In accordance with Executive Order RP36 issued July 12, 2004 by Governor Rick Perry, the Texas Department of Insurance Fraud Unit offers this notice regarding the reporting of insurance fraud to an authorized entity.
Timely reporting of suspected insurance fraud directly enhances law enforcements' ability to investigate and take appropriate action, including but not limited to a referral for prosecution of those persons who defraud insurers and consumers. Indirectly, reporting of suspected fraud alerts officials to new schemes that, while not resulting in legal prosecution, helps to identify emerging fraud patterns and results in better allocation of resources. The timely reporting of suspected fraud allows for warnings to the general public of particular fraudulent activities, further enhancing fraud detection and deterrence.
Texas Insurance Code, Article 1.10D Sec. 4 (2) directs each person, including insurers, to report suspected fraud that has been or is about to be committed to a local, state, or federal law enforcement authority. Fraud may be reported to TDI via the internet at www.tdi.state.tx.us/fraud/ or toll free at 888-327-8818.
While Texas law requires reporting to a governmental agency, fraud may also be reported to other non-government organizations including but not limited to the following: the National Insurance Crime Bureau (NICB) at www.nicb.org, the National Health Care Antifraud Association (NHCAA) at www.nhcaa.org, and the National Association of Insurance Commissioners at www.naic.org. These and similar entities provide services in efforts to detect, study, and prevent fraud; however, regardless of the entity to which fraud is reported, it is critical that fraud is reported timely to a federal, state, or local governmental agency in order to be compliant with the Texas Insurance Code.
Should you have any questions regarding the reporting of insurance fraud, or comments on how to improve anti-fraud efforts, please contact Carlos Hinojosa at carlos.hinojosa@tdi.state.tx.us or at 512-305-7627.
Dennis Pompa, Associate Commissioner
Fraud Unit MC 109-3A