{"data":{"id":"us-in/ic-27-8-29-12","jurisdiction":"us-in","citation":"IC 27-8-29-12","heading":"Insurer to establish external grievance procedures","body":"Sec. 12. An insurer shall establish and maintain an external grievance procedure for the resolution of external grievances regarding the following:\n(1) The following determinations made by the insurer or an agent of the insurer regarding a service proposed by the treating health care provider:\n(A) An adverse determination of appropriateness.\n(B) An adverse determination of medical necessity.\n(C) A determination that a proposed service is experimental or investigational.\n(D) A denial of coverage based on a waiver described in IC 27-8-5-2.5(e) (expired July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1, 2007, and repealed).\n(2) The insurer's decision to rescind an accident and sickness insurance policy.","path":["TITLE 27. INSURANCE","ARTICLE 8. LIFE, ACCIDENT, AND HEALTH","Chapter 29. External Review of Grievances"],"source_url":"https://iga.in.gov/ic/2026/Title_27.html#27-8-29-12","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-25T05:39:04Z","sha256":"adb6689c855287b4ff61e6de7e7d358a3db1f1bf6cafb260b99a241391e23e43","source_id":"us-in","stale":false,"prev":"us-in/ic-27-8-29-11","next":"us-in/ic-27-8-29-13"},"notice":"GroundRules: Original legal text. Not legal advice."}