Hawaii Insurance Division Complaint/Inquiry Form

When a complaint is filed with the Insurance Division, the Compliance and Enforcement Branch conducts an investigation to assure compliance with the applicable statutes and rules. Appropriate disciplinary actions are taken by the Compliance and Enforcement Branch when necessary. To file a complaint, a complaint form must be filled out and submitted to the Hawaii Insurance Division.
  • Your Contact Information

  • First and Last name are required.
    If email, please be sure to include an address above.
    If email, please be sure to include an address above.
  • Insurance Company/Agency/Individual Information

  • Complaint/Inquiry

  • Drop files here or
    Accepted file types: jpg, jpeg, png, pdf, jpg, jpeg, png, pdf.
    Maximum number of 10 files. Maximum file size is 5MB. Only JPG, PNG, and PDF file types allowed.
  • Date Format: MM slash DD slash YYYY