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CoverMore Agent Complaint Form
Complaint Form
Contact Type *
Account Holder
Parent/legal guardian
Family member
Power of Attorney
Executor of an Estate
Legal representative
Insurance broker
Friend/colleague
Travel Agent
Investigator
Other Agent
Local Member
Company Name *
Cover-More
Medibank
Australia Post
AHM
NRMA/SGIO/SGIC
Helloworld
Freely
Indepedent Brokers
Independent Agents
Virgin Australia
Flight Centre
Webjet
Air New Zealand
Travellers Choice
STA Travel
Malaysian Airlines
Resilium
Steadfast
Coles
Halo
CBA
Phil Hofman Travel
Other
Date you received the complaint *
First Name
Surname
Policy Number (if known/applicable)
Mobile Phone
Email Address *
Description of Complaint Issue *
Desired Outcome
By submitting this complaint, I consent to have read and understood the Privacy Policy and confirm that I am aware that my personal info. (including sensitive information where relevant) will be used and disclosed in accordance with the Privacy Policy.
Yes, I provide my consent.
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