Commercial insurance protects against losses, restores businesses to operation and provides for injured workers. Unfortunately, when insurance fraud is committed, funds that should go to pay legitimate claims are diverted to dishonest claimants. According to industry estimates, nearly $80 billion in fraudulent claims are made each year in the U.S. alone.
At FCCI, we are committed to doing the right thing and keeping insurance costs down for everyone.
FCCI works to keep insurance costs down by investigating suspected incidences of insurance fraud. Our Special Investigations Unit (SIU) acts on referrals from a variety of sources. If fraud is suspected or reported to us, we are required to refer the case to the appropriate state’s fraud department. We also work with the National Insurance Crime Bureau (NICB), ISO ClaimSearch, arson investigators, accident reconstructionists, fire departments, local law enforcement agencies and, occasionally, with the FBI and IRS.
Our goal is not to reject any legitimate claim, but to ensure that our resources are directed to honest claimants with legitimate claims.
Medical Billing Review
In addition to our SIU, FCCI has a medical billing review department. Registered nurses check medical bills and treatment plans to ensure our claimants receive proper care and that charges are billed appropriately.
What to expect after reporting fraud
Each report is handled on an individual basis. If you choose to give your information, you may be contacted by a special investigator. Remember that you have right to remain anonymous at any point in the process.
Please know that we appreciate the vigilance of informants and take reported fraud very seriously.