What is insurance fraud?
Insurance fraud is a crime that involves using deception to obtain an unjust financial advantage from an insurance program. In Washington, insurance fraud occurs when someone provides false information or fabricates documentation in an effort to get insurance funds to which they are not entitled. It can also occur when a healthcare provider over-charges an insurance program or alters a medical record in order to get a reimbursement from the insurance company. Insurance fraud can occur in a variety of ways, including filing a false claim, inflating a legitimate claim, providing medical services that are not necessary, and submitting claims for services that were not provided. The consequences of insurance fraud in Washington can be serious. Depending on the case, insurance fraud can be considered a felony offense, punishable by imprisonment and/or fines. Additionally, insurance fraud can lead to increased insurance premiums for everyone in the state of Washington, as insurance companies seek to make up for the losses they incur. To protect against insurance fraud, Washington has state and federal laws in place to help detect, prevent, and prosecute fraudsters. The Washington Office of the Insurance Commissioner works to reduce insurance fraud by investigating suspicious activities and enforcing laws that pertain to healthcare services. Other initiatives include encouraging insurance companies to share information, increasing public awareness, providing whistleblower protection, and encouraging citizens to report suspected cases of insurance fraud to the authorities. In Washington, insurance fraud is a serious crime and those found guilty of it can face criminal prosecution and serious consequences.
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