What is life insurance fraud?
Quick Facts
Life insurance fraud is any illegal activity that involves life insurance policies or benefits
It can include activities such as misrepresentation of facts, sales of fake policies, and misappropriation of funds from policyholders
The most common form of life insurance fraud is premium diversion, where a policyholder diverts premiums into their own pocket rather than paying for coverage
Buying a life insurance policy is one of the most responsible decisions for yourself and your family. Doing so ensures that your family doesn’t have to cover your funeral and burial expenses.
Sometimes, criminals can take advantage of life insurance companies or vice versa. This is called life insurance fraud, and this guide will explain everything you need to know to about what life insurance fraud is and how to avoid being a victim of this crime.
What is life insurance?
To put it simply, a life insurance policy is a contract between an insurance company and a customer. This contract dictates that the life insurance company will pay out a large sum of money to one or more beneficiaries when the policyholder dies.
This large sum of money is traditionally called the death benefit — it’s the total value of your life insurance policy, including any cash-value investments. The money you pay every month to the life insurance company is called the premium.
To best demonstrate how life insurance works, let’s use an example. A woman named Sarah buys life insurance through their employer. The life insurance policy is worth $500,000, and Sarah is required to pay $35 a month to maintain the policy.
There are multiple different types of life insurance, but the two main types of coverage are term vs. permanent life insurance:
Term life insurance is easier to buy because it eventually expires. Customers typically don’t even have to submit to a medical exam. Learn how to get term life insurance quotes.
Conversely, whole life insurance is a greater investment for you and the life insurance company since it agrees to coverage for your entire lifetime. Find whole life insurance companies here.
When applying for a permanent life insurance policy, you will have to take a medical exam. As a result, your life insurance premiums can fluctuate depending on the results or if you have any pre-existing conditions.
This is usually how buying a life insurance policy works. As you will find out, life insurance fraud is an attempt to game the system and steal thousands of dollars in the process. Learn more about no-medical-exam life insurance.
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What is life insurance fraud?
Life insurance fraud is the attempt or a successful act of theft from an insurance company or customer. Fraud happens when the perpetrator deceives the insurance company for personal gain.
It is a very serious crime in the United States. According to the FBI, life insurance fraud costs victims more than $40 billion every year.
There are many ways a criminal can commit life insurance fraud. A few common instances include:
Providing false or misleading information on a life insurance application in order to receive lower rates
Tampering with another customer’s policy
Faking one’s death to collect the death benefit
Insurance agents can also commit life insurance fraud by selling fake policies that provide no coverage or misappropriating the money you are paying on a legitimate policy.
Overall, life insurance fraud can take on many forms. If you’re buying a life insurance policy, it’s essential to be mindful of this crime so you can avoid being a victim.
Different Types of Life Insurance Fraud
There are several different types of life insurance fraud. Below, we’ll break down each major type of life insurance fraud you might encounter.
Faked Deaths
As silly as it sounds, there are several recorded instances where people have faked their deaths to collect the death benefit for their policies. In some cases, fraudsters will even attempt to collect the death benefit for a person who never existed.
Nonetheless, life insurance companies are privy to working with private investigators and the police to truly find out if beneficiaries are real people and uncover the truth about reported deaths.
Because of this, life insurance companies are rarely fooled by fake deaths. Though, you shouldn’t be surprised if one day you find out that a customer committed fraud via fake death on the news.
Pocketed Premiums
If the fraudster happens to be your life insurance agent, they may try to pocket the money you owe on your policy. Usually, they’ll request that you write a check out to them in the amount of your monthly or annual premium.
They may even send over fake documentation or cancellation notices to cover their tracks or intimidate you. You can prevent this situation by never sending personal payments to an insurance agent, no matter how authentic they appear.
Unethical Upgrades
One of the most notorious and unethical forms of life insurance fraud happens when an agent coerces you to upgrade your existing life insurance policy to gain from any commissions.
If you’re already satisfied with your life insurance policy and are getting harassed by your life insurance agent, contact your company immediately to file a complaint.
Fraudulent Applications
What happens if you lie on your life insurance application? For example, you may write that you don’t have high cholesterol when you really do. A simple medical exam can uncover these errors, as life insurance companies label these errors as “misrepresentation.”
It’s important to point out that making a small error on your life insurance application isn’t grounds for fraud. In addition, most small mistakes won’t warrant a change in your life insurance rates or coverage.
However, if you intentionally lied on your life insurance application to get a better price or hide a pre-existing condition, your life insurance company will cancel the policy and withhold any death benefits.
In addition, your life insurance company will report the incident to Medical Information Bureau (MIB), meaning other life insurance companies will see the notice and deny you coverage in the future. Here’s how to access the Medical Information Bureau (MIB).
Forgery
Forgery happens when a person with unauthorized access takes control of someone’s life insurance policy to make changes.
Usually, the forger will change the name of the beneficiary. The only person allowed to change the beneficiary information is the policy owner. Unfortunately, these changes can go unnoticed for years, which is why it’s essential to constantly monitor your policy.
If you’re not vigilant, a malicious actor can gain access to your policy and make unauthorized changes. Luckily, reputable life insurance companies offer security measures to prevent forgery.
For example, you can set up two-factor authentication to require anyone logging into your online account to verify their identity before accessing any sensitive information. Another security measure is account updates, notifying you when changes have been made to your policy.
Overall, it’s impossible to know who exactly can have access to your account, so taking advantage of these security features is the best way to safeguard your account from any malicious people.
Fake Policies
Some people claim to be life insurance agents to fool people into paying them directly for coverage. Savvy criminals will go through any means to present themselves as authentic agents.
The best way to avoid a fake policy is to closely check the documents you receive from any life insurance agent or company. Look for official letterheads and logos. You should also check social media, including LinkedIn and Facebook, to confirm your agent’s identity.
Industry Insiders
There are several situations where life insurance agents can take advantage of their customers and defraud them. Sometimes, they’ll convince customers to write personal checks to them. Other times, scammers can steal their customers’ information and make any changes they want to policies.
For example, in Minnesota, a life insurance company employee pled guilty to stealing nearly $2 million from her employer. With the assistance of a friend, they cashed in more than $1 million in bogus refund checks.
Consequences of Life Insurance Fraud
Life insurance fraud is punished very severely in the United States. Depending on the severity of the crime committed, punishment can range from restitution to jail time.
Below are some of the consequences to expect for those who commit life insurance fraud:
Rejected application: If you knowingly include any misleading or false information on your application, the company can deny your application. Examples of misleading information include lying about a major health condition or grossly misstating your weight.
Premium increase: If you lie on your life insurance application, the company could approve your application with a higher premium. This would defeat the purpose of lying on your application, especially if you tried to get lower rates in the first place.
Canceled claim: If your life insurance company discovers that you lied on your application after your death, they can decide not to award your death benefits during the contestability period.
Policy cancellation: If the life insurance company finds out you provided misleading information on your application, they can cancel your policy altogether. A canceled policy could make it more difficult to receive coverage in the future.
Smaller cases of life insurance fraud, like lying on your application, are rarely prosecuted. However, you could face large fines and jail time if you commit fraud and forgery to cheat customers or companies out of substantial money.
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How to Prevent Life Insurance Fraud
Life insurance fraud carries very stringent penalties. Therefore, you want to be certain your application is accurate before submitting it. Also, it doesn’t hurt to ensure that you are protecting yourself from fraud.
Here are some convenient ways to protect yourself from life insurance fraud and keep your investment safe:
Take your time filling out your application. Rushing on a life insurance application often leads to mistakes. Remember, it’s up to the discretion of the life insurance company to determine if you lied if it finds an error.
Only work with a licensed life insurance agent. All life insurance agents should have a valid state license. If you’re unsure about an agent, call the company and check their credentials.
Read your policy carefully. It’s common to skim over a policy’s underwriting documentation or neglect it completely. However, reading it may allow you to find glaring inconsistencies in your coverage.
Only pay the insurance company. Never send life insurance payments to an agent, no matter what they tell you. Your contract is with the life insurance company, not your agent.
Following all of these tips can help you stay clear of life insurance fraud and make sure your policy is secure.
The Bottom Line: What is life insurance fraud?
Ultimately, life insurance fraud is a serious crime that affects thousands of Americans every year. The good news is that you can avoid being labeled as a fraudster by taking the time to fill out your life insurance application and monitoring your account regularly to catch any unusual changes in your policy.
The most common insurance frauds are forgeries and fake policies, so protect yourself by monitoring your policy and working with life insurance agents you trust.
If you suspect your life insurance agent is committing fraud, reach out to your company directly.
Frequently Asked Questions
How do I report insurance fraud?
If you suspect that you’re the victim of life insurance fraud, you should contact your state’s division of consumer fraud. Alternatively, you can call the National Insurance Crime Bureau hotline at 800-835-6422.
Is there a reward for reporting insurance fraud?
According to the FBI, you may be eligible to receive a reward for reporting life insurance fraud, but reward rules vary by state.
Are there consequences for making a mistake on my life insurance application?
Generally, you will not be punished for making a small mistake on your application. Larger mistakes will almost always result in policy cancellation or criminal charges if a lot of money is involved.
How can I find the best life insurance company for me?
You can find the best life insurance company by fielding multiple quotes from different companies and checking online reviews.
How much life insurance do I need?
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Editorial Guidelines: We are a free online resource for anyone interested in learning more about life insurance. Our goal is to be an objective, third-party resource for everything life insurance-related. We update our site regularly, and all content is reviewed by life insurance experts.
Rachael Brennan has been working in the insurance industry since 2006 when she began working as a licensed insurance representative for 21st Century Insurance, during which time she earned her Property and Casualty license in all 50 states.
After several years she expanded her insurance expertise, earning her license in Health and AD&D insurance as well. She has worked for small health in…
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Written by
Rachael Brennan
Licensed Insurance Agent
Benjamin Carr worked as a licensed insurance agent at State Farm and Tennant Special Risk. He sold various lines of coverage and informed his clients about their life, health, property/casualty insurance needs.
Assessing risks and helping people find the best coverage to suit their needs is a passion of his. He appreciates that insurance was designed to protect people, particularly during times…
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Reviewed by
Benjamin Carr
Former State Farm Insurance Agent
