Describe the problem or concern that this complaint is about. If this complaint is regarding an insurance policy of any type, please include the following information, if you have it: Policy and/or Claim number, the date on which the policy was purchased, the amount of premiums paid to date and the manner in which payment was made.
(Note: 3000 characters maximum; 0 characters entered, 3000 characters remaining.)
What outcome do you seek from filing this complaint:
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AG's office will direct me to resources on how to find my own lawyer. AG's office will provide information so I can try to resolve the problem myself. AG's office will review my complaint for possible mediation. I only want to let the AG's office know about this business or trade practice. I would like to update a complaint I filed recently.
If you are requesting mediation, what resolution do you seek (optional):
(Note: 300 characters maximum; 0 characters entered, 300 characters remaining.)
I. Disclosure of Your Complaint. Public Record. Under most circumstances, your complaint, and any documents submitted with your complaint, will be considered a public record and available to any member of the public upon request. In response to such a request, we generally will not disclose your name, address, phone number, or any other information that identifies you and will not disclose this form in response to any request that specifically seeks the complaint you submitted.
Disclosure to the Business or Organization. Do you authorize us to discuss your complaint with the company you are complaining about and any other parties that are related to your complaint?
Disclosure to Other Entities. Your complaint and any related information may be disclosed in its entirety to other law enforcement and regulatory agencies.
II. Consulting With a Private Attorney. The AGO cannot give you legal advice and is not able to be your private attorney, but represents the public interest. If you have any questions concerning your individual legal rights or responsibilities you should contact a private attorney.
By filling in my name above and checking this box, I acknowledge that I have read and understood the provisions above and certify that the information I have provided is true and correct to the best of my knowledge, and I adopt this as my online signature.