State Law

Office of the Commissioner of Insurance-Chapter Ins. 18-Subchapter II. Grievance Procedures

08/29/2023 Wisconsin Section 18.05

Expedited grievance procedure

State Medical Necessity Appeals-Deadlines

Section Ins 18.03 (2) to (4) and (6) does not apply to expedited grievances. For these situations, an insurer offering a health benefit plan shall develop a separate expedited grievance procedure. An expedited grievance shall be resolved as expeditiously as the insured’s health condition requires but not more than 72 hours after receipt of the grievance. An insurer offering a health benefit plan, upon written request, shall mail or electronically mail a copy of the insured’s complete policy to the insured or the insured’s authorized representative as expeditiously as the grievance is handled.