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South Carolina · Through 2025 Session of the General Assembly

S.C. Code Ann. § 38-71-1950: Requests for external review.

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Where this section sits in the code
  1. Title 38 - INSURANCE
  2. CHAPTER 71 Accident and Health Insurance
  3. ARTICLE 19 Health Carrier External Review Act

(A) All requests for external review must be made in writing to the health carrier.

(B) A covered person or his authorized representative may make a request for an external review of an adverse determination or final adverse determination only when the amount payable for covered benefits is at least five hundred dollars.

(C) A covered person is not entitled to an external review of a retrospective review determination unless the covered person has exhausted the health carrier's internal appeal process and may be held financially responsible for the covered benefits.

Collected 2026-09-02T07:14:39Z. Source file · JSON

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