Insurance fraud occurs when individuals deceive an insurance company, agent or other person to try to obtain money to which they are not entitled. It happens when someone puts false information on an insurance application and when false or misleading information is given or important information is omitted in an insurance transaction or claim.
Insurance fraud is committed by individuals from all walks of life. Efforts of the Insurance Fraud Unit have resulted in convictions of doctors, lawyers, chiropractors, car salesmen, insurance agents and others who have committed fraud.
Insurance fraud can be "hard" or "soft."
- Hard Fraud: Someone deliberately fakes an accident, injury, theft, arson or other loss to collect money illegally from insurance companies. Crooks often act alone, but increasingly, organized crime rings stage large schemes that steal millions of dollars.
- Soft Fraud: Normally honest people often tell so-called "little white lies" to their insurance company. Many people think it's just harmless fudging. But soft fraud is a crime, and raises everyone's insurance costs.
|Type of fraud issue||How to report fraud|
|To report fraud against insurance companies (including but not limited to cases involving insurance-related identity theft, telemarketing and spam)||Use our Fraud Referral Form|
|To report Health Insurance Marketplace consumer fraud||Call the Health Insurance Marketplace at 1-800-318-2596|
|To report fraud or scams against an insurance consumer (individual or business)||File a complaint with the Department of Insurance|
|To report identity theft; unwanted telemarketing, texts, or spam; and, various other types of business practices that are unfair to consumers|