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Insurance Fraud. Recognize, Report, Reduce

Insurance fraud costs consumers in the U.S. between $80-120 billion each year, equaling about $950 per family annually. It is the second most profitable crime in the U.S. behind only illegal drug sales.

    R1Recognize Insurance Fraud

    Examples of insurance fraud include but are not limited to:

    • Deliberate attempts to stage an accident, injury, theft, arson or another type of loss that would be covered under an insurance policy (e.g., setting fire to your home)
    • Exaggerating a legitimate claim (e.g., doubling the value of stolen jewelry)
    • Knowingly omitting or providing false information on an insurance policy application (e.g., purchasing a policy for a previously damaged vehicle and omitting the damage in the application to file a claim at a later date)

     

     

    Report Insurance FraudR2

    If you witness someone committing insurance fraud, or suspect someone doing so, please report it to the North Dakota Insurance Department.  Our team of investigators will review the report and conduct an investigation, if necessary.  Appropriate steps, including legal action, may be taken.

    Department investigators regularly work closely with multi-jurisdictional task forces, state and federal agencies, fire departments, local law enforcement, insurance companies, and the public to identify, investigate and prosecute insurance fraud.

     

     

    R3Reduce Insurance Fraud

    A common misconception about insurance fraud is that it is a victimless crime, however, that couldn't be further from the truth. Insurance fraud doesn't just negatively affect insurance companies - it touches all North Dakotans. The Fraud Investigation Division of the North Dakota Insurance Department is working to reduce, and even eliminate, the practice of insurance fraud in the State.

    In our efforts, we actively communicate with the public on how to Recognize, Report, and Reduce insurance fraud through multiple channels, including speaking engagements.  If you would like a representative of the Department to speak to your group, please contact us.

     

     

     

    North Dakota Fraud Referral Statistics

      2016 2017 2018 2019 2020 2021
    Insurance fraud cases 228 235 265 339 302 272
    Declined by prosecutor 0 1 0 0 0 3
    For information only 21 31 36 45 40 125
    Investigative criteria not met 87 105 86 135 137 331
    Jurisdiction 33 22 44 28 39 108
    No evidence of a crime 37 22 33 77 42 167
    Prosecuted 14 8 18 6 7 18
    Prosecution not appropriate 6 17 20 4 5 10
    Statute of limitations 4 6 6 5 4 13
    Unable to prove beyond a reasonable doubt 26 24 21 31 18 82
    Open 0 0 0 8 10 56
    Amount of actual loss $545,728.96 $148,616.86 $140,473.66 $1,189,788.05 $626,792.64 $1,084,722.70

     

    If you suspect that a fraudulent insurance act is occurring, or has occurred, please contact the Department. Individuals can report fraud online through the National Association of Insurance Commissioners (NAIC) Online Fraud Reporting System (preferred method) or submit a Uniform Suspected Insurance Fraud Reporting form (SFN 58333).

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