Cunning fraudsters have perfected their skill and work daily to take advantage of well-intended insurance consumers who want to protect their assets. All consumers are impacted by insurance fraud and scams, even if not directly targeted. The Coalition Against Insurance Fraud estimates that at least $80 billion in fraudulent claims payments are made annually. Who ultimately pays for insurance fraud? All of
us!
As a result of insurance fraud:
Misrepresentation occurs in many forms but the most common is misleading you to believe more coverage is available or the coverage period is longer. It occurs often with short-term or limited benefit health insurance plans. Misrepresentation also occurs when non-insurance products are presented as insurance, such as discount medical plans.
Consumer Tips:
To Verify an Insurance Company License:
Office of Insurance Regulation
Active Company Search
www.FLOIR.com/CompanySearch
To Verify an Insurance Agent License:
Florida Department of Financial Services
Division of Insurance Agent and Agency Services
www.MyFloridaCFO.com/Division/Agents
850.413.3137
A person(s) contacts you and pretends to be an insurance agent or representative from the insurance company and threatens to cancel your coverage if specific personal information or actions are not taken.
Consumer Tips:
An agent who is not licensed by the Florida Department of Financial Services or not authorized to sell insurance for a specific insurance company. If you purchase a policy from an unlicensed or unauthorized agent, the policy is not valid and you will not have coverage.
To Verify an Insurance Company License:
Office of Insurance Regulation
Active Company Search
www.FLOIR.com/CompanySearch
To Verify an Insurance Agent License:
Florida Department of Financial Services
Division of Insurance Agent and Agency Services
www.MyFloridaCFO.com/Division/Agents
850.413.3137
Unnecessary repair(s) or pretending to repair a vehicle in order to file a fraudulent or inflated insurance claim or to access your personal information. This type of scam also occurs with homes and other property.
To Verify Workers’ Compensation Coverage:
Florida Department of Financial Services
Division of Workers' Compensation
www.MyFloridaCFO.com/Division/WC
850.413.1609
A person(s) intentionally causes or stages an automobile accident in order to file fraudulent or inflated insurance claims with your insurance company for repairs, injuries, etc.
A person using your identity and insurance to obtain medical services or prescriptions.
A medical provider charges for services that were not performed or falsely inflates the cost of services in order to file fraudulent insurance claims with your insurance company and receive payment.
A person represents themselves as a licensed, professional contractor when, in reality, they have not been licensed by the Florida Department of Business and Professional Regulation.
The unlicensed “professional” may also misrepresent their workers’ compensation and/or liability insurance coverage to give the impression that they are properly insured.
Unlicensed contracting work is illegal and dangerous for you, as a consumer. Using an unlicensed contractor can put you at risk of receiving unsatisfactory, subpar repairs, which could potentially cause more issues in the future or even cause severe injury to you or someone visiting your property.
To Verify Contractor License:
Florida Department of Business and Professional Regulation
www.MyFloridaLicense.com
850.487.1395
To Verify Workers’ Compensation Coverage:
Florida Department of Financial Services
Division of Workers' Compensation
www.MyFloridaCFO.com/Division/WC
850.413.1609
An employer can commit workers' compensation insurance fraud by intentionally not providing appropriate coverage to their employees. This can occur by the employer:
Before joining a company, verify with the Department of Financial Services that the employer has workers' compensation coverage. Then, verify the coverage is up to date on an annual basis.
To Verify Workers’ Compensation Coverage:
Florida Department of Financial Services' Division of Workers' Compensation
Division of Workers' Compensation Proof of Coverage Database
850-413-1609
If you have any concerns regarding an employers workers' compensation insurance coverage, please contact the Division of Workers' Compensation:
Florida Department of Financial Services' Division of Workers' Compensation
Workers' Compensation Exemption/Compliance: 1-800-742-2214
Workers' compensation insurance scams perpetuated by an employee occur when an employee files a claim for a fake injury or pretends to be more injured than they actually are.
Remember that claiming to be injured or purposely exaggerating injuries in order to claim workers' compensation benefits is insurance fraud. Workers’ compensation fraud is a third-degree felony that can result in fines, civil liability and jail time.
DFS Fraud Hotline: 1-800-378-0445
Online: Division of Investigative and Forensic Services, Bureau of Workers' Compensation Fraud
Office of the Insurance Consumer Advocate
200 East Gaines Street, Tallahassee, FL 32399
Phone: (850) 413-5923
Email: YourFLVoice@MyFloridaCFO.com