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Insurance Division

Independent Review Organizations

Long-Term Care Insurance Appeals

The Oregon Insurance Division certified the following Independent Review Organizations to decide disputes about whether you qualify for benefits under your long-term care insurance policy. This is most likely because you can no longer perform certain activities of daily living or have a cognitive impairment.

Your appeal rights can be found in administrative rule (OAR 836-52-0768) and (836-052-0770).
Your first appeal is through the company that denied coverage. If the denial is upheld by the company, your insurer must send you a letter telling you how you may file an external appeal. The letter will include this list of Independent Review Organizations. All of these organizations meet the state's qualifications to review your case.

You may select the company you want to review your case. If you don't name a company, the insurance company will do so on your behalf. If you have questions about this process, contact an Oregon Insurance Division consumer advocate at 1-888-877-4894.