File A Complaint

If you have questions about insurance or are experiencing a problem with an insurance company, we are here to help. 

• Toll-free number: 1-877-310-6560 
• Life and Health Consumer Services: 804-371-9691
  • AskAQuestion@scc.virginia.gov
• Property and Casualty Consumers Services: 804-371-9185
  • AskAQuestionPC@scc.virginia.gov 

Please do not submit complaints by email.  

Before filing a complaint: 

• Talk to your agent or insurance company.
• Contact us by phone or email to ask general questions. 

​What we can do:

• Acknowledge and assign your complaint to an insurance examiner.
• Contact the insurance company or agent for an explanation regarding your concerns.
• Review the company’s response to make sure they complied with Virginia insurance laws and your policy provisions.
• Share our findings with you upon receipt and review of the company’s response.
• Recommend steps you can take when we don’t have the regulatory authority to resolve the complaint.

What we can’t do:

• Recommend an agent, company, or specific insurance product.
• Force a company to pay a claim outside the terms of the policy provisions.
• Review medical records to determine payment or denial of claims.
• Act as your legal representative or get involved in a pending lawsuit.
• Get involved if you have an attorney without your attorney’s written permission.
• Locate an insurance policy for a deceased individual without the name of the insurance company.
• Determine who was negligent or at fault.
• Determine the monetary value.
• Decide the facts of a disagreement or which version is true when there are differing accounts of an incident.

We cannot assist with matters that are not subject to Virginia insurance laws or that are governed by other state or federal agencies such as:

• Commonwealth of Virginia employee benefit plan
• Federal employee plans 
• Home Warranty/Home Service Contracts
• Medicaid 
• Medicare
• Military Insurance plans (e.g. Tricare, etc.) 
• Self-insured employer plans and health and welfare benefit plans
• Unemployment Benefits
• Workers' Compensation Claims

Consumers:

1. Set up an account using a valid email address and create a password.
2. Submit your complaint. ​Provide as much information as possible and attach copies of all supporting documentation to the completed complaint form.
   • If you are unable to submit your documentation via the portal or the file is too large to upload to the portal, you may mail or fax it to us.
3. An email confirmation with your complaint number will be sent to you after the complaint has been submitted.
4. To add additional information, you can log back into the portal to add a comment or attach a document. Click the Submit button to save information.
5. You will receive an email when there are updates to your complaint. To view these updates:
   • Log in to the Portal. Your complaint(s) will be listed by number on the Workspace page.
   • In the Action column next to each complaint, select one of the two links—Comments or Documents. You will be taken to a list of all updates- select the one you want to review.

Health Care Providers:

If you are unable to file a complaint on the online portal, please select the applicable form below to submit a complaint by mail or fax (fax cover sheet). Provide as much information as possible, attach copies of all supporting documentation to the completed complaint form, and keep the original documents for your records.

• Property and Casualty Insurance Complaint Form
• Life and Health Insurance Complaint Form*
• Formulario de Queja o Recurso de Apelación por Seguro de Vida y Seguro de Salud
• Balance Billing Complaint Form 
• Continuing Care Retirement Community (CCRC) or Community-Based Continuing Care (CBCC) Complaint Form
• File a Pharmacy Benefit Management Complaint

• Appeal Denial by a Managed Care Health Insurance Plan
• Request an External Review

• Provider Complaint Form