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Knox-Keene Act · DMHC IMR · CDI · SB 510 · AB 72 · SB 855

California Has the Nation's Strongest Insurance Consumer Protections — Use Them

California's DMHC and CDI give consumers binding independent review, no balance billing, language access rights, and some of the most powerful complaint tools in the country. Most Californians never use them.

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California's Two Insurance Regulators

Which one you use depends on your plan type. HMO = DMHC. PPO = CDI. Both are free.

HMO / MANAGED CARE

DMHC — Department of Managed Health Care

Regulates HMOs, Knox-Keene licensed plans, and managed care organizations — including Kaiser Permanente, Blue Shield of CA (HMO), Health Net, Molina Healthcare, LA Care, and most Covered California plans. DMHC runs California's powerful Independent Medical Review program.

Contact DMHC
Web: dmhc.ca.gov
Help Center: 888-466-2219
File IMR: dmhc.ca.gov/FileAComplaint
File DMHC IMR →
PPO / INDEMNITY / LIFE / DISABILITY

CDI — California Department of Insurance

Regulates PPO plans, indemnity plans, life insurance, disability insurance, and other non-Knox-Keene products — including Anthem Blue Cross PPO, Aetna PPO, Cigna, and most employer self-funded plan stop-loss policies. CDI handles bad faith investigations and prompt payment violations.

Contact CDI
Web: insurance.ca.gov
Consumer Hotline: 800-927-4357
File complaint: insurance.ca.gov/01-consumers/101-help
File CDI Complaint →

Your 5 Key Rights Under California Insurance Law

California law gives health insurance consumers rights that don't exist in most other states.

1

Independent Medical Review (IMR) Right

Under the Knox-Keene Act and CA Insurance Code §10169, you have the right to a free, binding Independent Medical Review administered by DMHC. An independent physician — with no financial ties to your insurer — reviews the denial. The IMR decision is legally enforceable against your health plan. DMHC data shows IMR overturns 40–80% of denials depending on category. You can request IMR after your plan denies your internal grievance, or after 30 days if the plan has not responded.

2

Continuity of Care Right

California law (Health & Safety Code §1373.96) gives you the right to continue treatment with an out-of-network provider during transitions — including when your insurer changes networks, when you become newly covered, or when a provider leaves the network mid-treatment. You can request continuity of care for up to 12 months for serious, chronic, or terminal conditions. Your insurer must allow you to complete an ongoing course of treatment.

3

No Balance Billing (SB 510 / AB 72)

California's AB 72 and the federal No Surprises Act protect you from unexpected bills from out-of-network providers at in-network facilities. If you receive care at an in-network hospital, facility, or emergency room, out-of-network providers there cannot bill you more than your in-network cost-sharing amount. For emergencies, you can never be billed more than in-network rates regardless of which hospital you visit.

4

Network Adequacy Right

Under California's network adequacy standards, your insurer must maintain a network sufficient to provide timely access to all covered services. If your plan cannot provide a covered service within required time and distance standards — 15 minutes/15 miles for primary care, 30 minutes/30 miles for specialists — you are entitled to an out-of-network provider at in-network cost-sharing. File a DMHC complaint if your insurer claims no in-network providers are available.

5

Language Access Right

Under California Health & Safety Code §1367.04, health plans must provide translated notices, interpreter services, and translated EOBs to enrollees who speak one of the state's threshold languages (Spanish, Chinese, Vietnamese, Korean, Tagalog, and others). If you received a denial notice in a language you don't understand, or were denied interpreter services, that is a separate violation you can raise in your DMHC complaint.

Step-by-Step: How to Fight a Denial in California

California's IMR process is the fastest and most powerful first move for HMO members.

Step 1

File Internal Grievance With Your Insurer

Submit a formal written grievance (not just a phone call) to your insurer citing the specific denial reason, your policy number, and the medical records supporting your claim. Your plan must respond within 30 days for standard requests and 72 hours for urgent/expedited requests. Keep copies of everything.

Tip: Request the specific InterQual or MCG criteria your insurer used for the denial — you are entitled to this under CA law.
Step 2

Request IMR Through DMHC (Fastest Path)

For HMO or managed care plan members: file for Independent Medical Review at dmhc.ca.gov or call 888-466-2219. You can request IMR immediately after receiving a denial — you do not need to exhaust multiple levels of internal appeal. Standard IMR takes up to 30 days. Expedited/urgent IMR takes 3 business days. The IMR decision is binding on your health plan.

Tip: Attach your physician's letter of medical necessity, clinical notes, and any peer-reviewed studies supporting your treatment.
Step 3

File CDI Complaint (PPO / Indemnity Plans)

If you have a PPO, indemnity, or non-Knox-Keene plan, your regulator is CDI (California Department of Insurance) at insurance.ca.gov or 800-927-4357. CDI can investigate improper denials, order claim payments, and refer cases for bad faith investigations. CDI complaints typically resolve in 30–60 days.

Tip: CDI and DMHC can also investigate network adequacy failures, language access violations, and prompt payment violations.
Step 4

Small Claims Court for Amounts Under $10,000

California Small Claims Court (limit: $10,000 for individuals) is a powerful tool for smaller denied claims. You can sue your insurer for the denied amount plus consequential damages without an attorney. Insurers frequently settle rather than send executives to small claims court. Filing fee is $30–$75.

Tip: File in the county where you live or where the medical services were provided — not where your insurer is headquartered.

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Frequently Asked Questions

What is the DMHC Independent Medical Review in California?

The DMHC IMR is a free, binding independent review of a denied health insurance claim administered by the California Department of Managed Health Care. An independent physician reviews your case and the decision is legally binding on your health plan. DMHC data shows IMR overturns 40–80% of denials in some categories. File at dmhc.ca.gov or call 888-466-2219.

What is the difference between DMHC and CDI in California?

DMHC (Department of Managed Health Care) regulates HMOs and managed care plans such as Kaiser Permanente, Blue Shield of CA HMO, and Health Net. CDI (California Department of Insurance) regulates PPO plans, indemnity plans, and other commercial insurance. If your plan is an HMO, go to DMHC. If it is a PPO, go to CDI.

Does California protect against surprise billing?

Yes. California AB 72 and the federal No Surprises Act protect you from balance billing by out-of-network providers at in-network facilities. You can never be billed more than your in-network cost-sharing for emergency services, or for non-emergency services at in-network facilities without your informed written consent.

How long does the DMHC IMR process take?

Standard IMR takes up to 30 days from the date DMHC receives your complete application. Expedited (urgent) IMR must be completed within 3 business days. You can request expedited IMR if a standard timeline would seriously jeopardize your health or ability to regain maximum function.

Can I sue my health insurer in California?

Yes. Beyond the administrative process, California recognizes bad faith insurance claims under Brandt v. Superior Court and Insurance Code §790.03. You can pursue small claims court for amounts under $10,000, or file a civil bad faith lawsuit for larger amounts — potentially including punitive damages if the insurer acted unreasonably and in bad faith.

Fight Your California Insurance Denial Today

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ClaimBack provides AI-assisted document drafting. We are not a law firm and do not provide legal advice. For complex litigation or bad faith claims, consult a licensed California attorney.