Winnie Murugi
Winnie Murugi
Health and Beauty Expert
Download a Sample Letter of Complaint About an Insurance Company

Amid the looming uncertainties of life, insurance has become essential for safeguarding ourselves from the inherent risks of living. The importance of the different types of insurance cannot be overstated. Insurance, from health and life to property and auto offers financial security and the sense of serenity.

However, the process of claiming your benefits when the time arises can be challenging, as evidenced by the numerous insurance complaints on Sometimes, the once smooth-talking insurance providers become elusive and difficult to deal with when processing requests.. 

This leads to immense frustration. However, before you report insurance companies to the relevant agencies that protect consumer rights, such as the State Department of Insurance, it is recommended that you first attempt to resolve the issue with your service provider. 

Key Insights:

  • You can file a complaint about an insurance company for issues such as claim denials, delays in processing, and unfavorable hidden policy terms. 
  • The most effective ways to raise a complaint with your insurance company are by phone, through writing an official complaint letter, or by filling out the online complaint form.
  • To successfully address any concerns or issues with your insurance company, thoroughly consider your complaint and gather the necessary documentation to support your case.

This article will offer the best tips on how to complain about an insurance company.

1. When to File a Complaint Against an Insurance Company?

Below are some common issues or circumstances that may warrant that you file a complaint against an insurance company:

  • The terms of the insurance policy have changed without your approval or were unknown to you.
  • The terms of the insurance policy were not clearly discussed or explained during the purchase.
  • Your complaint was not drafted or fulfilled in a proper or legal way.
  • Your insurance claim has been unreasonably denied or underpaid.
  • Delays in processing your claim.

2. How to File a Complaint Against an Insurance Company?

Download a Sample Letter of Complaint About an Insurance Company

There are 3 ways you can file a complaint against an insurance company – by phone, online, or in person. The following provides an outline of each method.

Insurance complaints by phone

Before sending any type of your complaint letter, you should call your insurance company first. Most of the companies have pretty good technical support with toll-free customer assistance. Your insurance complaints can sometimes be discussed and resolved during a telephone conversation with the company's representative. It may eliminate the need to write a letter of complaint about the insurance company.

Follow these steps to effectively complain to your insurance company over the phone:

  • Think over your complaint in detail and describe it in the most effective way.
  • Be ready to send copies (by no means your original papers) of the documents, pictures, invoices, and any other “pieces of evidence” concerning your case.
  • Familiarize yourself with the insurance policy terms that have been breached and refer to them during your call.
  • Ask the representative all the relevant questions you may have regarding your claim. 
  • Make a record of the call, either by taking notes or recording the phone call on your phone for future reference.
  • Ask for a written response in return to your claim.

If your case was not resolved on the phone, you have the opportunity to file your insurance complaints in alternative two ways.

Send insurance complaints online

If the company has an email, you can always complain via email. However, typically, insurance companies provide an online form that a consumer should fill out. The information included in the form depends on the type of insurance.

This is the example of filling in a claim form with fully described steps on insurance company official page:

How to file insurance claim online

Submit claim in person

Personal visit to the insurance company is also a good way to solve your problem. Majority of people are sure that this is the most effective way to make a claim. No doubt, the private visit has a lot of advantages – you have the opportunity to speak to a company representative face to face, understand how your conversation ‘flows’, describe your issue in your words, and so on.

3. Tips to Write a Letter of Complaint Against an Insurance Company

Download a Sample Letter of Complaint About an Insurance Company

It’s possible to go to the company office and forget about some facts or details, get nervous, or you will have to spend much of your time in a queue. In this case, it is best to write a letter of complaint against the insurance company. 

Below are the best tips on how to write a grievance letter to your service provider.

Main points to include in a complaint against an insurance company 

Any type of complaint letter (life insurance complaints, auto insurance complaint, home insurance complaint, health insurance consumer complaints or any other) should be drawn correctly.

A complaint against any insurance company must include:

  • Your personal details including full name, contact telephone number, e-mail, and address.
  • The exact name of the insurance company.
  • Your insurance policy number.
  • Names of all the participants who were involved in the case.
  • Copy of your insurance card (if requested).
  • The exact date of your incident or loss.
  • Description of your issue in details.
  • Your Claim number.
  • Your offers, variants or suggestions concerning the resolution of your problem, fair and full problem settlement description.
  • Copies of the documents that can assist in the resolution process of your claim – invoices, certificates, pictures, advertising materials, video recordings, proof of communication between insurance company representative and you.

Don’t forget to ask for your complaint reply. Remember that every insurance company is obliged to return you the answer in details. You may also download a sample letter of a complaint about an insurance company above to keep it as an example.

Before writing a letter of complaint yourself, remember first to check thoroughly your insurance company’s website. Many insurance companies would like to see some definite forms of complaints. That’s why they publish these forms on their official websites for their customers to write claims in a way they want it. For example, Aflac insurance company offers such insurance claim forms:

how to submit insurance claim

how to claim insurance injury

Key steps in filing a complaint

In order to avoid different misunderstandings you should also:

  • Thoroughly learn insurance policies.
  • In order to be sure about your rights and responsibilities, get acquainted with the Consumer Bill of Rights.
  • Systematically check your phone, email and give quick responses.
  • Collect all the documents concerning your problems.
  • Always abide the rules of the procedure.

You always have a chance to have your complaint be previously reviewed by an experienced claims specialist. Some attorneys provide these services for free.

4. How Long Does an Insurance Company Have to Investigate a Claim?

The exact time it takes an insurance company to investigate a claim varies from state to state, depending on the complexity of the claim, the type of insurance, and applicable laws and regulations. 

That said, insurance companies have a duty to their customers to conduct the investigation and resolve the issue promptly. At the bare minimum, the company should acknowledge receipt of your complaint within a few days of filing it and regularly update you on the progress. On your end, check in with the company regularly.

Before proceeding to report insurance companies to the relevant customer rights agencies, reach out to your insurer in an effort to resolve your issue. It is crucial you understand your policy and learn how to write a grievance letter to be able to communicate your complaint effectively. If you are not sure what to do, check out a sample complaint against the insurance company.

What has been your experience with your insurance service provider? You may leave a review on our website.

Legal disclaimers:

  1. While every effort has been made to ensure the accuracy of this publication, it is not intended to provide any legal, medical, accounting, investment or any other professional advice as individual cases may vary and should be discussed with a corresponding expert and/or an attorney.
  2. All or some image copyright belongs to the original owner(s). No copyright infringement intended.

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