Insurance Fraud FAQs

 

Fighting Fraud

Amica's Special Investigations Unit (SIU) is an investigative and informational resource that examines claims for fraud, sponsors training sessions for law enforcement agencies and conducts educational presentations for community organizations.

Insurance fraud is any act committed with the intent to obtain a fraudulent outcome from an insurance process. The most common methods include:

  • Staged car accidents
  • Fraudulent car thefts
  • Inflated losses
  • Fraudulent injury claims
  • Application fraud

People who commit insurance fraud could be individuals or organized groups.

People who commit insurance fraud come from all walks of life regardless of their individual economic status. Perpetrators of insurance fraud range from organized groups that often target innocent policyholders simply because they "look like" they have insurance to unscrupulous medical and legal providers to the "one-timer" who inflates a legitimate loss.

The total cost of insurance fraud is estimated to be more than $40 billion per year, according to the Federal Bureau of Investigation and National Insurance Crime Bureau. That means insurance fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums.

Amica is one of 1,000 insurance companies that supports the National Insurance Crime Bureau (NICB), an organization that helps identify, detect and prosecute those who commit insurance fraud. Our continued vigilance and cooperative efforts with agencies and state insurance departments help reduce the payment of fraudulent claims.

Reporting Fraud

Some examples include staged car accidents, solicitation of provider service, parking lot schemes, “jump-in” passenger accident or providing an incorrect address to avoid premiums.

Taking a few simple precautions can make a world of difference for you and your insurer. When an accident occurs:

  • Call the police. They're trained to investigate accidents and file the necessary reports.
  • Document the accident scene. Whenever possible and if it’s safe, take photos of the damage and position of the cars after the accident. Make quick notes to yourself about the time, date and location of the accident and anyone who was involved. Report accidents to Amica as soon as possible. 
  • Report schemes. If someone asks you to be involved in an insurance fraud scheme, notify the Amica Special Investigations Unit or your file handler.

If you have information that may be helpful to Amica in identifying insurance fraud, please call our toll-free Fraud Hotline at 877-407-3344 (available 24 hours a day).

All calls to the Amica Fraud Hotline are completely anonymous and confidential.