Online Complaint Form

By submitting this form, I hereby authorize the Office of the Consumer Advocate for Insurance to help me resolve my issues, problems with my insurance company. Therefore, the OCAI may check my personal information with my insurance company. My insurance company and/or broker is hereby authorized to give and share any and all pertinent information relevant to my file to the OCAI. I acknowledge and agree that this disclosure of my personal information will only be for the purpose of resolving my issues or problems with my insurance company.