We answer hundreds of insurance questions every day. If you’re not sure if we can help you, call our toll-free Insurance Consumer Hotline at 800-562-6900 or chat with us.

What we can do:

• Send your surprise/balance billing concerns to Washington state providers/facilities.
• Send your complaint to the insurance company and require them to provide an explanation for their actions.
• Send your complaint to the Washington Healthplanfinder and ask them to resolve your concerns.
• Review the company’s response to make sure they followed Washington state laws and your policy.
• Tell the company to fix the problem if they didn’t follow the laws or your policy.
• Try to find patterns of problems that may need further reviewing.
• Try to help fix your insurance problem or help you and the company communicate with one another.
• Help you understand your insurance policy.
• Recommend places you can go for help if we don’t have the legal right to resolve your complaint.

What we can’t do:

• Require medical providers/facilities to adjust their charges, respond to complaints, or comply with state insurance laws.
• Act as your lawyer, give you legal advice or be your claims adjuster.
• Make medical judgments or determine if further treatment is necessary.
• Make liability decisions or determine who is at fault.
• Establish the facts surrounding a claim (for example: who is being truthful when there are conflicting reports of the situation).
• Determine the cause of loss, value of a claim, the amount owed to you, or act as your adjuster.
• Address issues we can’t legally enforce.
• Require the Washington Healthplanfinder to comply with state insurance laws as it’s not an insurance company regulated by our office.
• Tell a company to pay a claim, refund a premium, or reinstate or issue a policy (if they followed the law and your policy).

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