How do I submit an appeal?

Eligible health benefit plan enrollees may appeal claims that have been denied in whole or in part, or authorizations that have been disapproved.

Download Appeal Form

Appeal Process:

Please note that the following language applies to most WGAT health benefit plans, however, the language of your health benefit plan is controlling and applicable in the event of a conflict between your health benefit plan and these instructions.

Eligible health benefit plan enrollees may appeal claims that have been denied in whole or in part, or authorizations that have been disapproved. Appeals must be in writing and sent to Western Growers Assurance Trust (“WGAT”) at the following address:

WGAT Claims
P.O. Box 2220
Newport Beach, CA 92658-8952

Please complete in the entirety the WGAT Appeal Form. Importantly, in your appeal please provide the reason(s) you disagree with the denial of the claim.  Your written appeal must be filed within 180 days from the date the notice of denial was mailed to you as indicated on the postmarked envelope unless your health benefit plan states otherwise. For example, some plans require an appeal to be filed within 60 days from the date the notice of denial was mailed to you as indicated on the postmarked envelope. You may request copies of any documents created by this office regarding your denial and PCMI may make a reasonable charge for the copies.

Claims Payment Questions:
Email: customerservice@wga.com
Phone:  800-777-7898
Fax:  949-809-8938