GAPS Insurance Services
Submit Above Form, and then please download and submit the accompanying Prior Carrier Form
Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and (NY: Substantial) civil penalties. (Not Applicable in CO, HI, NE, OH, OK OR; In DC, LA, ME and VA, insurance benefits may also be denied).
Fax: (212) 575-1897
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