Lodge a Complaint

The Insurance Regulatory Authority has a mandate to protect the interests of policy holders. The Authority therefore takes complaints seriously and has developed an internal procedure for handling complaints. Please use this form to tell us about your complaint so we can be able to help you. If you’re not sure about anything or have any difficulties filling in this form, you can get in touch with us by phone or email.

Highlighted fields are required!

Details of Person Filing Complaint

First Name

Last Name

Email Address

Phone Number

Street/Postal Address

City/Region

Country

My Complaint is Against:

Details of Policyholder

Same as applicant

First Name

Last Name

Email Address

Phone Number

Policy Details

Type of Policy Held

Policy Number

Claim Number

Complaint Particulars

Has there been any court action relating to your complaint? (either past or planned)

No / Yes

Declaration

I would like The Insurance Regulatory Authority to consider my complaint. I confirm that all the information I have given you is true and accurate to the best of my knowledge.

I understand that:

IRA will need to handle personal details about me which could include sensitive information in order to deal with my complaint effectively;
IRA may need to exchange information about my complaint with the party I have complained about and any other relevant organisations;
IRA may publish examples of where things can go wrong, based on real cases, but you will always respect my privacy and keep my personal information confidential.

I declare that the information furnished in this submission and supporting documents is true and correct.

Detail of the Other Insured Party

Policy Details

Complaint Dates

Complaint Particulars

Declaration

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