To report insurance fraud in Texas, file a complaint with the Texas Department of Insurance (TDI) Fraud Unit online, by email, or by mail. You can file anonymously, but giving investigators your contact information lets them follow up when they have questions. Texas law defines a fraudulent insurance act broadly, covering any violation of penal law committed while engaging in the business of insurance, as part of an insurance transaction, or as part of an attempt to defraud an insurer.1State of Texas. Texas Insurance Code 701.001 – Definitions
Three Ways to File a Report With TDI
The fastest option is the online reporting system hosted by the National Association of Insurance Commissioners, which you can reach from TDI’s fraud reporting page.2Texas Department of Insurance. Report Insurance Fraud The portal walks you through describing the type of fraud, identifying the people and companies involved, and uploading supporting documents.
If you prefer email, download the fraud report form from TDI’s website, fill it out, and send it as an attachment to FraudUnit@tdi.texas.gov.3Texas Department of Insurance. Fraud Unit Forms For paper filings, mail the completed form to:
Texas Department of Insurance
Mail Code 109-3A
Fraud Unit
PO Box 149336
Austin, TX 78714-9336
Mailed complaints take longer to process. Sending yours by certified mail with a return receipt lets you confirm it arrived. If you aren’t sure whether what you’ve seen qualifies as fraud, TDI’s Help Line at 800-252-3439 (Monday through Friday, 8 a.m. to 5 p.m. Central) can point you to the right place.2Texas Department of Insurance. Report Insurance Fraud
What to Put in the Report
Detail is what makes a report useful. At a minimum, give the full names, addresses, and phone numbers of the people you believe are committing fraud. If a policy is involved, include the policy number, the claim number, and the name of the insurance company.
Pin down the when and the where, even if your dates are approximate. A short timeline helps investigators see a pattern rather than a scattering of incidents.
Attach documents. Copies of claim forms, emails, invoices, text messages, medical records, and photos can make or break an investigation. Written communications are especially useful because they can establish intent. If other people witnessed the activity, list their names and contact information so investigators can reach them independently.
Can You Report Anonymously, and What About Retaliation?
Yes, TDI accepts anonymous reports. That matters if you’re worried about blowback from an employer or someone you know personally.
Formal whistleblower protection in Texas is narrower than many people assume. The Texas Whistleblower Act bars state and local government employers from firing, suspending, or otherwise punishing an employee who reports a violation of law in good faith to an appropriate law enforcement authority.4State of Texas. Texas Government Code 554.002 Private-sector employees don’t have that same blanket statutory shield, though federal protections under OSHA’s whistleblower provisions may apply in certain industries. If you work for an insurance company and are weighing an internal or external report, consulting an employment attorney before you file is worth the cost. Filing anonymously with TDI is a practical workaround when retaliation is a realistic concern.
What Happens After You File
An analyst reviews each complaint to decide whether the conduct described fits the legal definition of insurance fraud and whether TDI has jurisdiction.1State of Texas. Texas Insurance Code 701.001 – Definitions If a complaint raises regulatory concerns that fall outside fraud, TDI may redirect it to another division.
Complaints that meet the threshold for investigation go to a fraud investigator, who examines policy documents, claim records, and financial transactions. The Texas Insurance Commissioner has statewide subpoena authority, which lets investigators compel witnesses to testify and force the production of records.5State of Texas. Texas Insurance Code 36.152 – Subpoena Authority When the subject of scrutiny is an insurer, TDI can require the company to turn over relevant information within 15 days of a written request.6State of Texas. Texas Insurance Code 701.108 – Insurers Duty to Provide Information
When investigators find strong evidence, TDI works with prosecutors and law enforcement to build a criminal case, which can involve sworn statements, forensic accounting, and coordination with local district attorneys or the Texas Attorney General’s Office. Don’t expect quick turnaround. Insurance fraud investigations routinely take months, and prosecutions can stretch longer. You generally won’t get updates on an active investigation.
When to Report to a Different Agency
TDI is the primary agency for insurance fraud in Texas, but a few situations fit elsewhere.
- If the fraud involves a Medicaid provider, or abuse or neglect of patients in Medicaid-funded health care facilities, the Medicaid Fraud Control Unit within the Texas Attorney General’s Office handles those cases.7Office of the Attorney General of Texas. Medicaid Fraud Control Unit
- Large-scale deceptive trade practice schemes can be pursued by the Attorney General’s Consumer Protection Division, which has authority to seek civil penalties, consumer restitution, and injunctions.
- Fraud contained within a single county is often prosecuted by the local district attorney.
- Multi-carrier schemes that cross state lines can be reported to the National Insurance Crime Bureau, a private nonprofit that coordinates with law enforcement nationwide. The NICB tip line is 800-835-6422 (Monday through Friday, 7 a.m. to 7 p.m. Central), with Spanish-speaking assistance and anonymous online tips available.8National Insurance Crime Bureau. Report Fraud
Reporting to one of these agencies doesn’t preclude also reporting to TDI. A report filed with TDI’s Fraud Unit legally counts as notice to every other authorized governmental agency in Texas.9State of Texas. Texas Insurance Code 701.051 – Duty to Report
Keep Copies of Everything
Once you file, hold onto the fraud report form, every document you submitted, and any correspondence with TDI. If an investigator comes back weeks or months later with follow-up questions, you’ll want to reference exactly what you originally provided.
Build a simple timeline: when you first noticed the activity, when you reported it, who you spoke with, and any case or reference numbers you received. If the investigation leads to criminal prosecution or civil litigation, that record becomes evidence. Fraud cases that result in restitution sometimes let victims recover losses, and thorough documentation strengthens any reimbursement claim you may have later.