Making a complaint about insurance

About this form

Please use this form to tell us about your complaint and we will forward the information to Hiscox Insurance Company Ltd. on your behalf.

Please be aware that Hiscox may contact you directly with regard to your complaint and by completing this form, you are consenting to Hiscox using your contact details solely for the purpose of resolving your complaint.

If you need help with this form, please telephone FHT on 023 8062 4350 and we will do our best to help you.

Details about the policy holder…

Title

First Name

Surname

Street Address

Address Line 2

Town

County

Postcode

Phone Number

Email Address

How would you prefer to be contacted? *

Post

Email

FHT Membership number

Insurance policy number *

Claim reference number (if applicable)

Please give details of your complaint...

Which policy is your complaint in relation to?

Is your complaint in relation to the handling of a claim?

Yes

No

On which date did the incident occur? * +

Please describe the incident you are complaining about *

If your complaint is upheld, what would you consider an acceptable resolution? *

Do you have supporting evidence?

List below any supporting evidence you intend to provide

+-

Please upload your supporting evidence here

Finally, please read and sign the declaration...

I would like the Federation of Holistic Therapists to consider my complaint. I confirm that all the information I have given is true and accurate to the best of my knowledge.

By signing this declaration I confirm that:
1. I give permission for the FHT and Hiscox Ltd. to handle personal details about me, which could include sensitive information, in order to deal with my complaint effectively. I understand that the details provided on this form will only be used for the purpose of handling this complaint.
2. I give permission for the FHT to pass the details of my complaint to Hiscox member concerned as part of the complaint procedure and for Hiscox Ltd. to handle personal details about me, which could include sensitive information, in order to deal with my complaint effectively. I understand that the details provided on this form will only be used for the purpose of handling this complaint.

*

clear