What is (and isn't) fraud?
What exactly is insurance
fraud?
Good question! Each state defines
insurance fraud differently. But fraud generally happens when someone
intentionally deceives another about an insurance matter to receive
money or other benefits not rightfully theirs. Here are some actions
that usually aren't frauds:
- good-faith disagreement between
an insurance company and consumer about a claim;
- decision by the insurance company to decline your insurance application, or not renew your coverage.
If you have a dispute over a claim, here are a few suggestions:
- Read your insurance policy
to make sure you know exactly what you are entitled to.
- Write a carefully worded letter
to the president of the insurance company, stating the facts of
the dispute. Make sure you include vital information such as the
policy or claim number and the date of loss.
- If you don't get any satisfaction
from the insurance company, contact your state insurance department.
- If you do not find your state
insurance department helpful, contact your state legislators.
Most insurance departments provide useful assistance to consumers
but some are not given adequate resources to do their jobs well.
Your state elected representatives can help to correct that.
- You also can get information on filing a complaint against an insurance company online.
