Fraud Reporting Forms
for Insurance Companies, SIUs and TPAs
Online Form for Reporting Insurance Fraud
Online Reporting of Fraud Tips
Please take a moment to read over these helpful tips before using this form for the first time.
- The online form is divided into the following sections:
- Information About You
- Description of the Fraud
- Fraud Subject(s) Information
- Report Review and Submission
- Do not use the "Back" button on your browser, instead use the navigation buttons at the bottom of each page.
- Required fields are marked with a red asterisk.
- Use the tab key to move between fields.
- At the time of submission, you may print a copy of the report which will include your submission verification number.
- Online reports of fraud are retrieved by the Texas Department of Insurance Fraud Unit each business day. If you provide your name and address, a written acknowledgement from the Fraud Unit will follow our receipt of the report.
- We work to protect the security of your information during transmission by using Secure Sockets Layer "SSL" software, which encrypts information you input.
- If you have supporting documentation to include with your report, please do not use this form. Follow the instructions in the section below to download and mail a printable form.
- For further information or assistance, please contact: FraudReport@tdi.state.tx.us
Download Versions - You may download and print a Fraud Reporting Form and email the completed form as an attachment to: FraudReport@tdi.state.tx.us
Please remember - Information sent by e-mail is not encrypted. If you prefer, you may send the report form by regular mail to:
Texas Department of Insurance
Fraud Unit
P O Box 149336
Mail Code 109-3A
Austin, TX 78714-9336
Return to Fraud Unit Home Page
For more information contact: FraudUnit@tdi.state.tx.us