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Complaint Form

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Please Note

The following form is designed to escalate your complaint/concern to an appropriate member of the Peel Mutual Insurance Company Management Team.

Name *

First

Last

Email *

Phone *

Policy Number and/or Claim Number *

What is the nature of your complaint? *

Billing
Claims
Broker
Service
Vendor
Policy – Personal Insurance
Policy – Commercial or Farm Insurance

Have you discussed your concerns with your agent/broker or claims adjuster? *

What advice did you receive from your agent/broker or claims adjuster when discussing your concerns? *

What is your complaint against Peel Mutual Insurance Company? *

What impact has your complaint had on you? *

What is your expected outcome? *

Date / Time *

Date

Time

I hereby declare: *

That by submitting this complaint, I am the above indicated and/or named insured and the information provided is true and accurate to the best of my ability.

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Peel Mutual Insurance Company

103 Queen Street West, Brampton, ON L6Y 1M3

Phone: (905) 451-2386 or (800) 268-3069

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PMIC has been providing a complete line of home, automobile, farm and commercial insurance products and serving Ontario residents since 1876. PMI has grown to be one of the largest mutual insurance companies in Ontario and is proud to be a member of the Ontario Mutual Insurance Association

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