The Fight Against Insurance Fraud
by Judith L. French, Director
Insurance fraud is a regular topic of concern in my interactions with different insurance stakeholders for good reason. Insurance fraud is one of the leading crimes in the country and it impacts all of us.
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. That figure translates to about $932 annually for every American and more than $70,000 over a person's lifetime.
Fighting insurance fraud in its many forms is a major priority for us at the Ohio Department of Insurance involving many of our different divisions and many different stakeholders. We 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.
During the State of Ohio's July 1, 2022, to June 30, 2023 fiscal year, we received more than 8,794 allegations of insurance fraud and agent misconduct. As a result of these referrals, we opened 811 administrative and criminal investigations, identified 148 potential law violations, and took administrative and/or criminal action against
147 individuals. You can read about our top cases in our most recent annual report.
Please join us in the fight against insurance wrongdoing. If you suspect or are aware of insurance fraud and/or insurance professional misconduct, report it to 800-686-1527, odi.fraud@insurance.ohio.gov, or through our website.
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Director French Takes "Ohio, The Heart of Insurance" Conversation to Northeast Ohio
Director French took her "Ohio, The Heart of Insurance' conversation to the Cleveland area on Sept. 14 for engagements with leadership and employees from Progressive Insurance, Brooker Insurance Agency, the local chapter of the National Association of Insurance and Financial Advisors, and the National Association of Health Underwriters.
Discussion centered around the importance of a stable and predictable regulatory environment, workforce development in the Ohio insurance industry, the department's involvement in representing Ohio at the National Association of Insurance Commissioners and International Association of Insurance Supervisors, and on insurance product and insurance company solvency topics.
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Employers: Ohio's 2023 In-Demand Jobs Survey is Now Open
Ohio’s In-Demand Jobs Survey is now open. This survey allows Ohio businesses to provide feedback on the state’s Top Jobs List, which guides workforce training priorities and federal funding.
The survey helps the state collect feedback based on what Ohio businesses need, creating a portal for Ohioans to learn what jobs will be important now and in the future, so they can better plan their pathway to a successful career. The survey is open to any registered business in Ohio, allowing businesses of all sizes and in all areas of the state to share their needs.
Click here to take the survey. Help shape Ohio's workforce priorities.
Medicare Town Hall with Director French and OSHIIP
Director French and Medicare experts from the department’s Ohio Senior Health Insurance Information Program are hosting a virtual town hall on Oct. 12 at 11:30 a.m. to help Ohioans on Medicare prepare for Medicare open enrollment.
Participants will learn about Medicare changes for 2024, how to compare options and select coverage, ways to save money, and tips to avoid Medicare fraud. Register here.
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Medicare's Open Enrollment Period Begins Oct. 15
Medicare's annual open enrollment period starts Oct. 15. This means if you're one of the more than two million Ohioans on the federal health insurance program, it's time to become familiar with changes for 2024 and review your healthcare needs, including preferred prescription drugs and doctors.
The Ohio Senior Health Insurance Information Program is conducting virtual and on-site Medicare Checkup events in communities across the state now and through open enrollment, which ends Dec. 7 to help Ohioans on Medicare evaluate options that are best for their healthcare needs and budget.
Beware of Scams During Medicare Open Enrollment
Director French urges Ohioans on Medicare to guard against scams seeking their personal information during the Medicare open enrollment period.
Ohioans should be on alert for fake Medicare communications seeking personal information or money in exchange for any of the following: to help with enrollment, to schedule health services, to sign up for a Part D prescription drug plan or Medicare health plan coverage, and to provide a new Medicare card.
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What to Know About Life Insurance Beneficiaries
Tens of millions of dollars in death benefits go unclaimed each year because beneficiaries lack basic information about their deceased loved one’s life insurance policies.
The National Association of Insurance Commissioners, of which the Ohio Department of Insurance is a member, is helping consumers be prepared when it comes to receiving a death benefit after a family member or significant other passes away.
Medicare Supplement Guaranteed Issue Opportunity for Ohioans Disenrolled From Medicaid
Ohioans and insurance companies that sell Medicare Supplement insurance policies in the state are reminded that Ohioans who qualify for a Guaranteed Issue Opportunity, such as being disenrolled from Medicaid, may enroll in a Medicare Supplement insurance policy without underwriting considerations by the insurance company.
This means the insurance company cannot refuse to sell a policy to beneficiaries who qualify for this special enrollment. It also means those beneficiaries cannot be charged higher premiums because of their health status, claims experience, or medical condition.
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 Mental Illness and Accessing Mental Health Insurance Benefits for Treatment
Mental Illness Awareness Week is Oct. 1-7 and Ohioans are reminded that the Ohio Mental Health Insurance Assistance Office, which is part of the Ohio Department of Insurance, is the state's official resource to help consumers, mental health advocates, behavioral health providers, employers, first responders, and other stakeholders understand and navigate mental health and substance use disorder insurance so Ohioans get access to the treatment they need.
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