If available, please include names, addresses, and telephone numbers of any parties you believe are involved in the false statement / misrepresentation / potential fraud.
You can mail a printed copy of this form (and all documentation) to:
South Carolina Department of Insurance
Insurance Fraud Division
P.O. Box 100105
Columbia, SC 29202
Or attach it in an email and send it to FraudDivision@doi.sc.gov.
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