State of Maine
Workers' Compensation Division 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.
Important
information about filing a complaint
Please complete this complaint
form and submit it to our office. The form authorizes the Bureau to investigate
the matter on your behalf and provides us with 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, except that a copy
will be provided to the company, agent, or other insurance entity against
whom your complaint is made.
PLEASE PROVIDE INFORMATION
needed to help us research your complaint. The following is a list of information
that may be helpful: a copy of the information sheet (declarations page of
your policy), a copy of the final premium audit, insurance company loss runs,
written correspondence.
We may contact you if we have
questions or need further information. Additionally, we will advise you of
our conclusions once the investigation has been completed. This usually
takes a minimum of thirty days.
Please
note: The Bureau of Insurance does not have the authority to order the payment
of monetary judgments. In some instances we can order restitution for violations
of the Insurance Code. There are some disputes that are more appropriately
handled by the courts. However, we are often able to help and we will make
every effort to see that the insurance companies are complying with Maine
Insurance laws.
