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
- 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