State Department of Insurance Complaint (Template)

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Replace each [BRACKETED] placeholder with your specific information:

Template body

[YOUR FULL NAME]
[YOUR ADDRESS]
Email: [YOUR EMAIL]
Phone: [YOUR PHONE]

[TODAY'S DATE]

[STATE] Department of Insurance
Consumer Services Division

Re: Complaint regarding total-loss valuation handling
    Insurer:       [INSURER NAME]
    Policy:        [POLICY NUMBER]
    Claim:         [CLAIM NUMBER]
    Date of loss:  [DATE OF LOSS]

To Whom It May Concern,

I am submitting this complaint regarding [INSURER NAME]'s handling of my
total-loss claim. I believe the carrier has failed to comply with its
contractual obligations and with [STATE]'s unfair-claims-practices
standards.

Background:

  1. My vehicle was declared a total loss following the [DATE OF LOSS]
     incident.
  2. The insurer's first-pass valuation report contains documented
     errors, including incorrect comparable selection, missed factory
     options, and (where applicable) an unsupported typical-negotiation
     discount applied to advertised prices.
  3. I submitted a documented counter-valuation supported by current
     local-market dealer comparable listings and a line-by-line
     adjustment audit. The carrier's most recent offer is $[INSURER
     OFFER]; my documented counter is $[YOUR COUNTER].
  4. The carrier has rejected my counter without providing itemized
     justification for the rejection. A supervisor-level escalation has
     not produced a substantive response.

Specific concerns:

  - Failure to provide a complete, itemized explanation for the
    valuation adjustments, despite repeated written requests.
  - Selection of comparable vehicles that are not representative of the
    local replacement-vehicle market.
  - Use of condition grades and adjustment categories that are not
    supported by the documented condition of my vehicle.

Requested resolution:

  1. Investigation of [INSURER NAME]'s handling of this claim.
  2. Order requiring the carrier to provide a complete, itemized
     explanation of every adjustment in the valuation report.
  3. Order requiring the carrier to issue a revised offer that reflects
     the documented errors, or a specific evidence-based explanation of
     why each adjustment is declined.

I have attached supporting documentation, including the carrier's
original offer letter, my documented counter-valuation, the current
dealer comparable listings, and copies of all written correspondence
with the adjuster and supervisor.

Thank you for your attention to this matter. I am happy to provide
additional documentation as needed.

Sincerely,



[YOUR FULL NAME]

Attachments:
  - Carrier's offer letter and valuation report
  - Counter-valuation worksheet
  - Comparable listing screenshots / URLs
  - Email correspondence with adjuster and supervisor

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