Article Guide
Navigating the world of insurance can often feel overwhelming, especially when issues arise that require formal intervention. The New York Department of Insurance provides a structured approach for consumers to voice their concerns through a specific complaint form. This form is designed to streamline the process of reporting grievances against licensed insurance entities, ensuring that your voice is heard. It requires essential details such as the name of the entity you are complaining about, your contact information, and specifics regarding your policy or claim. Importantly, while the Department investigates these complaints, it does not offer legal advice or representation. Instead, it serves as a mediator to facilitate resolution. Additionally, the form encourages you to attach any relevant documents that could support your case, but remember, originals should never be sent. After submission, you can expect a written acknowledgment that includes a file number, which is crucial for any follow-up correspondence. Understanding how to properly fill out this form can significantly enhance your chances of a satisfactory outcome.
Preview - New York Dept Insurance Form
New York State Insurance Department
Consumer Services Bureau
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25 Beaver Street |
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Empire State Plaza Building #1 |
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New York, NY 10004 |
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Albany, NY 12257 |
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(212) |
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(800) |
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Fax (212) |
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Fax (518) |
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Name |
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Complaint Is Against |
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Telephone Number Including Area Code |
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Complaint Is Against |
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On Behalf Of |
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Policy/Claim Number/Date Of Loss |
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The Insurance Department investigates insurance complaints involving licensed insurance entities.
The Insurance Department CANNOT: Act as your lawyer, give legal advice, recommend, or rate insurers.
Use the other side of this form to provide us with the details of your complaint or inquiry. Include copies of papers or photos you believe will assist us. Do not send originals!
You will receive a written acknowledgment with your file number(s) by mail. If you wish to send further correspondence, please include that number. If you fail to do so, it may slow down the processing of your complaint.
I authorize the respondent to furnish to the Insurance Department any information related to this matter. I am enclosing copies of any correspondence or other papers which I feel would help your investigations. I understand that a copy of this form and any or all of the enclosed information may be sent to the respondent.
Signature ________________________________ Date: ______________________________
Form Characteristics
| Fact Name | Description |
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| Contact Information | The New York Department of Insurance is located at 25 Beaver Street, Empire State Plaza Building #1, New York, NY 10004, and Albany, NY 12257. Phone numbers include (212) 480-6400 and (800) 342-3736. |
| Complaint Process | The form allows individuals to file complaints against licensed insurance entities. It requires detailed information about the complaint and relevant parties. |
| Limitations | The Insurance Department does not provide legal advice, act as a lawyer, or recommend insurers. Its role is strictly investigative regarding insurance complaints. |
| Authorization Requirement | By signing the form, individuals authorize the respondent to share information with the Insurance Department related to the complaint. |
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