Insurance Fraud Investigations

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Overview of Insurance Fraud and Helpful Resources for Investigations

The article provides an overview of insurance fraud investigation resources.

Insurance fraud is any act committed to fraudulently obtain payment from an insurer or insurance company. Insurance fraud, scams, and schemes have become 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 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 significant problem, and governments and other organizations are trying to deter such activities.

Insurance Fraud Investigation Resources

List of Insurance Companies – A list of all the major insurance companies in the United States.

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 over 3,000 locations place 80 percent of all U.S. products and services protecting business, industry, government, and the public, 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.

Insurance.com – Brings top companies together in one place to compete for the 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 criminal identification, detection, and prosecution.

State Insurance Commissioners’ Phone Numbers

Please note that state information lines change frequently. The numbers below may be outdated, 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

The 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

What Do Private Investigators Need to Know about Insurance Fraud Investigation?

Investigators should be aware of the various types of insurance 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 common with each type. The more an investigator knows about a scam, the better they can solve a case.

Hire a Private Investigator

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

See also: List of Insurance Companies in the United States.

1 COMMENT

  1. I believe that the personal injury case against my sister is a scheme. Thanks for pointing out that innocent people are often affected by this. Hopefully, I will be able to find a personal investigation service who can assist her so I’ll consider looking for one soon.

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