Below are some of the most common questions and answers that the department's Fraud & Enforcement division receives. If you have a question not addressed here, please fill the feedback and/or contact forms on the right side of the page or call us at 800-686-1527.
The Fraud Unit solely conducts criminal investigations involving individuals. If you have a complaint regarding an insurance company, please contact the Consumer Services Division. To file a complaint regarding potential agent misconduct, please contact the Enforcement Unit.
Fraud: Click on the links below to file a fraud complaint.
There are many indicators of fraudulent property and casualty, arson/fire-related, and burglary claims. Learn more about them and other common red flags here.
The mission of the Enforcement Unit is to protect consumers by investigating suspected violations of laws and rules pertaining to insurance transactions conducted in the State of Ohio.
The unit investigates allegations of misconduct involving insurance agents and agencies, as well as unlicensed individuals and entities who appear to be engaged in the business of insurance. If evidence obtained by the unit substantiates an Ohio insurance law or rule has been violated, the department has the authority to pursue administrative action against the license holder or unlicensed individual or entity. Administrative hearings are conducted in accordance with Chapter 119 of the Ohio Revised Code.
Depending upon the severity of the offense and the findings of the hearing officer, the superintendent of insurance has the authority to deny a license application, suspend or revoke an insurance license, and/or assess the individual or entity civil and/or administrative penalties.
The Fraud Unit solely conducts criminal investigations and works with local, state, and federal agencies to criminally prosecute consumers, healthcare providers, insurance agents, contractors and other members of the general public who commit insurance fraud or engage in crimes associated with insurance.
Insurance fraud is the intentional submission of a false or deceptive statement to an insurance company for financial gain. According to the National Insurance Crime Bureau, insurance fraud is the second most costly white-collar crime in America. The Coalition Against Insurance Fraud estimates $80 billion dollars is lost each year as a result of fraudulent claims submitted to insurance carriers. It is believed insurance fraud costs the average U.S. family between $400 - $900 a year in the form of increased insurance premiums.
Read more about insurance fraud, who commits it, the role of the Ohio Department of Insurance's Fraud & Enforcement Division, common schemes and inflated insurance examples and learn how to report insurance fraud.