7 steps for reporting insurance fraud

By | September 26, 2016

Mainly, there are two types of motivations behind reporting about the insurance fraud. These are turning in a customer for fraudulent action against an insurance company. Another is turning in an insurance agent, insurance company and sovereign claims adjuster for an act of scam against customers. The proper steps can be differed depending on the type of insurance and fraud involved. Some steps for reporting insurance fraud are as following:

Step I:

It is very essential to learn the importance of reporting insurance fraud. When you are not the victim of the fraudulent action, it can still mean more cash out of your pocket in higher premiums when to renew your policy. Each and every consumer has an interest in reporting insurance scam. Also, gather the information as much as possible and collect the right documents. Insurance companies are very busy and are more expected to take your report in a serious manner if you have the proper certification and documents.

Step II:

If you are a victim of the insurance fraud, then you should definitely call your insurance company. Many insurance companies have anti fraud departments to look after into insurance agents as well as claims adjusters who are suspected of insurance fraud activities.

Step III:

The next step is to call insurance fraud bureau of your state as each state has its own government funded insurance scam bureau.

Step IV:

The insurance agencies will investigate the fraud activities more seriusly if law enforcement in that get involved. These local law enforcement agencies have fraud division and some cases of insurance fraud especially in the industry of healthcare, even follow under the authority of the FBI. You can also contact to the field office which is close to you for determining if your case falls under their jurisdiction.

Step V:

It is very important to learn that what constitutes the insurance fraud. A person who involved in the process of insurance can assign insurance fraud whether it is an agent who is selling the policy, insurance company, or even the consumer. In a broad manner, insurance fraud is when an agent or insurance company misleads an individual for unlawful gain.

Step VI:

You should understand the effects of insurance fraud as well as types of premium diversions. One of the most common types of insurance fraud is premium diversion. It happens when insurance premiums are misused. Generally, it occurs when an insurance agent gathers premiums for personal gain and don’t pass them along to the policy underwriter. Another type of premium diversion happens when an unlicensed person sells fraud policies and collects the premium with not an intention of paying claims ever.

Step VII:

The last step is to identify forms of customer insurance fraud and claims adjuster fraud. Customer insurance scam comes in a wide range of activities merely because of the diverse varieties of insurance which are available to patrons. You should also claim adjusters review insurance on behalf of individuals or insurance companies for determining the definite legal responsibility of the insurance company on a given claim.


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