External review in Hawaii: deadline, cost and how to ask
Hawaii runs its own independent review of denials: External Review (Insurance Commissioner). You generally have 130 days to ask for it.
External review means a doctor or reviewer outside your plan decides again. Internal appeal means your plan looks at its own decision again.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Step 2: Outside review in Hawaii
- Program
External Review (Insurance Commissioner)
- Who runs it
- Hawaii Insurance Commissioner (DCCA Insurance Division), which randomly assigns an approved independent review organization: Health benefit plans issued by health carriers in Hawaii. Not Medicare, Medicaid (QUEST) or self-funded plans.
- Deadline to ask
130 days
File your request with the Insurance Commissioner within 130 days of receiving the denial notice.
- The deadline runs from
Your receipt of the notice of the adverse action
- Do I have to appeal to my plan first?
Finish the carrier's internal appeals first, unless the carrier waived that requirement, the carrier substantially failed to follow its internal appeals process, or you are eligible for and ask for an expedited external review at the same time as an expedited internal appeal.
- Cost
There is a $15 filing fee. It is refunded if the denial is reversed. The Commissioner waives it if paying would be an undue financial hardship, and you never pay more than $60 in fees in one plan year.
- What can be reviewed
Denials based on medical necessity, appropriateness, health care setting, level of care or effectiveness; rescission (retroactive cancellation) of coverage; and denials of experimental or investigational treatment. Only one external review is allowed for the same denial.
- Is the decision final?
The decision is binding on you and the health carrier, except for other remedies available under federal or state law.
- How to ask
Send a written request to the Insurance Commissioner (DCCA Insurance Division, P.O. Box 3614, Honolulu, HI 96811; insurance@dcca.hawaii.gov; phone 808-586-2790). Include a copy of the carrier's final internal decision (unless you are allowed to skip the internal appeal), a signed authorization to release your medical records, a conflict-of-interest disclosure, and the $15 fee (or ask for a hardship waiver). The Commissioner sends your request to the carrier within 3 business days; once it is found eligible, the Commissioner assigns a reviewer and tells you in writing.
Law: HRS 432E-33, 432E-34, 432E-35, 432E-36, 432E-37 (as amended by Act 103, SLH 2024, effective July 1, 2025)
- Phone
Write my appeal: free letters
Sources
The official sources for Hawaii are listed on the Hawaii page.