Grievance

Also called: complaint

A grievance is a formal complaint you file about how your plan or a provider treated you, such as poor service, long waits, or communication problems, rather than about a specific denied benefit. It follows a different track than an appeal, which challenges a coverage decision. Filing a grievance can still be worthwhile when the problem is about process rather than payment.

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Disclaimer: This definition is provided for general educational purposes only and is not legal, medical, or insurance advice. Insurance rules, deadlines, and terminology vary by plan, state, and over time. Always check your own plan documents and confirm current details before acting.