Get New Hampshire Insurance Department Consumer Complaint Form ... - Nh

This guide provides clear and detailed instructions on how to successfully complete the New Hampshire Insurance Department Consumer Complaint Form. By following these steps, you can efficiently submit your complaint regarding issues with your insurance provider.

Follow the steps to complete your complaint form

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Enter your name in the 'Name of Complainant' field. If applicable, include the date of loss.
3. Provide your street address, followed by your city, state, and zip code to ensure accuracy in your contact details.
4. Fill in your daytime telephone number and extension, if applicable, for further communication.
5. Input your email address in the designated field for correspondence regarding your complaint.
6. Indicate the name of the insured party. If it is the same as your name, select 'Same'; if different, choose 'Other' and specify their name.
7. Select who your complaint is against by choosing from the options: Company, Agency/Producer, Adjuster, or Other.
8. Provide the name and address of the company or agency involved in your complaint.
9. List relevant Group, Policy, or Claim Number(s) if you have them, aiding in the tracking of your complaint.
10. Select the type of coverage involved—options include Automobile, Homeowners, Health, etc.—to categorize your complaint.
11. Choose the reason for your complaint, such as Claim Delay/Denial, Premium issues, or Cancellation.
12. Answer whether you have attempted to resolve the matter with the responsible company or agent.
13. Provide the name and contact number of the person you spoke with regarding the issue, if applicable.
14. In the provided space, describe your problem in detail to give context to your complaint. If more space is needed, attach a separate document.
15. State what you consider to be a fair resolution for your issue to guide the resolution process.
16. Review and type your name to agree to the authorization statement regarding information sharing with the insurance company.
17. Confirm your agreement with the certification statement by typing your name and including today's date.
18. Once you have filled out all the necessary sections, save your changes. You can then download, print, or share the completed form as needed.

Submit your completed complaint form online to ensure it reaches the New Hampshire Insurance Department promptly.