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Fraud Unit Forms

You may download and print a Fraud Report form in Word and email the completed form as an attachment to: FraudReport@tdi.texas.gov.

Please remember – Information sent by email is not encrypted. If you prefer, you may send the report form by regular mail to:

Texas Department of Insurance
Mail Code 109-3A
Fraud Unit
P O Box 149336
Austin, TX 78714-9336

Fraud Unit Forms
TDI Form Number Description File FormatLanguage
FR028
Suspected Insurance Fraud Report (SIU) Form
WORD English
FR028
Suspected Insurance Fraud Report (SIU) Form
PDF English
FR029
Suspected Insurance Fraud Reporting form for Consumers
PDF English
FR029
Suspected Insurance Fraud Reporting Form for Consumer
Consumer Fraud Report
WORD English

For more information, contact: