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Don't be Victimized by Health Insurance Fraud

Don't be Victimized by Health Insurance FraudIt's unfortunate but true: health insurance fraud is prevalent in our society and it's not always possible to protect yourself from becoming a victim. In fact, most people won't even know they've fallen prey to health insurance fraud until they submit a claim for a medical service that they think is covered under their policy. It's often not until after a claim is denied that most people realize they've been a victim of health insurance fraud.

How to Spot Health Insurance Fraud

Is it possible to keep yourself from becoming a victim of health insurance fraud? Would you even know what to look for? While there probably are as many different fraud scenarios as there are victims, there is one thing that should always throw up a glaring red flag: health insurance coverage that seems too good for a price that seems incredibly low.

Be wary of unsolicited mail that advertises discounted health insurance, especially if you're not familiar with the name of the company making the offer. Before you take any further action, you should do what you can to research the credibility of the company. Health insurance companies are rated at this web site You should also check with your State Insurance Commission to see if the company is licensed to do business in your state.

Most importantly, you also need to read the offer in its entirety, especially the fine print. Be very careful of any salesperson that asks you to pay using cash and/or requires you to pay the total amount of your premium in advance.

If you find that you are a victim of health insurance fraud, follow these guidelines immediately:

1. Contact your State Insurance Commissioner. Find out if they have any other complaints about the company from which you purchased your coverage. Also file a health insurance fraud complaint.

2. Contact your bank or credit card company to stop any future automatic payments that may be scheduled.

3. Contact your local law enforcement agency.

Be sure to have all of your cancelled checks or credit card statements and a copy of the health insurance contract that you signed. Also get a copy of your personal credit report from all three major credit reporting agencies as soon as possible. Many times people who perpetrate health insurance fraud also use your personal information to steal your identity and to commit other fraudulent acts.

Be smart and check out the health insurance company before you sign on the dotted line. As a final precaution, call your local hospital or personal physician and ask if they accept the insurance. If not, at least find out if they have ever heard of the insurance. When it comes to protecting yourself from health insurance fraud, an ounce of prevention really is worth a pound of cure.


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    David Kristman Jr.  [send email] 8th of Nov, 2007

    I have a question about filling out insurance forms to recieve health insurance service. I know of a woman, who happens to be my freind's wife, she just recently filled out a re-newal form for adult basic insurance in the state I live in offers insurance to people who make under $24,500 . a year or less. The problem is she has been married since last August and makes way more than what the company allows in it's guidelines for eligibility. I know this because a friend of hers told and said "you better becareful". She never changed her maiden name and wrote on her form that she was single.
    And my freind does not even know about it, she had this ins. before she married him. He just figured she had her own ins. I s this insurance fraud and should I report it? I t does bother me that she is frauduently sucking the system, plus their marriage is almost over anyway. M y friend has insurance through work, would he get in trouble even if he did not know about it?

  • Un
    Julie Russian  [send email] 12th of Jan, 2008

    I was divored 8/30/05 and immediately hand delivered a copy of my divored decree to my personell office as instructed to have my ex removed from my health insurance policy. I also deleted him on the computer and called the insurance company. He continued to use my insurance. I received a statement of benefits from my insurance company recently and called to inquire why they were still paying on him. They now have sent me a bill for all his RX they paid for (979.00) and requested payment from ME in 30 days. When I asked how this was MY problem, they said I was the insured and I would have to prove I did all that was required to have him removed. Am I responsible for his doing this? What do I do? He is a health insurance salesman and knows full well he was not still on my insurance.

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