Insurance Fraud Investigation Resources for Private Investigators

Insurance fraud investigation
Learn about insurance fraud investigations.

The article provides an overview of insurance fraud investigation resources

Insurance fraud is any act committed with the intent to fraudulently obtain payment from an insurer, or insurance company. insurance fraud, scams and schemes have become some of the most prevalent and costly white collar crimes. This type of fraud is recognized internationally as a multi-billion dollar problem.

Fraudulent insurance claims account for a significant portion of all claims received by insurers, and cost billions of dollars annually. The different types of fraud, scams and schemes are very diverse, and occur in all areas. The crimes also range in severity, from slightly exaggerating claims to deliberately causing accidents or damage.

Fraudulent activities also affect the lives of innocent people, both directly through accidental or purposeful injury or damage, and indirectly as these crimes may cause premiums to increase. Fraudulent claims pose a very significant problem, and governments and other organizations are making efforts to deter such activities.

Insurance Fraud Resources

Council of Insurance Agents & Brokers – The Council represents leading commercial agencies and brokerage firms. Only the top one percent of all agents and brokers qualify. The Council’s members in more than 3,000 locations, place 80 percent –  well over $90 billion – of all U.S. products and services protecting business, industry, government and the public at-large, and they administer billions of dollars in employee benefits. Includes industry links and news.

Independent Insurance Agents and Brokers of America – The IIABA is a national alliance of business owners and their employees who offer all types of coverage and financial services products.  Includes industry studies.

Insurance Information Institute – Links to state and national associations.

Insurance NewsNet – Up-to-the-minute industry news, analysis and commentary.  Reliable, focused information from more than 12,000 sources. – Brings top companies together in one place, to compete for they buyer’s business. The site allows you to compare multiple rates, and buy the policy that’s right for you, all in one easy step, either online or by talking directly with knowledgeable and helpful licensed agents.

National Association of Insurance Commissioners – The mission of the NAIC is to assist state regulators, individually and collectively, in serving the public interest and achieving fundamental regulatory goals in a responsive, efficient and cost effective manner, consistent with the wishes of its members.

National Insurance Crime Bureau –  A not-for-profit organization that receives support from approximately 1,000 property/casualty companies. The NICB partners with insurers and law enforcement agencies to facilitate the identification, detection and prosecution of criminals.

State Commissioners Phone Numbers

Please note that state information lines change frequently. The numbers below may be out of date, so check the state’s website for the most recent phone number.

  • Alabama (205)269-3550
  • Alaska (907)465-2515
  • Arizona (602)255-5400
  • Arkansas (501)686-2900
  • California (800)927-4357
  • Colorado (303)894-7499
  • Connecticut (203)297-3800
  • Delaware (800)282-8611
  • Florida (800)342-2762
  • Georgia (404)656-2056
  • Hawaii (808)586-2790
  • Idaho (208)334-2250
  • Illinois (217)782-4515
  • Indiana (800)622-4461
  • Iowa (515)281-5705
  • Kansas (800)432-2484
  • Kentucky (502)564-3630
  • Louisiana (504)342-5900
  • Maine (207)582-8707
  • Maryland (800)492-6116
  • Massachusetts (617)727-3357
  • Michigan (517)373-9273
  • Minnesota (800)652-9747
  • Mississippi (601)359-3569
  • Missouri (314)751-4126
  • Montana (800)332-6148
  • Nebraska (402)471-2201
  • Nevada (800)992-0900
  • New Hampshire (800)852-3416
  • New Jersey (609)292-5363
  • New Mexico (505)827-4500
  • New York (212)602-0203
  • North Carolina (800)662-7777
  • North Dakota (800)247-0560
  • Ohio (800)686-1526
  • Oklahoma (405)521-1828
  • Oregon (503)378-4271
  • Pennsylvania (717)787-5173
  • Rhode Island (401)277-2223
  • South Carolina (803)737-6117
  • South Dakota (605)773-3563
  • Tennessee (800)342-4029
  • Texas (512)463-6464
  • Utah (801)530-6400
  • Vermont (802)828-3301
  • Virginia (800)552-7945
  • Washington (800)562-6900
  • West Virginia (800)642-9004
  • Wisconsin (800)236-8517
  • Wyoming (307)777-7401

Important Acronyms

Following are acronyms associated with the industry:

  • CIAB – Council of Insurance Agents and Brokers
  • IIABA – Independent Insurance Agents and Brokers of America
  • III – Insurance Information Institute
  • LTC – long term care
  • LTCI – long term care insurance
  • P/C – Property/Casualty
  • RIMS – Risk and Insurance Management Society
  • SMART – State Modernization and Regulatory Transparency Act

List of Insurance Companies in the United States

Insurance is a form of risk management that is used to hedge against the risk of a loss of something such as life, property or personal items.  It can be is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for payment.

An insurer or insurance company sells insurance; the insured, or policyholder, is the person or entity buying the policy. The amount to be charged for a certain amount of coverage is called the premium. Products come in many forms including: life, car, health, home, travel, and many other forms.

  • Aetna – Aetna is one of the nation’s leading diversified health care benefits companies, serving people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology services.
  • AFLAC (American Family Life Assurance Company) – Aflac is the number one insurance company in terms of individual policies in force in Japan, insuring approximately one out of every four Japanese households. Aflac has a presence in all 50 United States, and in Puerto Rico and the Virgin Islands.
  • AIG – AIG is the world’s largest insurance organization, with more than 88 million customers around the globe. AIG is a leader in property casualty, life insurance and retirement services, mortgage insurance, and aircraft leasing.
  • Allstate – The Allstate Corporation is the nation’s largest publicly held personal lines insurer. A Fortune 100 company, Allstate sells 13 major lines including auto, property, life and commercial. Allstate also offers retirement and investment products and banking services. Allstate is widely known through the “You’re In Good Hands With Allstate®” slogan. Allstate was founded in 1931 and became a publicly traded company in 1993.
  • AXA Equitable – In business since 1859, AXA Equitable Life Insurance Company (formerly The Equitable Life Assurance Society of the United States), headquartered in New York, NY, is a leading financial protection company and a premier provider of life insurance, annuities and related financial services.
  • Blue Cross Blue Shield – The Blue Cross and Blue Shield System consists of 37 independently operated Blue Cross and Blue Shield member companies, a Federal Employee Program® and an Association, which serves the collective needs of the Blue Cross and Blue Shield Plans.
  • CIGNA- Cigna (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, and other related products including group disability, life, and accident coverage. Cigna has sales capability in 30 countries and jurisdictions, with approximately 75 million customer relationships throughout the world.
  • Esurance Company – Esurance is comprised of over 2,500 associates in 16 offices nationwide. Esurance offers direct-to-consumer personal car insurance in 39 states. Esurance is backed by Allstate, the largest publicly held personal lines insurer in the U.S.
  • Farmers Insurance Company –  Farmers Group of Companies is the country’s third-largest insurer of both private Personal Lines passenger automobile and homeowners insurance, and also provides a wide range of other financial services and products.
  • GEICO – Government Employees Insurance Company. The name goes back to the beginnings of the company. Founder Leo Goodwin first targeted a customer base of U.S. government employees and military personnel. Today, the company has grown to provide solutions to a wide range of customers, no matter whether they’re employed by Uncle Sam or the private sector. In 1996, GEICO became a wholly owned subsidiary of Berkshire Hathaway, headed by Warren Buffett, one of the country’s most successful investors. For the past several years, Fortune magazine has named Berkshire’s property-casualty operation the most admired in the country.
  • Gerber Life – Since 1967, Gerber has provided quality life insurance, especially for young families on a limited budget. As a financially separate affiliate of the Gerber Products Company, “the baby food people,” the two companies share a common goal: to help parents raise happy, healthy children. Today Gerber is licensed to provide life insurance throughout the United States, Canada and Puerto Rico. We have more than $40 billion of life insurance in force, and help provide financial security to over 3 million people. Gerber Life has insurance products available for people at every stage of life.
  • GMAC – Changed to National General Insurance
  • The Hartford – In business to protect what people find most valuable—their homes, cars, businesses, income, and employees.
  • Humana
  • John Hancock Mutual Life – John Hancock’s core retail products in the U.S. focus on providing financial solutions at every stage of our clients’ lives. Products include life insurance, mutual funds, 401(k) plans, long-term care (LTC) insurance, and annuities. We distribute our products primarily through licensed financial advisors, and through John Hancock Financial Network, a national network of independent firms.
  • Kaiser Permanente – Kaiser Permanente is a community of 17,000 physicians committed to providing excellent care today, which leads to healthier tomorrows. From cancer and cardiology to high blood pressure and stroke.
  • MetLife
  • Mutual of Omaha
  • Nationwide
  • New York Life
  • Liberty Mutual –  Provides  broad, useful and competitively-priced products and services. The third largest property and casualty insurer in the U.S. based on 2012 direct premium written according to the National Association of Insurance Commissioners.
  • Progressive – The Progressive Group of Companies has always lived up to its name by being one step ahead of the industry, and finding new and affordable solutions. We began in 1937 with the first drive-in claims office, became the first to introduce reduced rates for low-risk drivers, and then changed the insurance shopping experience by offering comparison rates on the Web.
  • Prudential
  • State Farm
  • TIAA-CREF (Teachers Insurance and Annuity Association, for employees of educational organizations)
  • Transamerica
  • Travelers
  • MassMutual

What Do Private Investigators Need to Know

Investigators should be aware of the various types of insurance that are available such as: Car, Auto, Health, Travel, Life, Home, Homeowners, Dental, Medical, Term life, Renters, Whole life, Boat, Motorcycle, Liability and more. Investigators should also be aware of the different types of scams and schemes that are common with each type. The more an investigator knows about a scam, the better they are at solving a case.

Hire a Private Investigator

To hire a private investigator that specializes in fraud investigations, please visit our Private Investigator Directory.


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