customer-complaint-compliance-escalation.md

Uploaded 8/8/2026, 11:53:28 PM

# Customer Complaint Escalation to Compliance

When a policyholder files a formal complaint, the Claims Team or Agent who received it logs it in the CRM, then forwards it to the Compliance Officer.

The Compliance Officer first reviews the claim or policy history related to the complaint, then determines whether the complaint involves a potential regulatory issue.

Policy requires all formal complaints to be acknowledged to the policyholder within 5 business days, per state insurance regulations. In practice, the Compliance Officer usually responds within 2 days for complaints that look serious, to avoid escalation to a state regulator.

Complaints involving suspected discrimination in underwriting decisions are always escalated directly to the CFO, per the Discrimination Complaint Policy — this bypasses standard Compliance Officer review.