who do you report insurance fraud to?

Submitted by junettelogan on Wed, 04/23/2008 - 01:42

Insurance cancelled 2 weeks after it was put in force and after I had cancelled my other insurance.
They had all info ahead of time and could have found out anything by the next day as the insurance company I send with next. The I had the insurance only 24 days and had to pay for more than a months insurance with no explanation as to how they figured what I was getting back.

Posted: 23 Apr 2008 02:46 Post Subject:

Is this a question or just a statement?

Posted: 23 Apr 2008 06:48 Post Subject:

There are some state-sponsored fraud investigators towards checking frauds. So, what you need to do is to find out whether your state has a fraud bureau.
BTW, may I know which state you belong to?

Regards,
Plasticmind

Posted: 23 Apr 2008 06:54 Post Subject:

Hi,

Have you heard of the NICB?
The National Insurance Crime Bureau is all set to investigate & abolish all sorts of fraudulent attempts from the insurance industry. You may call them toll-free at hotline: 1-800-835-6422
Keep us updated..

Posted: 23 Apr 2008 12:12 Post Subject:

HUH? :?

I had the insurance only 24 days

Insurance cancelled 2 weeks after it was put in force

First off these two statements don't even come close to matching...and who do think committed fraud? Need to be more detailed in your discription, so we can 'try' and assist you.

Posted: 15 Jun 2009 06:05 Post Subject: insurance fraud

I just heard about a local woman that about 15 years ago checked her daughter into the hopsital and had knee surgery done. The mother used her other daughters insurance and name. The one daughter was in highschool and the daughter that had the surgery was out of highschool.

Is it too late to report it and to whom do you report it? What kind of punishment would they recieve and could I stay anamous?
Thanks for your time.

Posted: 15 Jun 2009 09:08 Post Subject:

I just heard about a local woman that about 15 years ago checked her daughter into the hopsital and had knee surgery done.



Hey what to do, how did you come to know about the incident?

Posted: 15 Jun 2009 11:05 Post Subject:

Geeze...let that one go...15yrs is past the statute, I'm sure, in most states, and frankly why?

Posted: 15 Jun 2009 10:24 Post Subject:

The girl was openly talking about it. She acted like it was no big deal. To me it is a big deal. I pay by insurance premiums and this is a classic case why premiums are so high. I don't feel that anyone should break the law in this manner, then to brag about it is insane!! I have looked it up and insurance companies want to know about this action without limitation. I will probably let it go as Lori suggested but next time you write a large check for your health insurance you might think about this kind of fraud and how it is impacting you. That is why I feel it matters.

Posted: 16 Jun 2009 04:33 Post Subject:

Hey what to do, I understand your frustration and I agree with the cause. It's true that insurance frauds are affecting all of us in terms of higher premium. But after fifteen years it'd be hard to investigate into the matter. May be there is no document left to prove a fraud was committed. However, you might still wish to check with the Insurance Fraud Bureau if anything can be done.

Just wondering.... is the girl only started bragging recently about the incident?

Posted: 16 Jun 2009 05:04 Post Subject:

Jeremyholter,
Thanks for your thoughts and a little understanding of my frustration. I will let it go. I do not need to be a do gooder. If I were to do anything like that, I would be caught right away. I'd probably tell on myself. HAHA!!!
I worked at Physicians Mutual home office in underwriting for five years. That may add to my passion/frustration of the matter.

Yeah, she recently started talking about it. We live in a small town of about 4000 people. I don't know why in the world she would ever say anything like that. You know, there is one in every crowd that thinks they are better than everyone else and just can't seem to keep their mouth shut. I think she probably feels like it's been long enough that it doesn't matter. It just really hit a nerve with me.

I really do appriciate your communication. It felt good to get it off my chest without telling anyone around here.

Posted: 16 Jun 2009 05:24 Post Subject:

Junettelogan-Was your policy in force or was it undergoing the underwriting process? From the time you fill out an application with an agent until the application is underwritten, you have the insurance. Maybe in the fine print you will see that on the copy of the application you filled out. (IDK) I believe typically companies return your money they collect at the time of application unless you have submitted a claim between the time you filled out the application and when the underwriting process is complete. Did you cancel your insurance beore you heard back from the new company and had a policy in hand?

Hope it works out for you.

Posted: 16 Jun 2009 09:39 Post Subject:

Yeah, she recently started talking about it.

But you don't have enough evidence to pursue this one in the court of law.
I'm sure the last thing you'd want is to get over a defamation lawsuit...won't you??

Steven

Posted: 16 Jun 2009 10:29 Post Subject:

Thanks for your thoughts and a little understanding of my frustration.



You are welcome, what to do. :D

Posted: 16 Jun 2009 10:32 Post Subject:

what to do, Don't get me wrong, as a P&C claims adjuster for more years than I care to remember, I'm the first one in line to bust someone for fraud. Your first post, just made me wonder about your motivation, (I thought you had known about this for 15 yrs)...I seriously doubt there is anything that could be done.. However, being the 'occasional' smart mouth :wink: if I heard her 'bragging' I'd probably tell her, she might want to 'tick a lock' and not openly discuss she and her mother commiting a felony..As there just 'might' be people that would turn them in, and really does she want to see her mother facing felony charges on this thing now? I know the type...but seriously the girl has to be just plain stupid to openly discuss such a thing...I'd throw a little fear her way, and let it go.. ........................ this time.. :wink:

Posted: 27 Jul 2009 08:45 Post Subject:

Who do you report insurance fraud to in Minnesota?

Posted: 29 Jul 2009 11:06 Post Subject:

Minn. dept of insurance

Posted: 29 Jul 2009 12:47 Post Subject:

I guess it also depends on the nature of fraud. Are you gonna report this fraud on behalf of an individual? Or is it that you wanna report fraud within the industry at large?

Posted: 05 Nov 2009 11:58 Post Subject: Cinergy Health

I am the victim of this company. My 10,000+ hospital bill was not paid. What can I do?

Posted: 06 Nov 2009 12:26 Post Subject:

What can I do?

file a complaint with your states dept of ins

Posted: 06 Nov 2009 01:03 Post Subject:

You state that they didn't pay your $10,000 hospital bill. They were required by law to disclose the reasons for the denial.

Could you tell us why they denied the claim? That might help point you in the right direction.

InsTeacher 8)

Posted: 06 Nov 2009 11:35 Post Subject:

Beth, I'm sure you could have asked for an explanation. Once you get an explanation you'd be able to check for discrepancies if any. If you come across a discrepancy it would give you an opportunity to negotiate with the adjuster. In case they fail to show you the right reason, you'd then need to register your complaint with your state doi.

Posted: 18 Jan 2011 09:02 Post Subject: hospital fraud?

Went in for a procedure and the hospital charged $1194.00. My insurance paid out $1887.00! When asked why they paid MORE than was charged, they replied that that is the contracted amount for the procedure between the hosp. and the insurance co. If that is so, why didn't the hosp. charge that higher amount and also, where does the extra $693.00 go...is it accounted for? One procedure, one person, one day times the thousands of procedures done each year equals lots of unaccounted for money.

Posted: 30 Jun 2011 06:10 Post Subject:

i know someone who didnt want to make pmt on snowmobile anymore and put it on trailer {barely} took it for a ride and it fell off and wrecked it. insurance paid it off. any advise?

Posted: 07 Jul 2011 04:22 Post Subject:

You can contact your local law enforcement agency and see if they are willing to investigate it.

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