What is Fraud? Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person, files a statement of claim containing any false, incomplete, or misleading information, may be guilty of a felony and subject to criminal and civil penalties.

 

Who is affected by the cost of insurance fraud?


Everyone. The costs associated with fraud raises rates which in turn affects what  you pay for insurance.

 

References to Claim Statistics:

  • About 11-30 cents, or more, of every claim dollar is lost to "soft" fraud (smalltime cheating by normally honest people), nearly half of property-casualty insurance companies say. Hardcore scams steal only a small fraction of that money. Insurance Research Council-Insurance Services Office (2002)
  • Nearly one of four Americans say it is ok to defraud insurers, says a survey by the consulting firm Accenture Ltd. Some 8 percent say it’s “quite acceptable” to bilk insurers, while 16 percent say it’s “somewhat acceptable.” About one in 10 people agree it is ok to submit claims for items that aren’t lost or damaged, or for personal injuries that didn’t occur. Two of five people are “not very likely” or “not likely at all” to report someone who ripped off an insurer.
  • More than one of three Americans says it is ok to exaggerate insurance claims to make up for the deductible (40 percent in 1997). Insurance Research Council (2000)
  • Arson and suspected arson are the largest causes of property damage in the U.S. National Fire Protection Association (1998)
  • Thieves stole the identities of 700,000 Americans last year. The Privacy Clearinghouse (2000)


Anti-Fraud Efforts:

  • Criminal convictions increased 31 percent. Coalition Against Insurance Fraud (2004)
  • Cases presented for prosecution rose 14 percent. Coalition Against Insurance Fraud (2004)
  • Investigations initiated increased by nearly 18 percent. Coalition Against Insurance Fraud (2004)
  • Referrals of suspected fraudulent actions were up 4.5 percent. Coalition Against Insurance Fraud (2004)

Reporting fraud:

If you suspect insurance fraud or want to report fraudulent activity please contact our SIU Department at ext 1223.

Examples of fraud:
 
  • Intentionally set home or business fires
  • Phony or Intentionally set home or business fires
  • Phony or inflated repair bills
  • Phony or inflated personal inventory or contents
  • Discarding personal property with no or little damage prior to an inspection
  • Phony or inflated Additional Living expenses
  • Intentionally creating damage to covered property
  • inflated repair bills