Insurance fraud is an increasing problem in North Dakota and across the country. It's estimated that about 10% of all claims paid out by insurance companies are fraudulent.
In addition, one of the most prevalent types of insurance fraud is health insurance fraud, characterized sometimes by doctors charging for a more expensive procedure than the one that was actually performed.
North Dakota fraud referral statistics
2008
2009
2010
2011
2012
Insurance fraud referrals received
23
48
94
120
93
Cases still under investigation
3
11
51
79
151
Losses due to fraud*
$28,938.27
$20,220,566.16**
$1,061,114.69
$1,997,392
$710,104
*This number reflects only those amounts that were reported by insurance companies; not all companies report the claim amount with their referral. **$20 million of this amount is from one case that is being investigated by a federal agency.
It is important to remember that insurance fraud affects all of us--consumers and insurance companies alike. It is estimated that fraud costs consumers between $400 and $700 per year in increased home and auto insurance premiums. (FBI)
For years, many people have believed that defrauding an insurance company is okay. Lots of people think that it's all right to pad a legitimate claim to recoup the deductible or make up for insurance premiums paid over the years when no claims were made.
Click here to search for fraud-related news from the Insurance Department.
Research conducted by the Insurance Research Council in 2003 showed that 22 percent of U.S. adults agree it is all right to increase insurance claims to make up for premiums paid. ("Insurance Fraud: A Public View," June 2003)
The bottom line is that fraud is not fine--it's illegal and punishable by law. In North Dakota, insurance fraud is a Class C Felony if the value of any property or services retained exceeds $5,000 and a Class A misdemeanor in all other cases. It may be punishable by up to five years in prison and up to $5,000 in fines and may include restitution and court costs.
If you suspect that a fraudulent insurance act is occurring, or has occurred, please contact the Department at:
