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Types of Insurance Fraud


  • The following is a list of the more commonly perpetrated acts or schemes of insurance fraud:

    Auto

    • False or inflated theft repair claim
    • Owner "give up" (false stolen car report) "Jump in" (someone not in vehicle at time of accident)
    • Staged accident
    • Intentional damage claim
    • Falsifying the date or circumstances of an accident to get coverage
    • Rate evasion

    Homeowner

    • False or inflated property damage
    • False or inflated burglary or theft report
    • Arson
    • Intentional damage claim

    Health Care

    • Billing for services not provided
    • Billing for a more expensive service than what was actually provided
    • Providing and billing for unnecessary services while representing that the services were necessary
    • Double billing

    Life & Disability

    • Fake death claims
    • Falsified beneficiary claims
    • Fake disability claim
    • Submission of forged documents to fraudulently continue a disability claim

    Agent / Industry Misconductcrutches  

    • Theft of premiums
    • Unlicensed and/or unauthorized activity
    • "Churning" - Falsifying information to a consumer in an effort to get them to use the cash value of an existing policy to buy a new, usually more expensive policy

    Workers' Compensation  

    • Working while collecting workers' compensation benefits
    • Faking injury
    • Claiming to be injured at work when injury occurred elsewhere
    • Employer under-reporting payroll and/or number of employees to obtain lower premium
    • Intentionally misclassifying employees' job codes
    • Employer failing to carry workers' compensation insurance