Your Rights and Responsibilities

When you buy insurance, you have certain rights and responsibilities.

Your Rights
You have the right to receive a copy of the insurance policy or certificate governing your coverage.

You have the right to receive copies of all forms and applications signed by you or the agent.

You have the right to appeal any denied claims.

Your Responsibilities
You are responsible for reading and understanding your insurance policy.

You are responsible for reading and understanding any “explanation of benefits” forms sent by your insurance company. These forms usually state: “This is not a bill.” However, you should still closely study them to make sure you actually received the medical services that your insurance company was billed for.

You are responsible for reporting suspected fraud to the Department of Financial Services. If you suspect a crime has occurred, call our Fraud Hotline toll-free at 1-800-378-0445.

You are responsible for making sure your application is accurately completed. This includes information on pre-existing conditions. If you make a fraudulent or unintentional misstatement on your application, the company may cancel your policy or refuse to pay a claim.

You are responsible for knowing what your policy covers and excludes.

You are responsible for paying your premiums, even while involved in a dispute with your company.

You are responsible for paying the deductibles outlined in your policy.

You are responsible for verifying licenses of an insurance agent and company by calling the Consumer Helpline toll-free at 1-800-342-2762.

Remember, a business card is not a license!