 Fraud adds $5.2–$6.3 billion to the auto premiums that policyholders pay each year. Insurance Research Council (1996)  Fraud amounts to 10 percent of U.S. healthcare expenditures. National Health Care Anti-Fraud Association (2001)  Nationally, insurance fraud is an $80–billion crime spree each year, which means families are paying an average of about $1,000 a year for this crime. Coalition Against Insurance Fraud (2004)

A person commits a "fraudulent insurance act" if he or she knowingly makes a statement or written document for a claim or insurance application which that person knows to contain false information or conceals information concerning a material fact.

A policy dispute can be many things. You may have a policy dispute if it is questionable that you had coverage at the time of an accident. A policy dispute could be a disagreement about how an insurance company handles your claim. A policy dispute could be if your claim is denied because of a misrepresentation that is not material to the loss covered on the policy.

Mr. Harrison damaged his vehicle at 9:00 A.M on September 1. Mr. Harris purchased insurance coverage for that same car at 10:00 A.M. on September 1, stating that there was no damage to the car and no prior losses (accidents or damage). Mr. Harris then reported that his car was damaged at 9:00 A.M on September 2. FraudPolicy Dispute

Mr. Harrison attempts to deceive the insurance company by misstating the facts of his accident. An investigation will produce a police report and show that this is a misstatement of facts. Giving an insurance company false information about pre-existing damage to your vehicle is fraud.

Mr. Fair signed an application for life insurance on May 31, The Life Insurance Company issued the policy on June 28, Mr. Fair died due to a heart attack on October 4, When The Life Insurance Company received the claim for the policy benefits, they conducted a standard investigation into Mr. Fair's health records. The Life Insurance Company found that Mr. Fair had a very extensive heart history and knew about his condition when he applied for insurance coverage. Based on the review of his health history, The Life Insurance Company would not have issued the policy if they had known about Mr. Fair's condition at the time of the application. Since Mr. Fair lied about his health history, The Life Insurance Company refunded all of the premiums that were paid into the policy. FraudPolicy Dispute

This claim was denied under the policy as a "misrepresentation of a material fact". The insurance company will not pursue a fraud claim against Mr. Fair's family or his estate, but rather simply contest the policy by denying the claim and refunding all the money paid into the policy. If you knowingly misstate your health condition to obtain insurance, you are committing insurance fraud.

Tammy filed a claim with her auto insurance company for hail damage two moths ago. The auto insurance company asked for proof of loss and specifically asked her to take pictures and mail them in. Tammy refused to take pictures because she felt that a claim adjuster should view her car and write her a check on the spot without questions asked. Her claim was denied due to lack of cooperation. FraudPolicy Dispute

Insurance laws do not specifically state that an adjuster has to view your car in person. Most companies will send someone to see you, but occasionally a company will start the process with paperwork and pictures. Check your policy for provisions that say you and the company will cooperate to complete the claim.

Amy has an Actual Cash Value policy and sustained roof damage to her home that was caused by a tornado. Amy filed a claim for a new roof, but the claim was denied because her roof was 35 years old and never had any repairs to it. Amy filed a complaint with the States Department of Insurance because her policy covers roof replacement caused by weather damage. FraudPolicy Dispute

Most homeowner's policies will not cover normal wear and tear. If the roofing material is not replaced or maintained as directed by the manufacturer, most insurance companies will not offer to pay for a new roof when the old one has had no upkeep or maintenance.

Mrs. Court took out a life insurance policy on Jim, 20 years ago, when he was 3. Jim has a condition that leaves him unable to independently take care of himself as an adult. Jim lives with his parents who have P.O.A. (Power Of Attorney) over his affairs. Mrs. Court called the insurance company to change his beneficiary to Jim's Estate. The insurance company refused to process the paperwork until Mrs. Court furnished a copy of the POA. FraudPolicy Dispute

When you become an adult, you have a responsibility to take care of your own paper work. Because you become an adult your parents cannot make changes to your insurance policy without your permission. Though, when an adult is unable to take care of him or her self, someone may hold a Power Of Attorney for them. This allows a specific person to deal in legal contracts on that person's behalf.