What Are Examples of Insurance Fraud?

From a young age, children are taught the value of telling the truth. In fairy tales, lies are distinguished with a growing nose, as in Pinocchio. And, no matter the story, the “good guy” always emerges as the victor. Yet, somewhat instinctively, it seems like human nature to lie. Sometimes the lies are small and cause no harm. Other times the lie is drawn out and carefully planned, used for personal gain.

As a judge in Dallas for 10 years, and as a part of The Wade Law Firm since 2007, Henry Wade has met hundreds of individuals charged with varying crimes. In the case of insurance fraud, Wade explains, the individual committing the forgery is looking to gain a large sum of money that he has neither worked for, nor deserved. While the average person probably won’t ever get caught in such a scheme, the networks of people who do commit insurance fraud are costing companies millions of dollars every year, and are driving up premium rates for everyone.

Examples of Insurance Fraud

• False vehicle theft, or making arrangements to have your vehicle stolen and then returned to you after you receive a check from the insurance company.
• After a car accident, causing more damage to your vehicle so that, when it is brought in for repair estimations, the damage exceeds what really resulted from the accident.
• Setting a fire in your home, and then making the claim that it was accidental, so that you can be reimbursed for the cost of repairs.
• After a fire, claiming you lost expensive possessions that you actually never owned.
• Taking a large amount of life insurance out on a person, and then forging a death certificate to claim the money.
• A doctor’s office orders unnecessary tests for patients that are never actually performed. But, since the doctor’s office and the patient’s insurance company are rarely in communication, the insurance company pays for the test anyway.
• Faking a painful injury to be considered for disability insurance. This means you get benefits and payments without having to work.
• Collecting unemployment benefits while continuing to work.
• Exaggerating on a genuine claim of damage done to your home in order to collect more money from the homeowner’s insurance company.

Reporting Insurance Fraud

If you suspect that someone is committing forgery, you can report insurance fraud anonymously. Each state has a fraud hotline.

Being Charged With Insurance Fraud

If you find out that you are being investigated by an insurance company for fraud, or the police, call a criminal defense attorney. Insurance fraud can be prosecuted on both civil and criminal levels, which could result in costly fines and jail time if you are convicted. Hiring the right attorney can provide you with the further information you need and give you guidance on what you should do next.