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This version of the form is not currently in use and is provided for reference only. Download this version of
Form C-TPC
for the current year.
Form C-TPC Consent for Third Party to File Insurance Complaint ("third-Party Consent") - Arizona
What Is Form C-TPC?
This is a legal form that was released by the Arizona Department of Insurance and Financial Institutions - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form C-TPC?
A: Form C-TPC is the consent form for a third party to file an insurance complaint in Arizona.
Q: Who can file Form C-TPC?
A: A third party, such as a family member or attorney, can file Form C-TPC.
Q: What is the purpose of Form C-TPC?
A: The purpose of Form C-TPC is to authorize a third party to file an insurance complaint on behalf of the policyholder.
Q: Is Form C-TPC specific to Arizona?
A: Yes, Form C-TPC is specific to Arizona and is used for filing insurance complaints in the state.
Q: Do I need to fill out Form C-TPC if I want to file an insurance complaint?
A: Yes, if you want a third party to file the complaint on your behalf, you need to fill out Form C-TPC to provide your consent.
Q: Can I file an insurance complaint without using Form C-TPC?
A: Yes, you can file an insurance complaint on your own without using Form C-TPC if you prefer.
Q: What information is required on Form C-TPC?
A: Form C-TPC requires the policyholder's name, contact information, and signature, as well as the third party's name and contact information.
Q: Is there a fee for submitting Form C-TPC?
A: No, there is no fee for submitting Form C-TPC.
Q: Can I revoke consent given on Form C-TPC?
A: Yes, you can revoke the consent given on Form C-TPC at any time by notifying the Arizona Department of Insurance in writing.
Form Details:
- Released on July 21, 2017;
- The latest edition provided by the Arizona Department of Insurance and Financial Institutions;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form C-TPC by clicking the link below or browse more documents and templates provided by the Arizona Department of Insurance and Financial Institutions.
