Office of Insurance and Safety Fire CommissionerJohn F. King
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Consumer Services Forms

Form #GID-258-LH (same as Provider Instructions) This is in the Adobe Portable Document format (pdf)\nDivision: Consumer ServicesPublished: 2017
Title: Provider Complaint Form
Please use this Provider Complaint Form when Mailing your Insurance provider issues into the Department.

If you are a Consumer, please do not use the Provider Complaint Form on consumer issues. Instead, you should use the Consumer Complaint Form GID-CS-CF-1 located under Quick Links on our Home Page of this website.
PID:402-SID:572-FN:GID-258-LH.pdf

Form #GID-258-LH (same as Provider Instructions) This is in the Adobe Portable Document format (pdf)\nDivision: Consumer ServicesPublished: 2017
Title: Provider Complaint Form
Please use this Provider Complaint Form when Mailing your Insurance provider issues into the Department.

If you are a Consumer, please do not use the Provider Complaint Form on consumer issues. Instead, you should use the Consumer Complaint Form GID-CS-CF-1 located under Quick Links on our Home Page of this website.
PID:402-SID:1561-FN:GID-258-LH.pdf

Form #GID-CS-CF-1 This is in the Adobe Portable Document format (pdf)\nDivision: Consumer ServicesPublished: 2017
Title: Consumer Complaint Form
Please use the complaint form attached when mailing or faxing your insurance issues to the Department. This is an Adobe Interactive Form, so you may fill it out on-line and print it and send it to us.

Instead of using this form to file a consumer complaint, we encourage you to use the CONSUMER COMPLAINT PORTAL located on the Home Page of this website and also located under Consumer Services Quick Links. On-line Consumer Complaint Portal filing is the preferred method because it follows a digital workflow reducing processing costs.
PID:91-SID:42-FN:GID-CS-CF-1.pdf

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