Insurance companies, regulators, and law enforcement agencies work hand-in-hand to detect insurance fraud and punish perpetrators.
To Report Fraud
Contact Credit Bureau’s fraud departments if you suspect your name or accounts are being used improperly. Ask for a “fraud alert” to be placed on your credit file, which can help prevent a thief from opening new accounts or making changes to your existing accounts.
- Equifax at 1-800-525-6285
- Experian at 1-888-397-3742
- TransUnion at 1-800-680-7289
Call your financial institutions if accounts have been corrupted by a crook or fraudulently opened in your name. Discuss closing those accounts and opening new accounts. Also consider filling out an “ID Theft Affidavit” available on the Federal Trade Commission web site or call 1-877-IDTHEFT (438-4338). This document can be used to help you prove you are an innocent victim.
Call the local police to fill out the necessary crime reports.
American General Life Companies has implemented wide-ranging fraud prevention programs. We do so not only to protect our organization from insurance fraud, but also to protect you, our valued customer. Remember, not only could you become a direct victim of insurance fraud, unchecked insurance fraud also results in higher costs to insurers that may be passed along to customers in the form of higher premiums.
By adding you to our team of insurance fraud fighters, our fraud prevention program becomes stronger and more effective.
How can I help fight insurance fraud?
By reporting activities you suspect may be insurance fraud to law enforcement agencies and to us, you serve as an invaluable resource in our fight against insurance fraud.
Okay, but what is insurance fraud?
Essentially, fraud is an intentional deception or misrepresentation that an individual or entity makes, knowing the misrepresentation could result in the receipt of an unauthorized benefit. In insurance fraud, the “unauthorized benefit” generally is money or the control of money that the perpetrator is not entitled to.
What are some examples of insurance fraud?
- Submitting claims for fake injuries.
- Receiving disability benefits when not disabled.
- Failing to accurately report medical history.
- Billing for services, medicines, and/or procedures that are not provided, not covered, or for more expensive treatments or medicines than those provided.
- Altering dates to fall within dates of eligibility
How does fraud impact you?
In 2007, $2.26 trillion was spent on health care and more than four billion health insurance claims were processed in the United States. It is an undisputed reality that some of these health insurance claims were fraudulent. Although they constitute only a small fraction of total claims, fraudulent claims carry a very high price tag. The National Health Care Anti-Fraud Association (NHCAA) estimates conservatively that 3% of all health care spending -- or $68 billion -- is lost to health care fraud. (National Health Care Anti-Fraud Association, 2008)
As a result of insurance fraud, good hard-working individuals like you could be adversely affected in many ways. For example, you could be faced with:
- Higher premiums
- Increased cost of consumer goods as businesses pass on the costs of fraud to you
- Business financial losses resulting from fraudulent health insurance claims
- Loss of access to insurance coverage or decreased coverage
What is American General doing to prevent fraud?
At American General, we believe that it is everyone's duty to aid in the fight against insurance fraud. Our anti-fraud procedures include:
- Fraud prevention training to all employees
- A dedicated Special Investigation Unit
- Cooperation with law enforcement agencies
- A toll-free hotline which you -- the consumer --can call to report suspected fraud
What is the Special Investigative Unit (SIU)?
American General’s Special Investigative Unit (SIU) is responsible for investigating incidents of potential fraud identified by customers, agents, health providers, groups, viatical companies and other parties. The SIU conducts audits, analysis, surveillance, undercover operations and interviews. They also cooperate on investigations with federal, state and local law enforcement agencies. The SIU also pursues civil actions against perpetrators of insurance fraud. Additionally, the SIU participates in American General’s pursuit to recover monies that we unknowingly paid on fraudulent claims.
How can I prevent/avoid fraud?
- Be vigilant, informed and know where to call when you detect or suspect fraud
- Be wary of physicians who insist you file a personal injury claim after an accident, especially if you're not hurt
- Be aware of attempts by agents, medical providers and others to convince you that everybody else is profiting so you may as well try to reap the benefits of insurance fraud
- Be informed and learn more by accessing the various public resources on fraud prevention
- Beware of unsolicited offers
- Safeguard your personal confidential information, including your insurance policy numbers
- Be wary of an agent who asks for power of attorney over your insurance policy
- Carefully review the Explanations of Benefits you receive from your health insurer and question charges for procedures that were not provided.
Where can I call to report fraud?
To report suspected fraud, contact American General’s toll-free Consumer Affairs hotline at (877) 574-3136. You may also contact your state Insurance Department’s Fraud Bureau.
What other resources are available to assist with the prevention of fraud?
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