Section 3-6 - Initiation of Proceedings (a) A proceeding under these rules shall be initiated by the filing of a statement of dispute by the complainant. The statement of dispute shall be filed within one (1) year of the occurrence or discovery of the event forming the basis of the dispute, and shall contain the following: - (i) The complainant's name, address, telephone number, social security number, and place of employment;
- (ii) A brief description of the dispute;
- (iii) If the dispute involves the denial of coverage or of a claim, the statement shall include the reasons for denial, as understood by the complainant;
- (iv) Copies of any relevant documents, including but not limited to bills, statements, and the carrier's explanation of benefits;
- (v) Information regarding any contacts the complainant has had with the opposing party regarding the disputed matter, including attempts to settle the dispute; and,
- (vi) A statement verifying that a copy of the statement of dispute has been sent to the carrier or other opposing party, and stating the date upon which the copy was sent.