Complaint Form

Global Atlantic Financial Group (GAFG) employees and field representatives strive to do the right thing for our customers. We are committed to handling complaints in a thorough, fair, expeditious and courteous manner in accordance with applicable laws, rules, and regulations. We understand that when a complaint is filed, it can be an opportunity to make a difference to a customer, to gain insight into how the Company can better provide value for all customers, and to preserve our relationships with our customers and business partners. In furtherance of this commitment, complaints may be sent to us directly by completing and submitting this form.

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Complainant First Name

Complainant Last Name

Relationship to Insured/Annuitant

Complainant Phone Number

Complainant Email Address

Complainant Street Address

Complainant City

State/Province

Complainant ZIP Code

Owner First Name

Owner Last Name

Insured/Annuitant First Name

Insured/Annuitant Last Name

Type of Policy/Contract

Life

Annuity

Preneed (Funeral Home)

Pension

Insurance Company Name

Policy/Contract Number

Have you reported this issue to a regulatory/governmental agency, (e.g. FINRA State Insurance Department) BBB or other third party?

Yes

If yes, who:

Description of Complaint/Issue/Grievance

What do you consider to be a fair resolution?

Please attach any supporting documentation

Limit 3 attachments
Upload requirements

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