Complaint Intake Form
(Insurance Company, Email and US Mail)


This non-jurisdictional Complaint Response (Email and US Mail) form will help insurance company complaints departments draft acknowledgements to complaints received through email and US mail, and includes practical guidance and notes. Bracketed terms should be amended to reflect company details where applicable.This form is an acknowledgement and not the response the company will provide after investigating the complaint.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, Customer Calls) and Complaint/Comment/Inquiry Acknowledgments (Insurance Company, Social Media).