What Is the Legislation in the United States on Insurance Fraud?

Insurance Fraud is specifically categorized as a crime in the United States. However, in most states, only certain types of insurance fraud are criminalized. For instance, Oregon only outlaws Worker Compensation and Property Claim fraud.

Approximately one-third of the investigations on insurance fraud end up with a criminal conviction, one-third result in denial of the claim, and one-third incur payment of the claim. Nineteen states require mandatory insurer fraud plans. This requires companies to form programs to combat fraud, and in some cases to develop investigation units to detect fraud. Forty-one states have fraud bureaus. These are the law enforcement agencies that review fraud reports and start prosecution.

Besides making laws more severe, legislators have also come up with a list for management that should be implemented so that companies can better combat the possibility of being scammed. This includes knowing that fraud does exist and that there is a high risk; understanding the dangers and seriousness of the problem; and being fully aware of the importance of the hiring process. Learn to address the economic side of business. That means putting procedures and policies in place to spot and deal with individuals who are trying to commit insurance fraud.