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Electronic Complaint Forms

In response to your request for our assistance, below are electronic Consumer Complaint Forms to be completed. If you choose to send an electronic form, the Bureau cannot guarantee the confidentiality of your complaint during electronic transmission. Once received by the Bureau your file will be confidential.

It is possible for some types of complaints you may be required to provide a signed release form. If this is the case, you will be contacted by a Bureau of Insurance staff person, who will provide you with the necessary form.

PHOTOCOPIES of any correspondence, insurance policies, or other documentation related to your insurance problem (such as itemized medical bills, explanation of benefit forms, property loss forms, vehicle appraisals, police reports, copy of all correspondence concerning your complaint and a copy of that portion of your policy relating to your concern, etc.) may be necessary in order for the Division to act upon your complaint.

Your complaint will be assigned to a Claims Examiner who will contact you by mail at the beginning of their investigation and will advise you of their conclusions once the investigation has been completed. This usually takes a minimum of thirty days.

Please note the Bureau does not have the authority to order the payment of monetary judgments, although in some instances we can order restitution for violations of the Insurance Code. Some disputes are more appropriately handled by the courts. We are often able to help, however, and we will make every effort to see that you are treated fairly by the insurance companies we regulate.

Health Complaint Form
(includes Annuity, Credit, Disability, Life, Health/Medical, Long Term Care, Medicare Supplement)

Property and Casualty Complaint Form
(includes Fire/Homeowners, Auto, Motorcycle, Workers’ Compensation, Boat, Snowmobiles)


Last Updated: August 22, 2012