West Virginia law gives you the right to an external review when health care services are denied by your insurer on the basis that the services are not medically necessary or that the services are experimental or investigational. An external review is a request that you make to the state for an independent review of a denial of services by your insurer. Reviews are conducted by Independent Review Organizations (IROs) that are certified by the state and have a network of medical experts to review your health insurer’s denial of services. You must complete and submit the application and all supporting documentation to the West Virginia Offices of the Insurance Commissioner at OICHealthPolicy@wv.gov to request an external review.

External Review Application