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Name of Customer*

Policy No.*

Complaint Against

Name of Insurance Agent you purchased the policy from*

Agent Code*

Were you satisfied with the advice rendered by the agent when selecting an insurance product for your specific need

If Dissatisfied, please elaborate why

Name of Agent Training Institute - ATI (These are offline agent training institutes which impart practical training to a prospective agent in person in a class room)*


Name of Insurance Agent you purchased the policy from*

Agent Code*

Do you think that the ATI has done a satisfactory job in training the agent

If No, please elaborate why

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Please note the fields marked with '*' are mandatory

 

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Report for the Month of January 2008

Month/year
No of complaints open in the begining of the month
Total complaints received in the month
Total complaints closed in the month
Total complaints open till date
-
-
-
-
-
 

Please Select the month and year

Month

Year


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Report for the Month of January 2008

Agent Training Institute
No of agents trained
No of Agents facing complaints
123456
1
-