File Agent Complaint

You may download and print (Adobe Acrobat Reader required) the complaint form below. Fax, e-mail (scanned copy), or mail the completed form to the fax number, e-mail address, or mailing address below:

Agent Complaint Form (Fillable PDF)

Mississippi Insurance Department
Attn: Investigations and Consumer Protection Division
P.O. Box 79
Jackson, MS 39205
Fax Number: 601-359-2474

***To request a form by mail, you may call 1(800) 562-2957, send a written request to the above mailing address or send a request to the above e-mail address.

The following information MUST be included in order for the Mississippi Insurance Department to be able to properly investigate your complaint:

  • Your name and your relationship to the insured.
  • Daytime telephone number
  • Name of insured.
  • Insured’s address name, address, city, zip code, and phone number.
  • The complete name of the agent complaint is against.
  • Type coverage.
  • Description of complaint
  • The form is signed and dated.

What happens when we receive your complaint:

Once we receive your complaint, it will be assigned to one of our Investigators, who will review it and take the necessary steps in an attempt to resolve the matter. Our investigators may request additional information/documentation from you to support your position. We will notify you of our findings.

Note: Agent/Fraud related complaints are handled by the Investigations and Consumer Protection Division. Please contact our Consumer Services Division at (800) 562-2957 or, if your complaint is claim related and does not involve fraudulent or questionable acts on the part of your agent.