Complaint Intake Form
(Insurance Company, Customer Calls)


This non-jurisdictional Complaint Intake form will help insurance company complaints departments memorialize contact that outside parties make with the company. This form should be used to collected information is consistent and to ensure correct forwarding of information, and includes practical guidance and notes.Employees charged with answering customer calls should use intake forms when a customer or client contacts the company directly via phone, including corporate hotlines and call centers. When drafting your own form, amend bracketed terms to reflect company details where applicable.For more information on complaint responses, see Complaint Response (Insurance Company). For a checklist on how to manage complaints, see Complaint Response Checklist (Insurance Company). For annotated forms relating to other specific types of complaints, see Complaint Intake Form (Insurance Company, Email and US Mail) and Complaint/Comment/Inquiry Acknowledgments (Insurance Company, Social Media).