November 2022
The Economic Impact of Insurance Fraud
by Judith L. French, Director
Insurance fraud is one of the costliest forms of fraud crimes in the United States and globally.
A new report from the Coalition Against Insurance Fraud estimates that the economic impact of insurance fraud is a $308.6 billion annual cost to U.S. consumers and businesses, equaling about $932 annually for every American and more than $70,000 over a person's lifetime.
The mission of the Ohio Department of Insurance is to serve and protect Ohio insurance consumers. This includes a significant prioritization of investigating, taking administrative action, and assisting in the prosecution of insurance fraud and insurance professional misconduct because insurance wrongdoing drives up the cost of insurance for all Ohioans.
Our investigators partner with investigators from insurance companies, government entities, law enforcement agencies, and prosecutors to take action against those who commit insurance fraud or engage in crimes associated with insurance.
The Ohio Department of Insurance, from July 1, 2021, to June 30, 2022, received more than 7,433 allegations of insurance fraud and insurance agent misconduct from insurance companies, consumers, government agencies, and law enforcement entities. As a result, the department opened 1,116 administrative and criminal investigations, identified 132 potential law violations, and took administrative and/or criminal action against 162 individuals. .
The negative impacts of insurance fraud and insurance professional misconduct are far-reaching and the consequences of committing wrongdoing are severe, including legal fees, fines, jail time, and personal and professional shame.
Join us in the fight against insurance wrongdoing. I encourage anyone who suspects or is aware of insurance fraud and insurance professional misconduct to report it to the department at
800-686-1527 or on our website.
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The Basics of Insurance Fraud and Insurance Professional Misconduct
Insurance fraud is the intentional submission of a false or deceptive statement to an insurance company for financial gain, and when someone falls victim to an insurance scheme intended to steal someone's money and/or personal information.
Anyone can commit insurance fraud. This includes consumers, business entities, insurance agents, attorneys, contractors, healthcare providers, individuals committing unlicensed/fake insurance activities, and members of organized crime.
Insurance professional misconduct can include allegations of wrongdoing involving insurance agents and agencies, as well as unlicensed individuals and entities who appear to be engaged in the business of insurance.
Allegations can include consumers submitting false and inflated homeowner and automobile insurance claims, an agent forging client documents and keeping insurance premium payments, an attorney altering client medical bills to defraud an insurance company, a contractor intentionally damaging a roof or siding to justify the need for repairs, a healthcare provider filing an insurance claim for a service/examination/test that were never rendered, and unlicensed/fake insurance activities to steal someone's money and/or personal information.
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Tips to Avoid Falling Victim to an Insurance Scam
Insurance wrongdoing and scams come in many forms. Information is available on the Ohio Department of Insurance website, insurance.ohio.gov, to help consumers avoid falling victim to illegal activity. This includes related to inappropriate insurance sales pitches, insurance contracts, unlicensed insurance activity, health insurance, fake health insurance plans, healthcare providers, property damage, and more.
Consumers can contact the department at consumer.services@insurance.ohio.gov and
800-686-1526 with any questions.
Not All Products are Health Insurance: Health Care Sharing Ministries, Discount Plans, and Risk-Sharing Plans
Consumer protection laws govern many types of health insurance coverage, like plans purchased through an employer or the health insurance marketplace.
But there are other types of plans that aren't insurance and they aren't required to protect consumers in the same way. Consumers who use health care sharing ministries, discount plans, or risk-sharing plans can best protect themselves by understanding the coverage they participate in.
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Medicare Open Enrollment Deadline for 2023 Coverage is Dec. 7
Ohioans on Medicare have until Dec. 7 at midnight to select Medicare health insurance coverage for 2023 through open enrollment.
The options are Original Medicare, often paired with a Medicare Part D prescription drug plan, or a Medicare Advantage managed care plan. These plans provide comprehensive health insurance benefits typically including prescription drug coverage.
Plan information is available at medicare.gov.
Staff from the Ohio Senior Health Insurance Information Program, which is part of the Ohio Department of Insurance, are available at 800-686-1578, oshiipmail@insurance.ohio.gov, and through insurance.ohio.gov to answer any questions.
2022 Annual Title Insurance Reviews Due Jan. 15
Licensed Ohio title insurance agents and agencies or their authorized representatives are required to file an annual title agent/agency review.
Authorized agents and agencies should upload annual title review forms to the Ohio Department of Insurance through OH|ID.
Annual filings for the 2022 filing period (Sept. 1, 2021, to Aug. 31, 2022) are due by Jan. 15, 2023.
Detailed annual title filing information and instructions are available on the department's website.
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Ohioans Urged to Winterize Property and Review Insurance for Winter
The dangers posed by winter weather are real and we're here to help you stay safe and warm. Step one, make time before it's too late to winterize your property and to conduct a winter insurance review with an insurance agent.
Next, you can never be too prepared, and the Ohio Committee for Severe Weather Awareness, has preparedness tips for you when it comes to power outages, emergency supply kits, health risks, and even for looking after pets and livestock.
Lastly, fire risk, due to candles, decorative lighting, space heaters, electrical malfunction and cooking, is certainly elevated during the holiday season. Take the necessary precautions to prevent a fire, and also conduct a home inventory of your possessions, which should be done at least once a year. Doing so will help speed up a potential claim and recovery process.
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