Fraud is not a victimless crime. Each year, billions of dollars are lost to insurance fraud. According to the Coalition Against Insurance Fraud, insurance fraud costs Americans at least $80 billion a year, nearly $950 per family.
To battle fraudulent claims that hurt policyholders who must shoulder the burden of higher rates, Citizens has created a public education campaign called Fraud: Identify It. Report It. Help Stop It. to increase awareness of the costs of insurance fraud and the ways to prevent it.
Fraud's Red Flag Indicators
Agents play an important role in preventing insurance fraud, both in their agency and with their customers. To assist agents in identifying possible fraud indicators, Citizens has created a new resource, for agents and agency principals, called Fraud: Red Flag Indicators. Four red flag indicators are:
Your customer is evasive in answering questions about the use of their home and/or prior losses.
The four-point inspection report provided by your customer conflicts with other known facts about the property.
Your agency employee has a larger number of complaints from policyholders concerning payments, when compared to their peers.
Inspection forms have inconsistent dates and signatures, which could be an indicator of the document forgery or falsification.
Under the Agent Resources section on the Call Citizens First page of the Agents site
Under the General section on the Training page
In Knowledge Base Answer ID 3250
Notes
Users must be logged into the Agents site to access this document.
Per Florida Statutes 817.234:
Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
As a government entity, Citizens has a responsibility to our policyholders, agents, employees and all Floridians to fight insurance fraud. In an effort to prevent fraud Citizens:
Dedicates resources to identify, detect and act on fraud
Actively educates agents and staff in identifying and reporting fraud
Educates policyholders about how to avoid being victimized by fraud
Works with law enforcement and the Florida Department of Financial Services in their efforts to fight fraud
Report Fraud
If you are aware of property insurance fraud involving a Citizens policy or claim, submit a report online through the Report Suspected Fraud topic on our Contact Us page, or contact Citizens' Special Investigations Unit toll-free at 855.748.8596.
Citizens provides agent communications online for historical purposes only, and the communications have not been updated to include any changes that may have been made after publication. Agents can find the latest information by reviewing the applicable underwriting manuals, and by logging in and accessing our FAQs, which are available from the top of any page on our website.
