Get Il Consumer Complaint Form 2021-2025

Filing a complaint with the Illinois Department of Insurance is a straightforward process that requires accurate completion of the IL Consumer Complaint Form. This guide will assist you in filling out the form online, ensuring all necessary information is provided clearly and concisely.

Follow the steps to complete the IL Consumer Complaint Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by indicating whether this complaint has been filed before. Select 'Yes' or 'No' and, if applicable, provide the previous complaint number.
3. Enter the complainant's name and circle the appropriate title (Mr., Mrs., Ms., Dr., etc.).
4. Fill in the date of loss, complete the address fields including city, state, and zip code, and provide phone numbers and email addresses.
5. If the insured or policyholder is different from the complainant, fill in their details including address, city, state, and contact information.
6. Identify the individual completing the form and their relationship to the insured—options include 'Self' or 'Public Adjuster.'
7. Enter the policy number and claim number, along with the associated state and zip code.
8. Specify the insurance company or agency against whom the complaint is made, including their address and city.
9. Clarify whether the complaint is against your insurance company, another party's insurance company, your insurance agent, or a public adjuster.
10. Sign the authorization section, allowing the Department of Insurance to investigate the complaint. This signature must be from the insured or authorized representative.
11. If your complaint concerns cancellation or non-renewal, complete the relevant section, including the original effective date of the policy and the date coverage will terminate.
12. Attach any notice received from your insurance company related to the complaint. Indicate if you wish to request a hearing and provide details of your complaint in the designated area.
13. Review the entire form for accuracy and completeness. You can then save changes, download, print, or share the form as needed.

Complete your IL Consumer Complaint Form online today for prompt assistance!