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PCTG Consumer Complaint Investigation Report
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The information submitted from this form is saved to a database and some of the collected data is available for public access. Consumer information is not made available for public access on this web site. A copy of the complete report is processed by the PCTG administrative office and forwarded to the Department of Insurance.

1	Consumer Name
	Address
	City, State and ZIP
	Phone Number	Day time Evening
2	Repair Facility State Appraiser License #
	Shop Representative
	Address
	City, State and ZIP
	Phone
3	Insurance Company
	Insurance Co. Claim Number #
	Insurance Co. Representative	Date of Loss
	Appraiser License #
	Phone
4	Consumer’s Legislative Representative	Senator
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	Repair Facility’s Legislative Representative	Senator
5	Complaint	Violation of Act 367 Title 63, Ch. 22B Violation of Regulation PA Code Title 31, Ch. 62 Violation of Unfair Ins. Practices Act Title 40, Ch. 4	Violation of Unfair Claims Settlement PA Code Title 31, Ch. 146, Subch. A Violation of Automotive Industry Trade Practices Title 37, Ch. 301
		Illegal Steering/Directing Refusal or Failure to Sign Appraiser License Omitted Refusal to leave copy of appraisal Arbitrary Capping & Underpayment Refusal to use Quality OEM Parts Non-itemized listing of all damages	Non-Independent Appraisal Unprofessional Behavior No regard for Public Safety Non-personal Inspection Refusal to re-inspect vehicle Inaccurate Total Loss Evaluation Inaccurate description of repairs
6	Brief Explanation of Violations:

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