Illinois Department of Insurance   blank
Illinois Department of Insurance
Welcome to the Illinois Department of Insurance
External Review Response Center

ATTENTION: SSL(HTTPS) encryption of the transmission is used to secure the communication.

Use this secure facility to:
Send Official Response to an external review request or assignment (Attach multiple documents as needed)
Send acknowledgment, quick note, or other short comments which don't require an attachment.

*All communications require DOI File Number, Requestor/Patient Name, Correspondence Type, and Sender Name and Phone

*DOI File Number:  
*Requestor Name:  
Patient Name:
*Type of Correspondence:  

*Sender Information: Please give us your entity name, your name and your phone number, in case we have questions about your correspondence.
*Entity Name:
*Your Name:   *Phone:
To receive an email summarizing your communication, please provide an email address.
Email Address:

Quick Note
For communications not requiring an attached document, please enter appropriate information.

Official Response
Supporting Documents
Please attach information (on company letterhead) and supporting documentation below.
(Please use common file formats: PDF, Word, Excel, TIF, and NOT PASSWORD PROTECTED.)

To attach files, click the 'Browse' button, select the file to attach, then press the 'Attach File' button.
Each attached file must be less than 4MB. Total size of all attachments should not exceed 19MB.
To remove an attached file, click the 'Delete' link next to the attachment name.