Haw. Code R. § 12-12-44 - Denial of claim

(a) If an employee's claim is denied by a health care contractor in whole or in part because of nonpayment of premium, notice of denial in a form prescribed by the director shall be mailed promptly to the employee.

(b) If an employee desires a review of the denied claim, the employee shall file the prescribed notice of denial and a statement giving specific reasons for the request with the director. The request for review shall be filed within twenty days after the date of denial at the office of the department in the county in which the claimant resides or to any office of the department. The director shall forthwith notify the health care contractor of the claimant's request for review, enclosing a copy of the claimant's reasons therefor.

(c) The director, or an officer or employee designated by the director for that purpose, shall investigate the request and render a decision. The decision is final with right of appeal in accord with section 91-14, HRS.

Notes

Haw. Code R. § 12-12-44

[Eff: 5/7/81] (Auth: HRS § 393-32) (Imp: HRS §§ 393-7, 393-32)