What is an insurance fraud investigation?

An insurance fraud investigation is an investigation conducted by insurance companies or the government that seeks to identify and prosecute fraudulent insurance claims. Insurance fraud is when someone knowingly lies on an insurance application or makes a false or exaggerated claim on their insurance policy to receive a larger payout than they are entitled to. Examples of insurance fraud are exaggerating the value of damaged property or making a false claim for injury or illness. In North Carolina, insurance fraud is considered a felony and is taken very seriously. Insurance fraud investigations are conducted by both private insurance companies and the North Carolina Department of Insurance (NCDOI). Private insurance companies may hire private investigators or employ fraud investigators to investigate cases as well as proactively work to detect and prevent fraud. The NCDOI Fraud Division is dedicated to investigating and prosecuting persons who commit insurance fraud in the state. Insurance fraud investigations involve gathering evidence, gathering witness statements, and reviewing documents. Investigators may interview witnesses, inspect property, review medical records, and search public records. Once the investigation is complete, investigators may refer the case to the district attorney for prosecution. In North Carolina, anyone convicted of insurance fraud is subject to fines, restitution, jail time, and can be subject to civil lawsuits. It is important to be aware that intentionally making false statements or submitting false claims is a crime and can result in serious consequences.

Related FAQs

What information do I need to provide when filing an insurance claim?
What is an insurance claim?
What is the statute of limitations for filing an insurance claim?
How do I dispute an insurance claim decision?
What happens if I can't get a hold of my insurance provider?
What is a power of attorney?
What evidence is needed to prove an insurance claim?
What is a breach of fiduciary duty claim?
What should I do if I don’t agree with an insurance adjuster’s decision?
What happens if my insurance claim is denied?

What is an insurance fraud investigation?

Related FAQs

Related Blog Posts