Every complaint is analyzed by the Department’s chief investigator or an investigative supervisor who makes one of three determinations. A determination may be made that no violation occurred, that the violation does not meet the criteria for investigation or that a violation does meet the criteria for investigation. If one of the first two determinations is reached then the case is dismissed. However, if the violation does meet the criteria for investigation then a thorough investigation is conducted. At the completion of the investigator’s investigation the case is resolved either through an administrative hearing or by a stipulated agreement. Sanctions against a licensee can range from a private reprimand to a revocation of the licensee’s license.
This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified health insurance lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local health insurance attorney to discuss your specific legal situation.