Annual Complaint Log

The State of New Hampshire

Insurance Department

56 Old Suncook Road

Concord NH 03301-7317

(603) 271-2261 Fax (603)271-0248

TDD Access: Relay NH 1-800-735-2964

Roger A. Sevigny

Comissioner

BULLETIN

Docket No. INS 04-003-AB

TO:

All Licensed Companies

Date: January 14, 2004

FROM:

Roger A. Sevigny

Insurance Commissioner

SUBJECT: Annual Complaint Log

The purpose of this Bulletin is to remind companies that pursuant to RSA 417:4 XVII ( c ) of

Chapter 417, companies must provide the Department an annual complaint log. For purposes

of this Bulletin, the definition of complaint is a communication primarily expressing a grievance.

Grievance is defined as any expression of dissatisfaction. The log must use the following

format. To complete, indicate the number of New Hampshire complaints received by the

Insurance Department and directly by the Company for each issue listed.

New Hampshire Complaints

Insurance Department

#

Company

#

A.

Cancellation

B.

Non-Renewal

C.

Claims (First Party)

D.

Claims (Third Party)

E.

Rating

F.

Sales

G.

Underwriting Procedures

H.

Miscellaneous/Other

Annual complaint logs are due to the Department by the last day in January for the preceding

year. If the logs are not filed by this date, appropriate fines and penalties will be assessed.

Annual complaint logs should be submitted to “Director, Consumer Services Division”. If you

have any questions on this Bulletin, please email the Consumer Division at

requests@ins.nh.gov, or contact the Department by phone at the above number.