Insurance fraud can happen when someone deceives you, agents steal your premiums, not buy coverage, steal your claim checks, or just sell you bogus policies. Medication or surgery can be given when not need that can have a significant impact on your health.

  • Insurance rate offered is lower than their current policies rates

  • Pressured to "sign up now" because the deal won't last.

  • Declines to show you an actual policy.

  • Sign a form with blank spaces

  • Plan promises vanishing premiums

  • Must join an "association" or "union" to get the coverage you need.

  • Life insurance disguised as a pension plan, investment or retirement fund

  • Turn in a small policy for a larger one without paying substantially more

  • Claims to be with a government agency or working on an officially-sanctioned program.

  • Email sent from addresses that appear similar to leading insurance companies

  • Cagey or evasive about the details of the policy


  • Avoids answering your questions and claiming the information is in the brochure.

  • Policy is exempt from state licensing, comes under provisions of special federal law

  • Sales rep demands your personal financial details before a "policy" can be issued.

  • Premium payment requested in cash

  • You are given a deadline

  • Request up-front administrative fees to the insurance broker

  • Encouraged to sign up online but the policy details are sketchy.

  • You're insurance card or policy just doesn't turn up.

  • Insurer fails to pay your medical bills promptly, blames red tape

  • Asks for credit card information over the phone

  • Told to ignore notices from the insurance company

  • Agent is unlicensed




Precautions You Should Take   TOP

  • Make sure the insurance company exists, is licensed and is the one issuing the policy. Call their headquarters which you look-up, (not gotten from their brochure) and validate the offer.

  • If a new policy replaces an old policy, make sure the old coverage is not terminated until the new policy has been issued.

  • Before purchasing any life insurance policy, check the state Insurance Board that licenses insurance companies and agents (see end below). Do not just rely on the company and/or agent to show the paperwork. Always contact the Board directly, as paperwork can be falsified.

  • If it's too cheap, you're almost certainly not going to get the coverage you might want or expect -- if anything at all.

  • Get the web site and phone number for any company you're thinking of doing business with, and investigate the company.

  • Get the list of providers who participate in a company's plan and call them to ask if they're really part of this plan; ask which of services are eligible for the discounts or coverage. Avoid any company that won't give you a provider list.

  • Beware of "guaranteed coverage," or promises of a specified percentage of savings

  • Be suspicious of large upfront costs.

  • Offer coverage for "dreaded" disease like cancer, heart attacks, strokes or just an unfortunate accident. Some are legitimate but watch for loopholes: time frames with no option to renew, fixed dollar amounts and quirky caps on care.


Agents May Not Give You All The Information-It Might Be What They Don't Tell You That's Important   TOP

  • Coverage whose price is 30-50 percent lower than competitors.

  • Working with a strict commission salesperson can add benefits not requested or wanted, or sign you up for annuities that are not in your best interest.

  • Uses a computer to show policy. Insist on a hard copy version.

  • Convinces you to use the built-up value of their current whole life policy to buy a "better" policy even though their present life coverage is perfectly suitable.

  • Urges you to change policies prematurely by "twisting" the truth about the downside.

  • Sells you fake coverage from a phony insurance company (make sure they are registered in your State)

  • Pockets your insurance premiums instead of sending it to the insurer (always send it directly to the company).

  • Slips in extra coverage you didn't ask for, e.g. motor club memberships, accidental death coverage and guaranteed renewable life insurance.

  • Suggests to invest in insurance-look alike documents (many are just a scam to steal your money).

  • Never pay a premium in cash or sign partially filled out forms.

  • Have salespeople explain all costs, including enrollment fees, monthly charges, deductibles, coverage maximums and any other expenses. Make them show it in writing. Calculate exactly how a plan would affect your out-of-pocket costs so you don't end up spending more than you save.

  • Claims coverage will be grandfathered or exempted from changes required by the Patient Protection and Affordable Care Act of 2009 (PPACA)  (Applies only to policies purchased before March 23, 2010).

Long Term Care Is A Balance Of What You Can Pay Verses What You Get Back   TOP

  • Make sure that you can afford  the premium.

  • Are you being sold overlapping policies when only one is needed.

  • Urged to cancel a perfectly good policy and trade up to a better policy from your current insurer or another company.

  • Sales person may eliminate or reduce vital policy features so you can afford the premium without telling you.

  • Policy covers all of your long-term medical expenses (BUT, read and understand all the fine print).

  • Deliberate misstatements about your current medical condition, age, past medical history or other key information are entered onto the policy application to secure the coverage or lower the premium. The company may not pay on claims.

Dentist   TOP

  • Perform useless surgery on perfectly healthy patients to hike their own insurance billings.

  • Check your dentist's billing to your insurance company, verify its what you had done.

  • Is your dentist's license still in force.

  • Is staff doing work that dentist should be doing and billing as though they did it (illegal).

  • Is your dental plans legitimate? Check to see if plan is licensed in your State.

  • Verify you need the treatment. Get a second opinion for a costly job.

  • You had an accident and a stranger contacts you soon afterward, and tries to convince you to get repairs at a specific auto-body shop, seek treatment from a certain doctor or chiropractor, or visit a lawyer he knows who can help you sue for injuries.

Caution Company List & Contacts   TOP



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