Fraud_form

Report Fraud Online

 

Information submitted in this form is neither secure nor encrypted. Please include your contact information if you would like a response. You may remain anonymous. All information we recieve is strictly confidential.

 

Please fill in as much information as possible:

  • Your information refers to you, the person reporting the fraud. As noted in the form, completing this section is optional if you wish to remain anonymous.
  • Insured's information refers to the person who carries the insurance.



Suspect Fraud?

Call us now, toll-free
1-800-314-0025

reportfraud@bsneny.com


What is Fraud?

 

Recognize & Report Fraud

 

Fraud Report Form

Your Information

You may remain anonymous:

 
 
 
 
 
 
 
 

Person or Company your complaint is about:

 
 
 
 
 

Insured's Information

Person who carries the insurance:

 I am also the insured person
 
 
 
 
 
 
 
 

Summary of Complaint: