To file a complaint against a life or homeowners insurance company with the Louisiana Department of Insurance, you need to complete the Complaint Report Form thoroughly. Here’s a detailed explanation of what information is required for each section of the form:
Section I: Personal Information
- Your Name: Provide your full legal name.
- Home Phone: Your home phone number.
- Address: Your full residential address including street, city, and zip code.
- Work Phone: Phone number where you can be reached during work hours.
- City, State, Zip: Specific location details.
- Cell Phone: Your mobile phone number.
- Insured: This may be your name if you are the policyholder. Look at the policy.
- Email: A valid email address for communication.
- Claimant: Specify the name of the insurance claimant’s name here.
- Date of birth: The claimant’s date of birth.
- Social Security # (last four digits): Last four digits of your social security number.
- Age Group: Mark the box that corresponds to your age category.
Section II: Complaint Information
- Who is the complaint against?: Full and exact name of the insurance company, broker, agent, or adjuster.
- Address (if known): The official address of the company or individual being complained about.
- What type of coverage does this involve?: Check the appropriate box(es) that apply to your situation (e.g., Life, Homeowners, etc.).
- Policy Number, Group Number, Claim Number: These identifiers help specify the exact policy or claim involved.
- If involving group insurance, name of the employer: If your policy is through an employer, provide the employer’s name.
- Date of loss: The date on which the incident that led to the claim occurred.
Section III: Legal and Detailed Complaint Information
- Do you have an attorney representing you?: Indicate whether you have legal representation.
- Is there any court action pending?: Indicate if there is ongoing litigation related to the complaint.
- Have you previously reported this problem to our office or any other agency?: If yes, mention to whom and provide the file number if available.
- Reasons for your complaint: Check all reasons that apply such as Claim Denial, Claim Delay, Unfair Offer/Payment etc.
- Describe your problem: Write a detailed account of your issue, using additional sheets if necessary. Enclose copies (NOT ORIGINALS) of available documentation relative to your complaint, including any applicable ID cards, front and back.
- What do you consider to be a fair resolution to your problem?: Describe the outcome you are seeking.
- Signature and Date: Sign to certify that the information provided is accurate and understand that it may be shared with the involved parties.
Additional Documentation to Include
- Copies of all relevant correspondence with the insurance company or agent.
- Copies of relevant sections of your policy or benefits handbook.
- Any sales literature or worksheets related to your policy.
- A copy of your insurance ID card, if possible.
- The initial claim you filed, if applicable.
HELP FROM A LOUISIANA INSURANCE LAWYER
If you are a victim of your insurance company and and your claim has been denied, delayed or underpaid or you have questions about your claim, call and insurance lawyer at 866-289-2802 or submit your inquiry online. Please be advised that you may be facing important legal deadlines, so don’t delay.
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