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Insurance Fraud Industry Referral Form

Section Resources

Please read the instructions before filling out the form.

Print a insurance industry referral form and send by mail

All printed documents should be sent to the following address:

Office of Attorney General
Insurance Fraud Section
16th Floor, Strawberry Square
Harrisburg PA 17120

Insurance Fraud Industry Referral Form

Referred by

Subject Information

Referral Status

Location Information

Claim Information