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Why Reporting Medical Car Insurance Fraud is Important

Written by Michele Wilmonen. Posted in Research Last Updated: 02/28/2013

Insurance companies aren’t the only victims of insurance fraud.

insurance fraud

It makes you wonder why medical professionals would need the extra money from insurance fraud.

Medical car insurance fraud is insurance fraud that focuses on getting payments from someone’s medical or liability coverage on their car insurance policy through creating fake medical expenses. This type of insurance fraud is one of the most common because it is so easy to commit if you have the right people involved.

It is also the most costly insurance fraud because medical expenses can be billed at high amounts without usually throwing up any fraud flags.

Who is Usually Involved in this Type of Insurance Fraud?

Insurance fraud that is focused on getting money from the medical payments or liability coverages of an insurance policy can be done by anyone. But usually there is a doctor involved. This makes the claim seem legit, and the insurance companies continue to pay the medical bills without questioning the treatment.

For example, in January a Texas chiropractor plead guilty to an insurance fraud scheme that was run for 2 years before it was shutdown finally. Before it was taken down, insurance companies had already paid out 1.2 million dollars in fake or exaggerated treatments that were billed by this chiropractor.

With elaborate schemes like this, there are usually multiple parties involved, but the medical professional is the key to getting the money for the scheme.

How Insurance Fraud Affects You

People that are involved in insurance fraud consider it a white collar crime. This means that they feel that since they are stealing from a large corporation that it is okay. It is a faceless crime because no one personally gets hurt. This type of thinking may help their conscious, but it is flawed thinking.

When someone successfully pulls off an insurance fraud scheme it’s not the insurance company that gets hit financially, it’s all of their customers. Insurance companies are in the business to make money, so if they are posting losses from these insurance fraud schemes they are going to turn around and raise your insurance premiums to make up for the loss.

Not such a faceless crime anymore is it?

What Can You Do to Fight Insurance Fraud?

Report, report, report! If you hear of anyone talking about an insurance fraud scheme that they are involved in report them to the Department of Insurance or the Insurance Commissioner in your state. If you know whom they are insured with, report them to their insurance company. You don’t have to worry about them finding out because you can report them anonymously.

If you are involved in a claim and the doctor is like the one above report any suspicious billing or activity to your claims adjuster. You will find that claims adjusters are very open to launching an insurance fraud investigation if something doesn’t feel right about a claim.

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Michele Wilmonen

Michele's first introduction to insurance was working for a major insurance company as a file clerk and a mailroom supervisor in a regional office. She learned insurance directly from underwriters and claims adjusters from questions and also watching them do their job. Since then, she's earned a number of insurance certifications from the Insurance Institute of America and also a Bachelor’s degree from the University of Idaho. She blogs at Car Insurance Guidebook.

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