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Complaint form
Have an unsatisfactory experience? We value your feedback and invite you to file a formal complaint using the form below.
Your personal information as complainant
First Name
*
Last Name
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Contract reference
Your contract reference starts with "P-" or a country code (e.g., FR, NL) followed by digits. Examples: P-ABCDE12345, NL1234567890.
Licence plate
*
Product
Country
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Context of your complaint
What is your complaint in reference to?
*
Claim (eg. you are not happy with the resolution of your claim)
Insurance coverages (eg. you are not satisfied with what is or is not covered by this insurance)
Roadside Assistance (eg. you are not satisfied with the assistance provided by the Assistance partner)
Distribution & Customer Care service (eg. you are not satisfied with the service you have received from the Qover Customer Care team)
Please provide your claim reference
*
Are you complaining on behalf of
*
yourself
someone else
Please make sure the insured person has given us authority to discuss the complaint with you.
Are you complaining in your capacity as
*
policyholder and/or insured
third party
Complaints details
Tell us in your own words what happened
*
What would you like to see happen to put things right for you?
*
Submit
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