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	Fraud and the Insurance Industry     Fraud is considered a “serious problem” by insurers of all sizes. In fact, over forty percent of insurers report they have increased spending over the past three years to fight fraud, contrasting with just three percent who have stated spending less. Unfortunately, fraud is hard to spot and harder to root out, causing loss ratios to increase while stretching corporate resources to their limits.  Medical insurance fraud is by far the biggest threat facing the insurance industry today. With total annual losses of approximately one trillion dollars, and that amount expected to double within the next three years, insurance fraud is a problem that affects everyone -- insurers, doctors, governments, and taxpayers. Fraud can be perpetrated by anyone, including the insured, the uninsured, dishonest employees, unscrupulous insurance agents, and of course, common criminals.   What is fraud?     It’s any act or attempt by someone to collect money from an insurance company through deception, whether it’s outright lying, or a slight “bending of the truth”.  Insurance fraud costs Americans at least $80 billion a year, nearly $950 for each family, according to the Coalition Against Insurance Fraud. Healthcare fraud alone costs Americans $54 billion a year from acts that include everything from fudging on legitimate insurance claims to lying about how, where, and to what degree injuries occurred, to actually staging phony accidents. It’s all fraud and it’s not just wrong, it’s illegal.   It’s enough to make you sick.     Unfortunately, the insurance system is set up to indirectly encourage fraudulent behavior. Employees, anxious to make sure their employers cover their expenses, claim they were injured on the job Monday when they broke a leg in their backyard on Saturday. Uninsured motorists, facing medical bills with no way to pay for them, change their stories to put the burden on the other motorist’s insurance company. Disgruntled policyholders, tired of “paying through the nose” for insurance, embellish their injuries to “get something back”. In fact a recent survey of consumers revealing the shocking fact that 70% of those surveyed thought it was OK to cheat on insurance claims and 40% thought cheating shouldn’t be punished because insurers deserve to lose money.   Download fraud PDF Sheet   For more information on insurance fraud, visit http://www.insurancefraud.org
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