Be Part of the Solution
Insurance fraud costs Americans about $30 billion each year, and adds $200 to $300 to the average household's insurance premium.
You can be part of the solution by taking two steps right now. First, you can protect yourself from becoming an insurance fraud victim by knowing more about these crimes. If you suspect someone may be committing insurance fraud, contact the insurance company involved, the appropriate law enforcement authorities or the National Insurance Crime Bureau (NICB). You can reach the NICB at 1 (800) 835-6422 (callers do not have to disclose their names when reporting fraud to the NICB).
If you suspect a medical provider is committing insurance fraud or there is a charge in question that you cannot resolve directly with the provider, you should contact the insurance company. The insurance company's address and toll-free telephone number will appear on your explanation of benefits.
If you suspect an insurance agent or broker of committing fraud, please contact Vicki Estrada at the Office of the Insurance Commissioner (OIC) at (360) 725-7263.
Medicare fraud
If you suspect Medicare fraud, call the Medicare carrier or intermediary who sent the Medicare Summary Notice (MSN). The carrier or intermediary name, address and toll-free telephone number appear on the notice. You also can contact the SHIBA HelpLine at 1 (800) 562-6900 for assistance. Specially trained volunteers located in your community can help resolve your concerns and report Medicare fraud.
Discount and medical repricing
"Discount" or "medical repricing" plans are not insurance. If you suspect a discount plan or medical repricing plan is acting fraudulently, you should contact the Washington State Attorney General's Office at 1 (800) 551-4636, or contact the OIC at 1 (800) 562-6900 to discuss your concerns.
Remember, you are part of the solution. If you suspect insurance fraud, report it.
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