STATE OF MAINE
LIFE AND DISABILITY DIVISION CONSUMER COMPLAINT FORM

Please note: Although it is most unlikely that you will experience any problems using this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may send an email to: Thomas.R.Michaud@maine.gov.

In response to your request for our assistance, below is a Consumer Complaint Form which must be completed and returned to this office. The form authorizes the Bureau to investigate the matter on your behalf; and provides us the basic information we need to investigate your complaint. The form may be submitted either electronically or by mail. If you choose to send the electronic form, the Bureau cannot guarantee the confidentiality of your complaint during electronic transmission. Once received by the Bureau your file will be confidential.

PHOTOCOPIES of any correspondence, insurance policies, or other documentation related to your insurance problem (such as letters you have written to the insurance company or agent concerning your complaint, letters the insurance company or agent has written to you, copies of your explanation of benefits or letter(s) explaining how benefits were calculated, a copy of your insurance policy, a copy of any insurance illustrations or marketing material presented to you by the agent or company, any additional information you feel might be pertinent to the complaint, etc.) may be necessary in order for the Division to act upon your complaint.

Your complaint will be assigned to a Claims Examiner who will contact you by mail at the beginning of their investigation and will advise you of their conclusions once the investigation has been completed. This usually takes a minimum of forty-five days after receipt of a company's response, although it may take much longer if your complaint involves a complex problem.

Please note the Bureau does not have authority to order the payment of monetary judgments, although in some instances we can order restitution for violations of the Insurance Code. Some disputes are more appropriately handled by the courts. We are often able to help, however, and we will make every effort to see that you are treated fairly by the insurance companies we regulate.