HTML Preview Insurance Company Complaint Letter page number 1.

ANNEX-VI-A

Complaint No: _________________

Date: _________________

To,

The Insurance Ombudsman,

________________________________

________________________________

________________________________

Policy No. : ________________________

Name of Complainant: ___________________

Being aggrieved, I am lodging complaint against the above referred Insurance Company.

Details are given as under:-

1. Complainant’s full Name and Address-

i. Name: _________________________________

ii. Address: _________________________________

Relationship to the Insured person: ___________________________