The Fraud Division has established a method for insurers to report suspected insurance fraud. It is important to know that notification of insurance fraud may be made anonymously. You may contact any of the Fraud Division Regional Offices directly responsible for your county. Other types of complaints may be directed to the Department's Consumer Services Division. For further information about the Fraud Division and its programs, go to the Fraud Division's home page.
The Insurance Code states that no insurer, or the employees or agents of any insurer, shall be subject to civil liability for libel, slander or any other relevant cause of action by virtue of providing information concerning a Suspected Fraudulent Claim (SFC) to law enforcement, including the California Department of Insurance, Fraud Division.
Registration to Submit Electronic eFD-1s on a Continual Basis (i.e. Insurers, TPAs, Self-Insureds)
Suspected Fraudulent Claim Form (electronic eFD-1)
Reporting Suspected Fraudulent Insurance Claims (Revised: January 2008)
FD-1 Referral Form - (Revised: January 2008)
Completed FD-1 forms and any attachments are to be mailed to the following address:
California Department of Insurance
Enforcement Branch Headquarters
Intake Unit
9342 Tech Center Drive, Ste. 100
Sacramento, CA 95826
Workers' Compensation Insurance Special Investigative Unit Guidelines and Protocols
The Fraud Division of the California Department of Insurance, Enforcement Branch is pleased to offer insurers and employers the latest version of
Workers' Compensation Insurance Special Investigations Unit Guidelines and Protocols. The manual is intended to provide general guidelines for employees assigned with anti-fraud responsibility. It is not intended to change any current reporting requirements. Use of the material is strictly voluntary. The California Department of Insurance offers these Guidelines and Protocols as an educational and training tool.
Online Insurance Reporting Form of Suspected Insurance Fraud to be used by the general public
The California Department of Insurance has developed a method for members of the general public to report cases of suspected insurance fraud. As noted in California Insurance Code section 1879.5, no person shall be subject to civil liability for filing a good faith report of suspected insurance fraud to the Department of Insurance. This form may be accessed by clicking the link below.
Online Insurance Reporting Form to the Department of Insurance
Completed Online Insurance Reporting Forms are to be mailed to the following address:
California Department of Insurance
Enforcement Branch Headquarters Intake Unit
9342 Tech Center Drive, Ste. 100
Sacramento, CA 95826
For further information, please contact the Department of Insurance, Fraud Division at (916) 854-5760.
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