Bad Faith Insurance Contact Form

Name

E-mail Address

Phone Number

Business Phone

Cellular or Pager

Address

City

State

Zip

I suspect I have been a victim of bad faith insurance practices because:

Name, address and phone number of any contacts you may have spoken with at the insurance company.

When did your insurance loss occur?

Why do you feel your loss is covered?

Do you have any evidence that the insurer acted without following customary claim practices?

Do you have records that indicate the insurer acted in a mean or malicious manner?
Yes No
If yes, please list

Do you have any additional information or concerns?

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