PPI Complaints submission form

Please complete this form with as much detail as you can. We will use the information you provide on this form to locate your records and, if required, to contact you to discuss your PPI complaint.

If your address has changed since taking out PPI, please provide the address you lived at when you took out the PPI policy.

Please tell us a time that's convenient to call.

If appropriate, we'll call you during our review. Please bear in mind we can only call between 8am - 8pm Monday to Friday.

Please use the box below to tell us if you require additional support (e.g. someone helps manage your affairs), or have a physical or mental health condition. Also if you need us to communicate with you in a different format (e.g. large print), let us know here.

Please note, by completing this section you consent to us recording all details you share, which might include sensitive information such as your health. This will only be used in relation to your PPI complaint.