Insurance Frauds Forum

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You will find experiences of insurance fraud as shared by our members and can also view suggestions of experts for free.

IRS audits
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Cancelled policy
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I had a portable life policy for both myself and my wife thru work that I paid 56.00 every 2 weeks for and could take with me when I retired. All premiums were paid on time and after I retired 17 months after paying for the policy was told would get info how to keep policy within 30 days. Never got any info. Called former employer to find out that policy was cancelled 2 months before I retired but employer was not notified. Unum ins. Co finally after a month said they would only reimburse me for the 2 months after the policy was canceled.

Insurance fraud - Faked Death
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I'm working on a situation where I suspect an individual, along with several accomplices, have faked a murder to escape prosecution as well as divert attention and help cover there exit. I also suspect Insurance fraud might of been involved to fund the scheme. I know who the executor of the estate was, but I need to quietly figure out if the person first had any Life Insurance, and if so, who the benefiturary was. How can one go about quietly finding out (so not to spook the people involved) if this person had Life Insurance, and if so what company it was issued by?

IRS audits lawsuits YOU need help 419 412i captive insurance
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412i,419, lawsuits, IRS audits
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April 24, 2012 By Lance Wallach, CLU, CHFC
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419, 412i, plans are being audited by the IRS. Lawsuits are the result.
Dolan Media Newswires 01/22/
Small Business Retirement Plans Fuel Litigation

IMO/Broker Fraud
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Hypothetically speaking, you would have to have indisputable proof of fraudulent billing. Assuming I had that, I would approach the broker/IMO with my evidence and simply ask questions. Play dumb if you want.

"Mr. Broker, I'm not sure I understand this: Right here, we can clearly see you've billed Blue Cross for marketing that never happened. Why would a successful guy like you bill insurance carriers for work that was never performed? I wonder how the insurance companies would feel about this? I wonder if this is illegal/unethical/immoral? What should I do here?"

This question is for my fraud class. How to commit the perf
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I'm taking a fraud class at college an for 10 points on my grade I need to write about committing the perfect insurance fraud. The teacher gave one clue and that is to go to another country where you can order up a dead body. I forgot the name of the country.

Service provider billed insurance 150% more than cash rate
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1) Is this fraud that when a service provider encourage clients to use insurance because they (the client) will has no out of pocket cost? The service provider is in NJ

2) Their published rate is $1,800 per week, which come out to be $360 per day, that's before any multiple weeks discount. However, they billed insurance company $850 per day and received $595 or 70%.

$595 is over 65% market over cash rate.

Is both fraud?

How to stop a policy deducted through payroll deduction?
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This is a MetLife policy through my daughters work place, Great Clips. She has health, dental and vision insurance through my work place as she is 24 years old and is covered until the age of 26. She told the agent this information. She also told the agent that she wanted NO insurance, everything the same as the year before. The agent had her sign the paper to waive the insurance (same as the years prior) and THEN the agent filled it out the paper work later and signed her up for disability, dental and vision.

Health insurance fraud case
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I’m just fed up with telemarketer insurance brokers. Trust me I just survived a stroke because of these nasty people. They just screwed us up!! A few months back, about 7-8...I don’t remember clearly, my husband and I were looking for some health insurance plan on the internet.

After few days of the initial registration with a vendor, we were flooded with unwanted telemarketing calls but there was a lady who sounded legit and so we signed up with HPA insurance company and they just paid less than $100 when we wanted it the most after paying 12 times more than that.

IME Insurance Corruption
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My wife suffered personal injury (broken ribs, compressed vertebrae) as a result of an auto accident when another car pulled out of a parking lot into the road and we ran into it. My wife's condition did not improve after a year but got worse, and one of our doctors noted that she had a permanent injury and would never be able to lift heavy objects, walk long distances, etc. Despite this, the insurance company ordered an IME (independent medical evaluation).