How to Fill Out and File the Michigan DIFS Insurance Complaint Form

To file an insurance complaint with Michigan DIFS, use the online complaint portal at difs.state.mi.us/Complaints or download the paper form from michigan.gov/difs/consumers/complaint and send it by mail, email, or fax. There is no single numbered form for a general insurance complaint — the online system walks you through a guided questionnaire, and the paper version mirrors the same questions. Form FIS 0018 is a different document used only for health care external review requests, so do not grab it by mistake if your issue is an auto, homeowners, life, or standard health insurance dispute.¹

Contact the Insurer First

DIFS asks that you try to resolve the issue with your insurance company or financial services provider before filing.¹ This is not a legal prerequisite for a general insurance complaint, but it often works. Many disputes come down to miscommunication or a processing error that gets fixed quickly once you escalate to a supervisor. When you call, write down the date, the representative’s name, and what they told you. That record is useful later if the company tells DIFS something different.

Health care denials follow a stricter rule. If a health plan denied, reduced, or terminated coverage for a medical service, you generally need to finish the plan’s internal grievance process before DIFS will accept an external review request. The exception is when the plan failed to complete its internal review on time; at that point DIFS treats the internal process as exhausted.²

What to Gather Before You Start

Missing information slows the process and may cause DIFS to send the complaint back. Have these ready before you open the form:

Your full name, mailing address, phone number, and a valid email address (required for online filing).
The legal name of the insurance company or agent you are complaining about, your policy number, and any claim numbers tied to the dispute.
Copies of your insurance policy, denial letters, explanation of benefits statements, and any written correspondence with the insurer. The online portal accepts MS Office files, images, and PDFs up to a combined 25 MB.³
A chronological description of what happened: when the policy was issued, when you filed a claim, when the insurer denied or underpaid it, and what response you received. Stick to facts and dates.
A clear statement of the outcome you want, such as payment of a denied claim or correction of an error.

If you are filing on behalf of someone else, attach the Authorized Designation Form so DIFS can discuss the complaint with you rather than the policyholder.³

Filing Online

The fastest route is the online complaint system at difs.state.mi.us/Complaints. A short set of questions routes your complaint to the right category: insurance or financial services, which product is involved, and whether you are complaining about a company or an individual.

You then enter your contact information, the insured person’s name, and details about the company or agent. The main text field is where you describe the dispute. Write a clear, chronological narrative. A separate field asks for your desired outcome. Upload your supporting documents at the end. Keep filenames under 70 characters and stay within the 25 MB total. If your files are bigger than that, fax the attachments separately to 517-284-8837.³

Before submitting, the system asks you to authorize DIFS to review and share information with any company, agency, or licensee involved. You also authorize the insurer to release records, including protected health information, to DIFS for the purpose of resolving the complaint. One warning: the online form has a 20-minute inactivity timeout that will erase your work, with a popup at 15 minutes. For a long narrative, write it in a separate document first and paste it in.³

Filing by Mail, Fax, or Email

If you cannot use the portal, download the paper complaint form at michigan.gov/difs/consumers/complaint, fill it out completely, and send it with copies of your documents using one of these methods:¹

Fax: 517-284-8837
Email: DIFSInfo@michigan.gov
Mail: Department of Insurance and Financial Services, P.O. Box 30220, Lansing, MI 48909

Label every attachment with your name and, if you have one, a complaint reference number. For questions about the form or which documents to include, DIFS call center specialists are available Monday through Friday, 8 a.m. to 5 p.m., at 877-999-6442.

When FIS 0018 Is the Right Form Instead

A general insurance complaint and a health care external review are two different processes. If your health insurer denied a medical service, reduced your benefits, or terminated coverage, and you have already gone through the insurer’s internal grievance process without success, the right document is Form FIS 0018, which triggers an independent external review of whether the denial was correct under your policy and Michigan law.²

DIFS will accept an external review request only if all of the following apply:

You have exhausted the health carrier’s internal grievance process, or the carrier failed to finish its review in the required time.
You file within 127 days of receiving the final adverse determination.
The patient was covered under the plan on the date of service.
The health care service appears to be a covered benefit under the plan.

You can submit FIS 0018 through the same DIFS online portal, or download it as a PDF and send it by mail or fax. If you are filing for a patient 18 or older, or as an authorized representative, complete sections 4 through 7 of the form. If waiting could jeopardize your life or health, request an expedited review.⁵

Plans DIFS Cannot Investigate

DIFS regulates insurance companies and fully insured health plans in Michigan, but it does not have authority over every type of coverage. Self-funded employer health plans, where the employer pays claims directly rather than buying a policy from a carrier, are governed by the federal Employee Retirement Income Security Act (ERISA) and sit outside state insurance regulation.4eCFR. 45 CFR 147.136 – Internal Claims and Appeals and External Review Processes Check your benefits summary or ask HR whether your employer’s plan is self-funded or fully insured before filing. If it is self-funded, your appeal rights are governed by federal law and typically administered through the U.S. Department of Labor.

DIFS also cannot take certain specialized filings online, including Provider Clean Claims and Proof of Claim Against a Mortgage Company Bond. Those require paper submission on their dedicated forms.³

What Happens After You File

DIFS assigns your complaint to an investigator and forwards it to the insurance company, which must provide a written response. The investigator then reviews both sides against Michigan insurance statutes, including the unfair claims practices standards in the Insurance Code.⁶ You receive copies of the correspondence and a letter explaining the findings. If the company violated Michigan insurance law, DIFS can impose fines or sanctions. If no violation is found, the letter explains the reasoning and outlines other options, such as pursuing the matter in court.

Limits on What DIFS Can Do for You

DIFS is a regulatory agency, not a court. It can determine whether an insurer violated the Insurance Code, order the company to correct its practices, and impose penalties. It cannot award damages for emotional distress, pain and suffering, or other losses the way a lawsuit can. Filing a DIFS complaint does not prevent you from suing the insurer, and the two tracks can run at the same time; a DIFS finding of a violation can also help a later court case. For many denied claims, billing errors, and delayed payouts, the regulatory route is enough to get the insurer to act. Where policy language is genuinely ambiguous and both sides have a reasonable reading, DIFS may find no violation and a court becomes the remaining option.