Frequently Asked Questions

What is insurance fraud?

Insurance fraud is when a deliberate material misrepresentation results in an unjustified monetary or financial gain.

Is insurance fraud a crime?

Yes. In fact, insurance fraud is the second largest economic crime in America today.

How big is insurance fraud?

Huge. It has been reported that insurance fraud is an $80-$120 billion dollar a year industry. In comparison, Wal-Mart was reported at the top of Fortune 500 with $379 million in revenues.

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What is the public's opinion of insurance fraud?

Nearly 25% of Americans believe it is okay to defraud insurers. (Accenture, Ltd.)
Some 8% say it is “quite acceptable” to bilk insurers.
While 16% say it is “somewhat acceptable.”
Two of five people are “not very likely” or “not likely at all” to report someone who ripped off an insurer.
About one in ten people agree it is all right to submit claims for items that are not lost or damaged, or for personal injuries that did not occur.

What insurance sector is most affected by insurance fraud?

Insurance fraud affects all lines of insurance. Medical fraud is the leading target of insurance fraud followed closely by workers’ compensation and automobile fraud.

How does insurance fraud affect me?

It affects you in the amount of premiums you pay annually. It is reported that most consumers pay $900-$1,000 more in higher premiums as a direct result of insurance fraud.

What can I do if I suspect someone is committing insurance fraud?

Contact your Special Investigation Unit (SIU). Also, most states have a hot line to report suspect insurance fraud. If you cannot locate one in your area you can report your suspicions to the NICB (National Insurance Crime Bureau) at 1-800-835-6422.