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What is Insurance Fraud?

Insurance fraud occurs when someone tries to make money from insurance transactions by deceiving others.

Insurance fraud is a multi-billion dollar problem and everyone pays: insurance companies, policyholders, consumers…everyone.

The National Insurance Crime Bureau (NICB) and the Collation Against Insurance Fraud both estimate that insurance fraud costs 10 to 25 cents out of every insurance premium dollar paid by consumers.

Insurance crime is committed by a wide range of individuals from career criminals making a systematic living off insurers to policyholders recouping their deductible by inflating claims; from white collar professionals such as corrupt lawyers and crooked medical providers to body shop owners.

Fighting insurance fraud is a high priority of the State of Idaho Department of Insurance (DOI). Our job is to detect fraud, stop it and help law enforcement agencies prosecute those who commit it.

The Director of the DOI has authority to revoke the licenses of agents and adjusters who commit fraudulent acts. He also has the authority to issue cease-and-desist orders to halt unlicensed insurance operations and deceptive trade practices and to issue investigative subpoenas to obtain records relating to fraudulent claims.

But the DOI cannot do it alone. The Investigations Section works as a team with insurance company special investigative units, law enforcement agencies and prosecutors to multiply limited resources.

Insurance fraud is a felony criminal offense under Idaho Code §41-293. Insurance fraud is punishable by up to 15 years imprisonment and/or up to a $15,000 fine