Mandatory Reporting

This form is provided for those required to report suspected insurance fraud pursuant to U.C.A. § 31A-31-110.  This includes Insurers and Title Insurance Auditors.  To review a copy of the statute click here.

 

To file a general complaint use our General Report Form.

 

If you are uncomfortable with using this online form then email us at:

jtchristensen@utah.gov.

 

Person submitting complaint:

Name
Company
Phone #
Claim #

   

Person suspected of committing fraud:

Name
Address
Date of Birth
Social Security Number
Phone #

   

 

Detailed Explanation: