency treatment or refuses to cover experimental or investigational treatment for a serious medical condition, you can apply for an Independent Medical Review (IMR).

Saved evidence: cf22574902ba5f14 · Agent source review

Find your health plan’s grievance contactOfficial instructions

Use member services on your card or DMHC’s licensed-plan directory. File a grievance for each issue before applying to DMHC, subject to urgent and experimental-treatment exceptions.

Service area: DMHC-regulated plans only; check the plan and issue before filing. Area details & sources

Find your health plan’s grievance contact

Use member services on your health plan card or DMHC’s official plan directory to find the plan’s grievance contact.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Managed Health Care · DMHC — How to File a Complaint with Your Health Plan (opens in a new tab)

Main content — service dmhc plan first

How to File a Grievance/Complaint with Your Health Plan

Saved evidence: ededf2de3825d1ad · Agent source review

Read a protected message about your DMHC caseOfficial instructions

Follow DMHC’s instructions to open encrypted case correspondence using a one-time passcode.

Service area: DMHC-regulated plans only; check the plan and issue before filing. Area details & sources

Read a protected message about your DMHC case

If you elected email correspondence on the application, DMHC sends case correspondence through protected, encrypted email.

Official information checked October 16, 2026 · Details & sources

Read a protected message about your DMHC case

Open “Read the message,” choose a one-time passcode, retrieve it from your email, then enter it on the secure page. The official instructions cover desktop and mobile.

Official information checked October 16, 2026 · Details & sources

Source checked October 16, 2026

California Department of Managed Health Care · DMHC — Protected Messages (opens in a new tab)

Main content — service dmhc protected

DMHC Protected Messages

Saved evidence: 3cb7dc04a6b48316 · Agent source review

Full guide, contact details & sources →

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