Nebraska Department of Insurance

NEBRASKA DEPARTMENT OF INSURANCE INSURANCE FRAUD PREVENTION DIVISION 941 O Street, Suite 400 Lincoln, NE 68508-3639

General Insurance Fraud Hints

It is important to remember that the hints listed below are merely possible "red flags" that there may be some evidence consistent with an insurance fraud scheme.  Any one or two of these by themselves, may not raise your suspicion; however, when you have several of these hints present or a pattern begins to emerge, you should investigate further or forward your suspicion to the Insurance Fraud Prevention Division.

1. An accident occurs after a recent uninsured loss.
2. There are no witnesses to the accident.
3. There is no police investigation of the accident or event.
4. Automobile accident involves a single car.
5. An accident involves an unidentified third party.
6. The claimant's witness is overly enthusiastic.
7. The loss was reported by the claimant, third party, or attorney.
8. Property was repaired or disposed of before final inspection.
9. Documentation provided consisted of photocopies.
10. The kind of accident or type of vehicles are not typical of those seen on a regular basis.
11. Insurance premiums paid in cash.
12. Insurance premiums paid and all other transaction conducted in person.
13. Claimant avoids use of telephone or mail.
14. Claimant is not known at the listed address.
15. Claimant uses multiple addresses.
16. Claimant uses post office box, hotel/motel room, or mail drop as an address.
17. Claimant is a transient or out-of-towner on vacation.
18. Claimant is eager to accept blame for an accident.
19. Claimant is demanding of a quick, reduced settlement.
20. Claimant threatens to go to an attorney or physician if claim is not settled quickly.
21. Claimant is unusually familiar with insurance terms and procedure, medical terminology, vehicle repair terminology, or "legalese."
22. Claimant has personal, financial or business problems.
23. Claimant is unemployed.
24. Claimant works in a depressed industry.
25. Claimant refuses to answer questions related to facts surrounding the loss.
26. Claimant has an extensive claims loss history.
27. The insurance agent is not familiar with the claimant.
28. The insured or claimant represents unsolicited business to the agent.
29. The agent has received inquiries from claimant regarding coverage just prior to loss.
30. There is no record of prior insurance coverage.
31. The policy has only been in effect a short time before the loss.
32. The policy is soon due to expire.
33. There is a sharp increase in the amount of coverage shortly before the loss.
34. There is duplicate coverage, multiple policies, or an over-insured loss.
35. Regarding a settlement, the claimant is willing to settle for less rather than document the loss.
36. Also regarding the settlement, the claimant offers to settle immediately by coming to the office.