The introduction of a request for mediation implies a certain formalism.
To facilitate the processing of your application, your file must include:
Depending on your choice, you can submit your application either by :
– Digital form via the online form ;
– Downloadable postal form via the form to be downloaded below;
Together, let’s take responsible actions!
At ACA, we are concerned about the environment, that’s why we invite you to use the paper form only if necessary.
Do you prefer to use the paper form? If so, please download the form below, complete it and send it back by post:
c/o Médiateur en Assurance