Georgia-Insurance-Commissioner-Complaint-Form-pdf

Georgia-Insurance-Commissioner-Complaint-Form-pdf

Instructionsfor Completing the CONSUMER Complaint Form
Consumer complaint filings can be made choosing ONE (please select only ONE) of the following methods:
Consumer Complaint
Portal:
www.oci.ga.gov
(preferred method)
Fax:
(404) 657-8542
Postal Mail:
Georgia Insurance Commissioner’s Office
Consumer Services Division
2 Martin Luther King, Jr., Drive, Suite 716, West Tower
Atlanta, GA 30334
* On-line Consumer Complaint Portal filing is the preferred method because it follows a digital workflow reducing processing costs.
Follow these steps only if faxing or postal mailing the insurance issues to the Department:
• Complete the Consumer Complaint Form GID-CS-CF-1 to file the complaint by:
– filling in the interactive form fields using a free Adobe Reader, then print and fax or mail; or,
– printing a copy of the form then type or handwrite legibly in blue or black ink to avoid unnecessary
delays in processing your complaint.
• Clearly state the full name of the company or third party administrator against whom you are lodging your
complaint. (Do not abbreviate the company’s or third party administrator’s name, as this may cause delays in
identifying the correct company.)
• Include your e-mail address for communication purposes.
• Date and signed (digital signatures are accepted for the electronic form) the completed form.
• Attach copies only of pertinent documents to support your complaint.
!!! KEEP YOUR original documents for your records, DO NOT send us your originals !!!
Upon receipt of your complaint, a case will be created and assigned to an investigator in the Consumer Services Division.
You will receive an acknowledgement letter stating your case number and the name of your investigator.