Consumer Complaint Guidelines
- Give you legal advice, act as your lawyer or interfere in a pending lawsuit
- Recommend one insurance company or agent over another
- Decide disputes based on who is negligent or at fault
- Determine the facts surrounding a claim (that is who might be telling the
truth in a matter when accounts of that matter differ)
- Resolve a complaint if the only evidence is your word against the word of others
What should I send with my complaint form?
- Documentation may be sent by postal mail or electronically.
- Letters you have written to the company or agent dealing with the problem
- Letters you have received from the company or agent
- Other letters written about the problem, that is, from your doctor or lawyer
- A copy of your policy or the excerpt from your benefits handbook that covers the situation
- Relevant sales literature or worksheets
- For a Health complaint, your insurance ID card (copied front and back) if possible
- The claim you filed, if applicable
NOTE: Documentation supporting your complaint must be received by the Division
within 10 days after the complaint is filed. Lack of documentation will cause your complaint to be closed.
- 1.Within two weeks of filing, you should receive an acknowledgement letter stating:
- your file number
- the name of the consumer service specialist assigned to investigate your complaint
- 2.The Division will send a copy of your complaint to the company or other appropriate party and ask for an explanation of their position.
- 3.Your specialist will review all responses received to assure the problem has been properly addressed. This may result in more letters or phone calls between the examiner and the company or other parties.
- 4.Your specialist will send you a letter with the investigation results
- if no evidence of a violation is found, the specialist will so advise and explain why the investigation is being closed
- if your specialist is not satisfied with the company's response, the investigation will continue