Our Fight Against Insurance Fraud
Passing on Costs, Passing on Savings
What Is Insurance Fraud?
What Is Being Done?
What to do if you Suspect Fraud
Insurance fraud takes many forms, from inflating a claim to faking a disability. It occurs when individuals intentionally deceive an insurance company to collect money that isn't rightfully theirs.
Each year insurance fraud costs all types of insurance companies and their customers billions of dollars. In fact, the Coalition Against Insurance Fraud estimates that insurance fraud costs Americans at least $80 billion a year.
Northwestern Mutual is proactive in its effort to fight insurance fraud, and we are continually improving our procedures for prevention, detection and investigation of insurance fraud.
Each incident of fraud forces insurance companies to absorb unnecessary expenses. Those excess expenses can cause companies to raise premium rates. Or, in the case of mutual insurance companies, those expenses may result in lower dividend amounts for policyowners. Conversely, when fraud decreases, the money an insurance company saves can be passed on to its policyowners.
According to The Coalition Against Insurance Fraud "Insurance fraud occurs when people deceive an insurance company or agent to obtain policies or collect money to which they are not entitled. Similarly, insurers and agents also can defraud customers, or even each other."
Some examples of insurance fraud include:
- Intentionally failing to disclose significant medical conditions or other material facts on an insurance application.
- Collecting disability benefits after returning to work.
- A representative who bills a client personally without delivering a policy.
- Unscrupulous health care providers who bill twice for the same service or for services not provided.
- Attempting to collect life insurance benefits while the insured is alive.
- A physician who assists a claimant by certifying an unfounded disability claim.
- Taking an unauthorized loan on a life insurance policy by an individual.
Northwestern Mutual has a Special Investigations Unit (SIU) whose responsibility is to investigate suspected fraud and to help local law enforcement officials prosecute offenders. The SIU works to detect, prevent and resolve fraudulent activities perpetrated against Northwestern Mutual.
Additionally, many states actively prosecute insurance fraud through established fraud bureaus. We urge you to visit your state's department of insurance Website for information about insurance fraud specific to your state. Also, the following organizations maintain Websites that provide information about the problem of insurance fraud:
- Association of Certified Fraud Examiners
- Coalition Against Insurance Fraud
- National Fraud Information Center
- National Healthcare Anti-Fraud Association
- Health Insurance Association of America
If you suspect insurance fraud has been committed against Northwestern Mutual or Northwestern Long Term Care Insurance Company, call our toll-free Fraud Detection Line at 1-877-607-2485 or email the SIU at antifraud@northwesternmutual.com. Or, contact your state's insurance fraud bureau.
When contacting the SIU, please provide the following information, if possible:
- Name and address of the person or business.
- The person's age
- Name of the person's employer or business.
- Details of the suspected fraud.
- The person's relationship to Northwestern Mutual (employee, policyowner, insured, service provider, financial representative).
- The type of policy in question (life, disability, group disability, long- term care, annuity).