Orlando Harmon
Insurance fraud is a crime that affects all New York State residents, costing consumers millions of dollars in the form of higher premiums and increased prices for goods and services. It occurs when an insured person intentionally misrepresents facts to obtain a lower premium, such as lying about their marital status, drivers in their household, driving history, or vehicle garaging. If you suspect insurance fraud, you can report it to the New York State Department of Financial Services (DFS) by calling the Insurance Fraud Hotline at 888-FRAUDNY (888-372-8369) or the Department of Financial Services at (800) 342-3736. Additionally, you can contact your insurer directly if you notice any discrepancies. Reports are kept confidential, and by making them, you can help reduce the impact of insurance fraud in New York State.
| Characteristics | Values |
|---|---|
| What is insurance fraud? | A crime that victimizes every resident of New York State, costing consumers millions of dollars in the form of increased premiums and higher prices for goods and services. |
| Examples of insurance fraud | A driver and a body shop worker agree to inflate the auto damage claim and share the profit; a homeowner falsely claims that their home was burglarized and valuable items were stolen; a doctor bills an insurer for services that were not provided; a worker collects workers' compensation benefits while employed. |
| How to report insurance fraud | Contact your insurer immediately if you feel there are discrepancies; report suspected fraud to the Department of Financial Services at (800) 342-3736 or 888-FRAUDNY (888-372-8369); report to the DFS in writing using the DFS Report Fraud Form, and send it by facsimile or mail; call the Special Investigations Unit toll-free line at 855-228-0549. |
| What not to confuse with insurance fraud | Delays in customer payment, monetary disputes, policy cancellations, and non-renewals. |
| Who can report insurance fraud? | Members, providers, vendors, contractors, employees, and the general public can report cases of fraud. |
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What You'll Learn
Reporting to the Department of Financial Services
Insurance fraud is a crime that affects every resident of New York State, resulting in higher premiums and increased prices for goods and services. Examples of insurance fraud include a driver and a body shop worker agreeing to inflate auto damage claims, a homeowner falsely claiming that their home was burgled, a doctor billing an insurer for services not provided, and a worker collecting workers' compensation benefits while employed.
If you suspect insurance fraud, you can report it to the Department of Financial Services (DFS) in several ways. Firstly, you can call the DFS Insurance Fraud Hotline at 888-FRAUDNY (888-372-8369). Alternatively, you can contact the Department of Financial Services at (800) 342-3736. An investigator will get in touch with you to discuss the details, and your report will be kept confidential. Additionally, you can report suspected fraud to the DFS in writing by completing the DFS Report Fraud Form and sending it by fax or mail to the following address:
New York State Department of Financial Services
Insurance Frauds Bureau
One State Street
New York, NY 10004
Fax: 212-709-3555
Furthermore, you can contact the Special Investigations Unit (SIU) of CareConnect Insurance Company, Inc. The SIU works with various entities, including the DFS Insurance Frauds Bureau, to combat health insurance fraud. You can reach the SIU by calling their toll-free line at 855-228-0549 or by downloading and submitting the Suspect Fraud Report Form to CareConnect.
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![Report of the Special Committee of the Board of Aldermen appointed to investigate the "ring" frauds, together with the testimony elicited during the investigation. Board of Aldermen, J [Leather Bound]](https://m.media-amazon.com/images/I/61kelb6mFML._AC_UY218_.jpg)
Common insurance fraud examples
Insurance fraud is a crime that victimizes every resident of New York State, costing consumers millions of dollars in the form of increased premiums and higher prices for goods and services. The exact cost of insurance fraud is challenging to estimate because much of it goes unreported. If you suspect that insurance fraud has been committed, you should report it to the DFS (Department of Financial Services) or call the Insurance Fraud Hotline at 888-FRAUDNY (888-372-8369). Alternatively, you can report suspected fraud by printing and mailing the Report Fraud Form to the New York State Department of Financial Services Insurance Frauds Bureau. Here are some common examples of insurance fraud:
- A driver and a body shop worker agree to inflate the auto damage claim and share the "profit."
- A homeowner falsely claims that their home was burglarized and valuable items were stolen.
- A doctor bills an insurer for services that were not provided.
- A driver stages a fake accident, and unscrupulous doctors and lawyers help "handle" associated medical claims and lawsuits.
- A worker collects workers’ compensation benefits while employed.
- Consumers are victimized by unscrupulous agents or brokers and discover only after filing a claim that they are without coverage.
Please note that insurance fraud is different from disputes with an insurance company, such as delays in customer payment, monetary disputes, policy cancellations, and non-renewals.
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Contacting your insurer
- Identify Discrepancies: If you feel there are discrepancies or irregularities in your insurance claims or interactions, contact your insurer immediately. Trust your instincts—if something doesn't seem right, it's worth investigating further.
- Report to Your Insurer: Contact your insurance company directly through their customer support or fraud reporting channels. Most insurance companies have dedicated fraud investigation units or departments that handle suspected fraud cases. They will guide you through the process of reporting the suspected fraud and may have specific procedures in place.
- Provide Detailed Information: When reporting suspected fraud to your insurer, provide as much detailed information as possible. This includes any relevant documents, claim numbers, dates, names of individuals involved, and a description of the suspected fraudulent activity.
- Confidentiality: Remember that when you report suspected insurance fraud, your insurer will treat the matter confidentially. Your privacy and the privacy of those involved will be respected and maintained throughout the investigation process.
- Follow-Up: After reporting the suspected fraud to your insurer, stay in communication with them. Inquire about the status of the investigation and provide any additional information or documentation they may request. Your cooperation can significantly aid in the investigation process.
- Inquire About Prevention: In addition to reporting fraud, you can also inquire about fraud prevention measures offered by your insurer. Many insurance companies provide resources and guidance to help their customers protect themselves from becoming victims of fraud.
Remember, insurance fraud is a serious crime that affects all residents of New York State. By actively reporting suspected fraud to your insurer, you play a crucial role in combating this issue and helping to reduce its financial impact on consumers. Always remain vigilant, trust your instincts, and take the necessary steps to report any suspected fraudulent activities.
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Reporting anonymously
If you wish to report insurance fraud anonymously in New York, you have several options. Firstly, you can contact the Department of Financial Services (DFS) by calling the Insurance Fraud Hotline at 888-FRAUDNY (888-372-8369). This hotline allows you to report your suspicions anonymously, and your call will be kept confidential.
Additionally, you can report suspected fraud to the DFS in writing by submitting the DFS Report Fraud Form. You can send this form anonymously via facsimile or mail to the following address:
New York State Department of Financial Services
Insurance Frauds Bureau
One State Street
New York, NY 10004
Fax: 212-709-3555
Another option is to contact the Special Investigations Unit (SIU) of CareConnect Insurance Company, Inc. The SIU is dedicated to investigating and addressing potential fraud, waste, or abuse. You can reach them anonymously through their toll-free hotline at 855-228-0549 or by downloading and submitting the Suspect Fraud Report Form anonymously.
Furthermore, you can report insurance fraud anonymously to the NYS Department of Financial Services in writing or by calling their fraud reporting number:
Frank Orlando Fraud Director
NYS Department of Financial Services
One State Street
New York, NY 10004
Report fraud: 1-888-372-8369
Remember that insurance fraud is a serious crime that affects all residents of New York State, resulting in increased premiums and higher prices for goods and services. Your anonymous report can help combat this issue and protect others from becoming victims of fraud.
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Fraud bureaus
Insurance fraud is a crime that affects all residents of New York State, resulting in increased premiums and higher prices for goods and services. The cost of insurance fraud is challenging to estimate, as a significant portion of it goes unreported. Examples of insurance fraud include a driver and a body shop employee agreeing to inflate vehicle damage claims, a homeowner filing a false burglary claim, a doctor billing an insurer for services not rendered, and a worker collecting workers' compensation while still employed.
In New York, the Department of Financial Services (DFS) is the primary agency responsible for addressing insurance fraud. If you suspect insurance fraud, you can report it to the DFS or call the Insurance Fraud Hotline at 888-FRAUDNY (888-372-8369). Your report will be kept confidential. Additionally, you can contact your insurance provider directly if you notice any discrepancies or suspicious activities.
It is important to be vigilant and proactive in recognizing and reporting insurance fraud. Educating yourself and others about the signs of insurance fraud can help minimize its impact and protect consumers from becoming victims. Remember, insurance fraud is a serious crime that affects not only individuals but also businesses and the entire community of New York State.
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Frequently asked questions
Insurance fraud is a crime that victimizes every resident of New York State, costing consumers millions of dollars in increased premiums and higher prices for goods and services. Examples of insurance fraud include a driver and a body shop worker agreeing to inflate auto damage claims, a homeowner falsely claiming that their home was burglarized, and a doctor billing an insurer for services that were not provided.
If you suspect insurance fraud, you can report it to the DFS by calling the Insurance Fraud Hotline at 888-FRAUDNY (888-372-8369). You can also report it to the Department of Financial Services at (800) 342-3736. Additionally, you can report it in writing using the DFS Report Fraud Form and sending it by facsimile or mail to the New York State Department of Financial Services Insurance Frauds Bureau.
When reporting insurance fraud, it is important to provide as much information and evidence as possible. This may include the names of the individuals or entities involved, the nature of the suspected fraud, and any relevant documents or communications. It is also helpful to provide your own contact information in case the investigating authorities need to follow up with you.
