Here’s the official forms to request review of your cancellation for non-payment of premiums.
We checked with the Department of Health Care plans and they also gave us the IMR Independent Medical Review form – Which can also be completed ONLINE ==> Online Independent Medical Review/Complaint Form The IMR is the preferred form, but they will accept the Review of Cancellation form. I suggest – and I’m not an attorney, that you use the Review of Cancellation form as it asks better questions so that you can prove your point. See also our appeals pages.
- How to properly terminate coverage
- Never got bill?
- Request Review of alleged wrongful cancellation
Other Pages in Appeals & Grievances Section
- Covered CA Appeals
- How Steve Shorr Insurance can help you
- Technical Links – Appeals & Grievances