{"data":{"id":"us-in/ic-27-8-28-6","jurisdiction":"us-in","citation":"IC 27-8-28-6","heading":"\"Grievance\"","body":"Sec. 6. As used in this chapter, \"grievance\" means any dissatisfaction expressed by or on behalf of a covered individual regarding:\n(1) a determination that a service or proposed service is not appropriate or medically necessary;\n(2) a determination that a service or proposed service is experimental or investigational;\n(3) the availability of participating providers;\n(4) the handling or payment of claims for health care services;\n(5) matters pertaining to the contractual relationship between:\n(A) a covered individual and an insurer; or\n(B) a group policyholder and an insurer;\n(6) an insurer's decision to rescind an accident and sickness insurance policy; or\n(7) a determination concerning a prior authorization request under IC 27-1-37.5;\nand for which the covered individual has a reasonable expectation that action will be taken to resolve or reconsider the matter that is the subject of dissatisfaction.","path":["TITLE 27. INSURANCE","ARTICLE 8. LIFE, ACCIDENT, AND HEALTH","Chapter 28. Internal Grievance Procedures"],"source_url":"https://iga.in.gov/ic/2026/Title_27.html#27-8-28-6","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-25T05:39:04Z","sha256":"c5d0c40e52ecc2dac08cae9d48c4c536f25ed8774af3ca7a66806187963e15b9","source_id":"us-in","stale":false,"prev":"us-in/ic-27-8-28-5","next":"us-in/ic-27-8-28-7"},"notice":"GroundRules: Original legal text. Not legal advice."}