Insurance Fraud Complaint Form

Insurance fraud includes making false statements to an insurance company, providing false documentation in support of an insurance claim, making false claims, staged accidents, and misconduct by insurance agents. If you have information about insurance fraud, we want to hear from you. Please provide as much information as possible. Please note: The Attorney General’s Office does not have authority to provide legal advice or legal representation to individuals.

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****ALERT: If you have been a victim of a false or fraudulent unemployment filing in Colorado, you may be a victim of identity theft. As a result, please contact the Colorado Department of Labor and Employment(“CDLE”) as CDLE has authority over unemployment claims in Colorado.****
Colorado Department of Labor and Unemployment
Complaint Details
Complaint Narrative
Please present the facts in the order in which they occurred. Be as concise as possible, providing dates and full names of those you dealt with during your transaction. Please include the location, date and time of suspected insurance fraud.
Attach Files
Please upload any relevant documents
Max. file size: 128 MB.
Have you reported this information to any other law enforcement agency or insurance company?
Please list the name(s) of other law enforcement or agency(ies) you have reported this to. Please also provide a brief description of the report and any associated outcomes.
Date of Suspected Insurance Fraud
MM slash DD slash YYYY
Location of Suspected Insurance Fraud
If applicable, please list the name of the insurance company that was affected.

About the Company or Individual
Name of Company or Individual*
Contact Information for the Business or Individual(s)
Name of Person you talked to
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Website
All website entries must start with one of the following prefixes: http:// or https://. If the website is unknown or entry errors occur, please leave blank.
Email

About You
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Demographic Information
This information is collected for statistical purposes only and is optional. Please simply click submit to file your complaint if you prefer not to provide this information.
Age Range
I identify my ethnicity as:
Language Spoke at Home
Are you an active or retired military member?
Email
This field is for validation purposes and should be left unchanged.

Insurance Fraud Complaint Form

Insurance Fraud Complaint Form

Step 1 of 3

Complaint Details

About the Company or Individual

Contact Information for the Business or Individual(s)

About You

Demographic Information