MAPFRE Insurance is committed to providing exceptional customer experiences as we are “people who take care of people”. It is our mission to provide high quality products and valuable services and a relationship built on trust. As such, we are invested in the prevention of insurance fraud in every line of business that we write.
Our Special Investigations Unit (SIU) consists of dedicated claims adjusters and field investigators who are responsible for the investigation of suspicious and fraudulent insurance-related activities and the payment of legitimate claims.
Additional Anti-fraud Resources
NICB: Website – http://www.nicb.org/. NICB is a non-profit organization that receives support from over 1,000 property/casualty insurance companies. They provide resources in the fight against insurance fraud and provide a communication forum on fraud issues.
IFB: Website – http://www.ifb.org/ The Insurance Fraud Bureau (IFB) conducts criminal investigations and refers appropriate cases for criminal prosecution.
Coalition Against Insurance Fraud: Website – http://www.insurancefraud.org/. This organization is made up of Insurance and Public Advocate members committed to the fight against insurance fraud.
What is Fraud?
The Webster’s Dictionary defines “Fraud” as:
“Intentional perversion of the truth in order to induce another to part with something of value or to surrender a legal right; an act of deceiving or misrepresenting.”
The key element of fraud is a false and material misrepresentation made by one who either knows its falsity or is ignorant of its truth.
Fraud has a far-reaching effect upon the insurance industry:
Insurance fraud occurs when an act is committed with the intent to deceive an insurance company to obtain some benefit or advantage to which they are not otherwise entitled. It can happen when someone puts false information on an insurance application or when false or misleading information is given or important information is omitted in an insurance claim.
MAPFRE takes a very active role within the insurance industry to recognize and control fraudulent claims.
There are two main categories of insurance fraud; Hard Fraud and Soft Fraud:
Hard Fraud: Hard fraud is premediated, planned, and deliberate type of fraud. It is when someone deliberately fakes an accident, injury, theft, fire or other loss to collect money illegally from an insurance company. Some examples of hard fraud would be intentionally setting a fire (arson) to collect insurance proceeds, or staging a loss in order to collect on an insurance policy.
Soft Fraud: Soft fraud is more of an opportunistic type of fraud. It is often when normally honest people omit information on an insurance application to reduce premium.
Commons forms of insurance fraud include:
- Staging a car accident – this happens when all parties intentionally cause an accident or report an accident that did not occur in order to make a claim against your insurance or their own.
- Jump-ins – a person claims to be involved in an accident but were not present at the time of loss.
- Stolen car – the owner of a vehicle reports their vehicle stolen, but they deliberately disposed of the vehicle or damaged the vehicle in order to collect money from their insurance policy
- False injury claim – when someone reports they were injured in an accident, but they are not injured or they are trying to claim a pre-existing injury is related to the accident.
- Lost wages – lying about missing time from work or the amount of lost wages they incurred.
- Inflated car repairs – this occurs when a repair shop and/or another individual enhances additional damage to the vehicle or writes for replacement of parts, but then doesn’t replace the part. Or they do not complete repairs in accordance with the appraisal.
- Premium fraud – providing false information regarding where you garage your vehicle or not listing the proper operators of your vehicle(s).
- Property fraud – includes exaggerating the value of stolen property; intentionally damaging property; staging a burglary; providing false receipts or concealing a residence is used as a rental or in commercial business on an insurance application.
How to Protect Yourself From Fraud
- Make sure you confirm the number of vehicles involved in the accident, also obtain the plate number; model and make of the vehicles involved.
- Take photos of the damage to each vehicle.
- Take note of the number of passengers in each vehicle, if possible obtain names of all parties involved.
- Report all accidents to MAPFRE Insurance even if there is no damage and no report of injury at scene.
Reporting Insurance Fraud
MAPFRE Insurance maintains a dedicated Special Investigation Unit (SIU) to combat insurance fraud. If you become aware of insurance fraud or fraudulent activities, you can report it to us anonymously at the telephone number listed below:
- MAPFRE TELEPHONE at 1-800-221-1605. Ask to report fraud and the caller will be transferred to the Special Investigation Unit to provide the details.
You may also report it via the links below:
- Report directly to the National Insurance Crime Bureau (NICB) via:
- TEXT the keyword “FRAUD” to 847411
- TELEPHONE at 1-800-835-6422
- ONLINE at www.nicb.org
- Report directly to the Insurance Fraud Bureau of Massachusetts via:
- TELEPHONE at 1-800-323-7283
- ONLINE at www.ifb.org