ASA-Michigan
P.O. Box 10099
Lansing, Michigan 48901-0099

(517) 484-2950 • (800) 451-2726
Fax: (517) 484-4950
in...@asamichigan.com
 
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Consumer Complaint Form

The information that is submitted will be saved at the ASA of Michigan database for three years. If the complaint is forwarded to the state of Michigan, some information may be deemed "public access."

ASA of Michigan will only share some or all of this information with the repair facility involved, the insurance company that is involved, or the state of Michigan only. Consumer information is not made available to public access on this Web site.

A copy of this report may be forwarded to the state of Michigan, either to the Bureau of Regulatory Services (B.R.S.) or to the Office of Financial and Insurance Services (O.F.I.S.).

Consumer Information
Name
Address
City
State
Zip
Daytime Phone
Evening Phone
Repair Facility Information
Repair Facility
Shop Representative
Address
City
State
Zip
Insurance Company Information
Insurance Co.
Insurance Claim No.
Insurance Co. Representative
Date of Loss
Insurance Co. Phone
Complaint About Repair Facility
 Facility not licensed
 Facility did not provide written estimate
 Inaccurate description of repairs performed
 Did not itemize list of damages
 Unprofessional behavior
 Work was not authorized by owner of vehicle
 Did not replace parts that were invoiced on repair order
 Repairs were not performed in a timely manner as told
 Did not communicate repairs with me
 See comments below
Complaint About Insurance Company
 Claim was not handled in a timely manner
 Unprofessional behavior
 Directed me to a facility that I did not want to go to
 Coverage was different that I had been told
 Did not send me a copy of the estimate
 Did not authorize proper repairs for my vehicle
 Safety issues were not addressed in claim
 Refusal to re-inspect vehicle
 Did not pay the entire claim
 Delayed repairs
 Betterment was overstated and/or not explained
 See comments below
Comments:
This complaint was filed by
(Must be filled out or complaint will be disregarded)
Name
Date

 

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