Complaint form

Title (required)

First name (required)

Last name (required)

Company/Organisation

Address 1 (required)

Address 2

Postcode (required)

Town (required)

Country (required)

Language (required)

E-Mail (required)

Phone (required)

Is someone complaining on your behalf (e.g. relative, acquaintance, conservator)?Yes

Insurance company (required)

Facts: What has happened? (required)

Date: When did the damage occur? (required)

Expectations: What is your complaint about? What would you like to happen? (required)

Insurance policy or pension certificate (required)Choose file: No file selectedMaximum 10 MB in pdf, jpeg, docx or png format

General Terms and Conditions of Insurance or RegulationsChoose file: No file selectedMaximum 10 MB in pdf, jpeg, docx or png format

Letter of complaint to insurerChoose file: No file selectedMaximum 10 MB in pdf, jpeg, docx or png format

Statement of insurerChoose file: No file selectedMaximum 10 MB in pdf, jpeg, docx or png format

Additional documentsChoose file: No file selectedMaximum 10 MB in pdf, jpeg, docx or png format

I agree to the declaration of consentDeclaration of consent (required)

I would like the Swiss Insurance Ombudsman to consider my complaint.

I authorise the Swiss Insurance Ombudsman to enter into direct contact with the insurance company if he considers it appropriate and forward to it, at his own discretion, letters and documents that I provide him with.
I am aware of and consent to the following: correspondence exchanged between the Swiss Insurance Ombudsman and me and the insurance company, respectively, during the intervention will not be forwarded. I shall receive a copy of the insurance company’s final statement.
I understand that if I inform the involved insurance company that I have submitted a complaint to the Swiss Insurance Ombudsman, he may inform the involved insurance company whether this is true and whether he deems it necessary to resolve the complaint through an intervention. If he does not intend to intervene, he will keep the reasons underlying this decision confidential.