What is Insurance Fraud?
Fraud Preparation and Awareness
The policy of The Hanover is to provide its products and services to individuals, families and businesses to meet their insurance needs and to pay claims for any legitimate loss from the coverage provided.
Insurance Fraud is the abuse of the insurance system for financial gain. The legal definition of fraud is making a material misrepresentation or failing to disclose a material fact in order to induce another to give up something of value.
Types of Schemes:
Insurance fraud involving medical schemes is the largest form of fraud in the nation. It may involve complex billing schemes, providers billing for treatment not performed, performing medical procedures that are unnecessary, inappropriate or even dangerous for financial gain.
Staged or Intended Accidents
Causing accidents for the purpose of creating a claim wherein parties to the fraud can collect on the policy for both medical treatment and/or physical damage.
Homeowner or Commercial Property Fraud
There are various forms of property insurance fraud; intentional damage such as arson, false water loss damage, fictitious burglaries and theft losses, inventory scams and the like are a few of the ways that property fraud is committed.
Workers Compensation Fraud
Employees who stage accidents to cover up injuries suffered outside of the work place, malingering and exaggerated injuries resulting from a real loss and premium avoidance by misclassifying workers are a few of the ways to commit this act.
Slip and Falls
Individuals target businesses by pretending to injure themselves in a fall on the premises. Sometimes the people involved in the act will create a risk, such as placing an object on the floor and then falling, then set up the "fall" in an area without witnesses or with an accomplice.