Insurance fraud is one of the oldest scams around. Fraud can consist of billing patients for services that never happened, reporting fake car accidents, or a host of other schemes. Since the average citizen doesn't know they can be compensated for reporting fraud, few take the time to report such activities. Consequently, the insurance industry continues running such scams on a daily basis. By taking action against this type of crime, you can help turn the tide on insurance fraud. .
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Determine if what you are seeking to report is, in fact, insurance fraud. If you happen to see your neighbour playing basketball, yet you know he recently filed an insurance claim for a leg injury, this may be considered fraud. However, not all insurance claims are fraud. Mental illness claims cannot usually be proven as fraud since only a trained psychologist can determine if someone is mentally unstable.
Gather evidence of the fraud. Before making a claim, it is advisable to gather evidence, such as inconsistent paperwork or photos. Showing physical proof of a person with no children filing claims for paediatric visits may garner a stronger case than just giving your version of what you believe to be fraud, for example. Presenting photos of the person's home without any children's items around may help build the case as well.
Contact the insurance agency in your area that is responsible for overseeing insurance regulations.and fraud (see Resource 1). Ask to speak with a director or another fraud unit employee and ask about the reward for reporting insurance fraud. Though the other party may be hesitant to tell you a specific monetary amount, rest assured they will be able to find someone who can tell you the reward details. If a specific reward amount is not available, inform the person that you would like to set an amount to be compensated.
Once you receive a written confirmation of your compensation amount, provide your evidence to the fraud unit.
Tips and warnings
- Seeking out cases of insurance fraud is a worthy cause. However, investigating and reporting on such activities must be performed without causing harm to the person or an invasion of their privacy.
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