Ill. Admin. Code tit. 50, § 926.EXHIBIT A
COMPLAINT RECORD
| Column A | Column B | Column C | Column D | Column E | Column F | Column G | Column H |
| Identification Number | Reason Code | Coverage Code | Disposition after Complaint Receipt | Date Received | Date Closed | Insurance Department Complaint | State of Origin |
(Source: Amended at 43 Ill. Reg. 3246, effective February 25, 2019)