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Ombudsperson Escalation Form

Please Note

The following form is designed to escalate your complaint to the Ombudsperson at Peel
Mutual Insurance Company. For the Ombudsperson to be in a position to help you, instead of redirecting
you, please ensure that you have followed the escalation steps below.

Name
What is the nature of your complaint?
Have you discussed your concerns with your agent/broker or claims adjuster?
If your concerns were not addressed in a satisfactory manner by your agent/broker or claims adjuster, did you escalate your complaint to a Peel Mutual Insurance Manager?
Did you request a business position from a Peel Mutual Insurance Manager?
Date / Time
I hereby declare:
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