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Request an independent medical review

Request review of an eligible health coverage denial; check your plan’s regulator, grievance requirements, filing deadline and urgent-review rules.

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.

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Map source

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.

Request a CDI independent medical review (opens in a new tab)Official 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

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.

Request a DMHC independent medical review (opens in a new tab)Official 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

Full guide, contact details & sources →