The majority of reported fraud claims are often committed by average people submitting claims that are not entirely truthful. Remember, in its simplest form, FRAUD is when an individual misrepresents FACTS to an insurance company concerning a claim or policy.

What is Fraud? 

Fraud is the intent to deceive a company or person for the purpose of financial gain. 

What is Insurance Fraud?

Insurance fraud is a manner in which a person or company deceives an insurance company or person into paying an amount to which they are not entitled to receive. 

Why is preventing insurance fraud important?

Insurance fraud costs Arizona consumers millions of dollars each year. If you’re an insurance consumer, you pay higher premiums because of fraud.

Some of the more common ways to common fraud may include filing fraudulent claims regarding 

•  Items reported stolen or damaged that were not actually stolen or destroyed (electronics, vehicle, equipment) or in some cases, made to look like they were stolen or destroyed.
• Repairs or services given but not actually completed or needed (auto glass, vehicle body repairs, medical services, or equipment)
• Exaggerated complaints about injury, disabilities (fake slip/falls, worker’s compensation, or disability claims)
• Providing misrepresenting information on insurance applications
• Providing false information regarding the date of loss to an insurance company
• Providing false insurance coverage to medical professionals
   

Fraud is not a victimless crime nor is a just considered a cost of doing business or a business loss.  The Federal Bureau of Investigations estimates that “Insurance Fraud costs the average U.S. Family between $400 and $700 per year in the form of increased premiums.”  

How to Prevent Fraud

• As a consumer, understand the terms and conditions of any policy or product before signing a contract and or exchanging payment.  
• Verify the company/insurance producer (agent) is authorized to do business in Arizona.  For more information on how to do this, visit our license search page or sbs.naic.org for more information. 
• Avoid hard sale tactics designed to push you into making a decision before doing any research on the product, the representative, or the company.
• Before accepting services that ask for your insurance policy information understand what they intend to do with this information and how they are expecting to receive payment.
• Review all statements to ensure services were performed and billed accurately and report any discrepancies.
• Avoid the temptation to make a false claim.  Knowingly filing a false claim is illegal and may have consequences that result in a cancellation of your policy, monetary penalties, or jail time.