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Department of Insurance and Financial Services

Fraud Complaint Form


Filing this form is restricted to legitimate business purposes only. Information will be submitted to the Michigan Department of Insurance and Financial Services (DIFS) Fraud Investigation Unit (FIU) for their review and investigation. DIFS bears no responsibility or liability for the accuracy or veracity of information submitted. Users reporting fraudulent activity through this form will do so in good faith.

By clicking in the box next to the, “I agree to the language above”, you acknowledge the following: that you have read and understand this statement regarding the use of this form; that access or use of this form for fraudulent activity is strictly prohibited by the State of Michigan and the  Department of Insurance and Financial Services; that use of this form or the reporting of suspected fraudulent activity which you know to be false, may subject you to criminal or civil penalties/remedies under state, federal, or other applicable domestic and foreign laws.


Person Reporting Suspected Fraud

YOU MAY REPORT ANONYMOUSLY: No personal identifying information is required to submit an allegation of suspected fraud. For those individuals wishing to receive verification of DIFS receipt of the report, please provide your name and e-mail address. You may also choose to provide additional contact information to facilitate additional communication from DIFS Fraud investigation Unit or other investigating authorities.


Voluntary Contact Information of Person Reporting Suspected Fraud


*I would like to remain anonymous:

Description of Suspected Fraud


Please provide the following information on the individual or entity that you suspect committed fraud, including identifying the industry, person, or business entity and other details. 




NOTE: The Following Section Is For Insurance Fraud Complaints Only


Please skip to the “Identify Other Agencies You Have Contacted Regarding This Referral” if your submission is not regarding insurance fraud.


Case Details and Claim/Incident Information for Insurance Fraud Complaints


In this section please provide additional information about the suspected insurance fraud including other investigations, litigation, claim, policy and financial information, etc.

If you are a consumer, please complete as much of this section as possible. If you are a memnber of the industry, please complete this section in its entirety. 


SIU Investigation Completed:
Civil Litigation Pending:
Is there any reason to believe that this incident is related to other suspected fraudulent activity?

Identify Other Agencies You Have Contacted Regarding This Referral 

Agency Type: