All Insurance companies Submitting Referrals to the Workers’ Compensation Fraud Unit : Workers’ Compensation Fraud Unit Referral Form

320 W. Washington Street Springfield, Illinois 62767 (217) 782-4515 http://insurance.illinois.gov Illinois Department of Insurance JB PRITZKER Governor KEVIN FRY Acting Director TO: ALL INSURANCE COMPANIES SUBMITTING REFERRALS TO THE WORKERS’ COMPENSATION FRAUD UNIT FROM: Kevin Fry, Director of Insurance (Acting) DATE: February 8, 2019 RE: Company Bulletin #2019-01 Workers’ Compensation Fraud Unit Referral Form All insurance companies that wish to submit a referral request to the Department’s Workers’ Compensation Fraud Unit for investigation and potential referral for prosecution, MUST submit the referral request on the attached Workers’ Compensation Fraud Unit Referral Form. This form will also be available on the Department’s website. The Workers’ Compensation Fraud Unit will not process any referrals without a completed Workers’ Compensation Fraud Unit Referral Form. Questions regarding this bulletin may be emailed to: DOI.InfoDesk@illinois.gov.