life insurance

life insurance fraud

Many people today have life insurance. It’s a good way to protect family and loved ones from money troubles if something should happen to the policy holder.

Unfortunately, life insurance fraud is a real and unsettlingly common occurrence. So we’ve put together some of the signs that you might be at risk for different types of fraud.

Take a look and make sure that you aren’t ignoring signs of insurance fraud.

Signs Of Life Insurance Fraud By Forgery

Faked deaths or murders may be the most intriguing cases of fraud, but they aren’t the most common. Most life insurance fraud will deal with some type of forgery or unauthorized changes in a life insurance plan.

For example, if someone else gains access to your life insurance policy and personal information, they could change the beneficiaries on your policy. That can lead to legal trouble when it comes time for the policy to pay out. Even worse, your intended beneficiaries might not get the payment from your policy.

Check your policy at regular intervals to make sure everything is as it should be. Have you received a notification of a change you don’t remember making? That’s a sign that some type of forgery may be going on.

Signs Of Fraud By Agents

Fraud by life insurance agents usually takes a couple forms. One type is when the agent diverts premium payments into their own pocket. A sign of fraud risk is an agent asking you to put their name on the check, instead of the company’s.

Ask questions and contact the insurance company if an agent asks you to make a check out to them, rather than the company. And don’t ignore any unexplained cancellation notices in the mail. If you’ve been making payments, that’s a sign that something is wrong and needs your attention.

Agents can also engage in the unethical selling of “upgraded” plans that really don’t offer any better benefits. The higher cost allows them to collect a commission on the plan.

Again, ask questions, do your own research, and request all of your documents. If your agent seems evasive or pressures you, those are signs that you may be at risk.

If you’re using a new agent that you don’t know, check them out on your state’s insurance department website.

Faked Deaths and “Double Indemnity” Schemes

These are the life insurance fraud schemes that you see on TV and in movies. Faked deaths involve claiming life insurance payouts for a person who is still alive, or never actually existed.

Double indemnity plots get their name from the classic 1944 film by the same name. The movie revolves around a murder committed in order to obtain a life insurance payout on a spouse.

Violent plots like this are rare. However, it might be suspicious if a spouse or beneficiary begins pushing you to buy more life insurance without good cause.

Unfortunately, insurance fraud can happen to anyone if they aren’t careful. If you need a fraud investigator, then give us a call today at WorldWide Resources.

insurance fraud investigator

Insurance Fraud is a billion dollar problem.

According to the FBI, the estimated loss for life and casualty insurers is $40 billion dollars a year. The cost to health insurers can be as much as $259 billion.

Companies large and small find themselves at risk. But the costs for large companies are the greatest, significantly trimming their bottom lines. An investigator can help insurers keep what’s theirs, so they can do what’s right for those who do have legitimate claims.

Let’s explore 5 high-cost reasons you’ll need to hire an insurance fraud investigator.

Stolen Cars

As you know when one of your insured has a car stolen, there’s actually a significant chance that the insured is involved.

According to the National Insurance Crime Bureau (NICB) 2 common stolen car scams you need to be concerned about are:

Owner Give-Ups

The owner lies about the theft and has the car destroyed in order to collect insurance money.

30 Day Specials

The owner hides the car and reports it stolen. After the claim is settled, the car is “miraculously” found. This scam is often used when the car needs major repairs.

These schemes can be hard to spot. And insurance fraud investigator will use technology and an analytical mind to help you scour claims. Through this, they can identify suspicious patterns to identify fraudulent activity.

Car Accidents

The lengths that people will go to stage accidents likely astounds you. These crimes are often sophisticated, making them difficult to prove. Sentences for this type of fraud has been historically low, as little as community service. This makes it a very lucratlow-risk risk crime.

Not only are insurers forced to pay out, but innocent bystanders and those in other vehicles are often put at risk during this crime. Innocent drivers may see their premiums go up when they are blamed for the accident.

In a “swoop and squat”, for example, a driver pulls in front of another driver suddenly and then slams on his/her brakes. The driver rams into the scammer and is considered at fault.

But an insurance fraud investigator can help identify these fraudsters and gather the proof needed to dispute the claim.

Fake Home Fires

Those involved in fake home fires are often well-organized and calculating. They do their research and execute a smart plan.

Recently, in Richmond, VA, thanks to an insurance fraud investigator, 6 people were arrested for an alleged multiple home fire scam through which they had been collecting money for 16 years. Thus far, they had collected nearly $1 million.

Thankfully, this alleged crime was finally stopped through insurance fraud investigation.

Health Insurance Billing

Health insurance fraud often takes years and millions of dollars in false claims to confirm. Medical professionals, who are often seen as pillars in the community, betray that community’s trust.

A fraud investigator can help you get to the bottom of this criminal activity to stop the crime and see justice served.

Organized Crime

The NICB reports that insurance fraud is big business for organized crime groups who have the resources, the people and the know-how to pull off large scale insurance schemes.

They can make their crimes appear to be unrelated as the insured individuals may have no inherent red flags. The schemes may encompass several countries.

Working through these intricate schemes, an investigator puts the pieces together to get a big picture of the operation. This requires in depth knowledge of how these enterprises work.

Hire An Insurance Fraud Investigator

When billions are at stake you need a company with international resources and connections. This company should be able to put the pieces together to identify that  fraud is taking place.

At Worldwide Resources Inc., we’ll help you win against insurance fraud. Start an investigation today.

insurance investigator

Based on recent surveys, property fraud reached $34 billion per year between 2011 and 2015. Healthcare fraud alone reached $259 billion in the year of 2010

Fraudulent insurance claims are reaching all time highs as people fake insurance claims. Fraudulent claims can range anywhere from forging dates on a claim form to faking an injury.

Thankfully, there are insurance investigators who look into these claims to ensure they’re legitimate. But how?

Read on to learn how an insurance investigator inspects insurance claims to fight fraud.

An insurance investigator will look at your past claims

An insurance investigator will go through your past claims to look for any red flags. They will take a look at how often you file claims and the nature of the claims. 

Insurance investigators will also look for patterns to see whether or not specific people have more probability than others to commit fraud.

They use data analysis to track patterns for all of their customers. So any red flags will be picked up immediately.

They check off a list of suspicious loss signals

There is a list of suspicious loss indicators that was created by the The National Insurance Crime Bureau (NICB). In fact, in 2013 the NICB released a press release stating that they have noticed a 26% rise in questionable claims since 2010.

When insurance investigators look at claims, they take a look at this list to make sure there’s nothing questionable about the claim.

Some of these indicators include:

  • Handwritten receipts when a repair has been done in damaged property
  • An increase in home or auto insurance immediately prior to a submitted claim
  • Significant financial debt on behalf of the claimant
  • Lack of police reports after the supposed accident

While these indicators do not always prove fraud, they do force investigators to look deeper into the claim.

They look to computers for help

Thanks to technology, computer software exists to detect fraudulent billing and charges.

Investigators use this software to pull billing records for fraudulent activity. And it doesn’t matter the insurance type. The computers use data and trends to investigate the legitimacy of the claims. For claims such as health claims, these computer software programs look for multiple surgeries on one claim for the same body part. 

But they can ultimately detect any fraud on any type of insurance, including auto insurance.

They’ll look at social media

Not all insurances will take a look at your social media pages. But if they suspect suspicious claims, they will take to social media for more information.

They will do a little digging to see if the claimant is in fact injured, or if their home is truly damaged. Social media often gives them the information they otherwise may not have found elsewhere.


As the statistics show, fraud is becoming prevalent across all insurance industries. From home to life insurance, investigators are taking a closer look at the claims that come through.

While most claims are legitimate, it’s always in their best interest to take a second look at suspicious claims. 

If you’re in need of insurance investigators for your firm, contact us for more information. 

life insurance fraud

Murder plots and faking one’s own death in order to collect insurance money might make for juicy headlines, but they’re just a small part of the overall damage caused by life insurance fraud.

It’s difficult to get a precise figure, but the annual cost of life insurance fraud to insurers is “in the billions,” according to Coalition Against Insurance Fraud communications director Jim Quiggle. “Many instances of fraud are stealth scams. Nobody knows they happened.”

Indeed, not all types of fraud are sensational. The bulk of scams are rather tame and are sometimes perpetrated by insurance agents themselves. Put it all together, however, and the losses pile up.

Here are five ways people attempt to commit life insurance fraud.

1. Faked deaths

Everybody loves a good faked death story. Fascinating as these scams might be, they’re not common. They’re also extremely difficult to pull off.

Faked death schemes are cooked up not only to collect on the insurance of a person who’s still living but sometimes for somebody who never existed at all.

Take this story out of New Jersey, in which a man was charged after trying to collect on a policy after the death of an acquaintance. “This defendant allegedly took out a sham life insurance policy in the name of a stranger, then spent years just waiting for someone to die so he could cash it in,” said state Attorney General Christopher S. Porrino.

2. Premeditated murders

If you’ve ever seen the movie Double Indemnity, you know what we’re talking about. The film noir classic depicts a wife who plots with an insurance agent to kill her husband for a big payout.

“A combustible combination of greed, large dollar payoffs, and resentment can lead to a murder of a spouse or close family relation,” Quiggle said. “Many of the perpetrators think this is an easy crime to get away with.”

It’s not.

3. Forgery

While it’s not as sexy as a faked death or murder plot, most insurance scams involve simple forgery, according to supervisory special agent Joshua Tison of the insurance fraud section of the Pennsylvania Office of Attorney General.

A common example is somebody who is not the policyholder taking control and changing the beneficiary by “nefarious means,” he said. “That’s the bulk of the fraud we see.”

4. Pocketed premiums

This sort of scam can occur if an insurance agent tells you to make the checks meant to pay for your policy out to him instead of the company. In the end, your policy gets canceled due to lack of payment and your money rests in the agent’s pocket.

5. Policy upselling

An unethical agent may try to sell you a “better” or “upgraded” insurance policy. If you’re not careful, what you may end up doing is replacing a perfectly good contract with a new one that offers no extras and pays the agent a much higher commission.

Protect yourself from life insurance fraud

A few tips to make things more difficult for scammers:

  • Be careful who you turn your policy over to, demand paperwork for how money might be set aside
  • Check your agent’s license with the state insurance commissioner
  • Save all paperwork for the policy, including forms filled out by an agent
  • Don’t sign any paperwork with blank spaces that could be filled later
  • Read and make sure you understand a policy before you sign it
  • It’s okay to say “no” if you feel pressured into a sale

Got any more tips or stories about fraud? Leave a comment below or drop us a line.


By Michael Ferguson, ALHC, CG, CII of Worldwide Resources, Inc.

As a life claim examiner presented with a foreign death claim do you have a thorough understanding of the funeral rituals based on the religion of your insured? More importantly, do you know what is usual and customary for that religion?  You should.  Having knowledge of the funeral rituals of various religions around the world will enable you to understand when the disposition of the insured’s body is contrary to their beliefs.  There may be a logical explanation but if not, the preverbal red flag may be waiving.

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