Fraud FAQ's

• What is insurance fraud?
• Who commits fraud?
• How serious is fraud?
• What is ICW Group doing to fight fraud?
• How can I avoid contractor fraud when I have a property claim?
• What can I do to fight fraud?
• What do I report to ICW Group if I suspect Workers' Compensation Fraud?

What is insurance fraud?

Insurance fraud occurs when someone tries to make money from insurance transactions by deceiving others, such as obtaining payment from an insurer on a fraudulent claim.

Who commits fraud?

People who commit insurance fraud come from all walks of life, from organized criminal enterprises, to unscrupulous doctors and lawyers, to dishonest body shop operators, to your own co-workers and neighbors. They do have one thing in common - they are motivated by money. They take what isn't rightfully theirs, and we all pay for it.

How serious is fraud?

Insurance fraud is one of the most costly white-collar crimes in America, second only to tax evasion. It affects every citizen of our state in an immediate and substantial way. According to the National Insurance Crime Bureau (NICB), while shoplifting costs the retail industry approximately $13 billion each year, insurance fraud is estimated to cost $100 billion. In both instances, the crimes translate into higher costs for everyone. Insurance researchers estimate that every U.S. household pays $200 to $300 a year in higher premiums in order to offset fraudulent claims.

What is ICW Group doing to fight fraud?

We take fraud seriously, and have created our Special Investigations Unit (SIU) to handle fraud investigations. SIU assists our underwriters, claims and accounting staff in the fight against insurance fraud. They are involved in anti-fraud efforts in multiple states, working closely with law enforcement, district attorneys and the Department of Insurance. As a result of our committment in this area, we have successfully brought many cases of fraud to prosecution .

How can I avoid contractor fraud when I have a property claim?

• Get more than one estimate.
• Do not be pushed into signing a contract.
• Get everything in writing: the cost, work to be done, and a full time schedule.
• Demand references, and be sure to check them out!
• Ask to see the salesperson's driver license and write the license number.
• Take down the license plate number.
• Never sign a contract with blanks.
• Never pay a contractor in full or sign a completion certificate until the work is completed.
• Check your local Better Business Bureau for references.
• Check out the contractor's business license and proof of insurance.
• Insurance coverage may be rendered void if intentional misrepresentation by a policyholder is discovered.

What can I do to fight fraud?

Call the NICB Fraud Hotline 800.835.6422, if you witness or suspect any of the following:

• Faked or inflated auto or commercial property losses.
• Arson to business property or auto fires.
• Staged auto or workplace accidents.
• Phony or inflated medical bills, auto, or business repair bills.
• Misrepresenting the ability to work (claiming medical disability).
• Employer cash exchange with injured worker.

What do I report to ICW Group if I suspect Workers' Compensation Fraud?

If you suspect workers' compensation fraud, report the following information immediately:

• If applicable, your Policy number, employee's name and claim number.
• Your contact number.
• Reason for suspecting fraud.
• Employees / others who witnessed the injured parties' activities away from work.
• List of witnesses who were working in the area or who may have seen the injury.
• Identification of any equipment that may have malfunctioned causing the employee's injury.
• Any information concerning an employer who is paying cash to employees, sending injured workers to the employer's doctor and not advising the carrier, and any information of the employer trying to avoid the proper classification of the employees' jobs.