State escalation
California
California Department of Insurance
Phone
1-800-927-4357File a consumer complaint
https://www.insurance.ca.gov/01-consumers/101-help/California's Independent Medical Review (IMR) is one of the strongest external-review processes in the country.
When to call the commissioner
- Insurer ignored your appeal past the legal response window (usually 30 days for post-service, 72 hours for urgent).
- Insurer denied a benefit explicitly required by state law (mental-health parity, emergency services, formulary exception, etc.).
- External reviewer overturned the denial but the plan still won’t pay.
- You suspect the plan is misapplying its own coverage policy or violating ACA prohibitions.
Verified 2026-05-06. If a number or link looks wrong, the official NAIC member directory at naic.org/state-insurance-departments is the canonical source.