What is insurance fraud?
Each state defines insurance fraud differently, but generally, fraud occurs when someone intentionally misrepresents information or hides the truth with the intent to receive money or other benefits from an insurance company.
Misrepresentations may be in written or oral statements, computer-generated documents, electronic claim filings, or other data transmissions that contain false or misleading material information. Insurance fraud may involve acts committed by an employee, employer, agent or medical provider.
SFM's fraud team
The experienced special investigators and in-house attorneys from SFM's Special Investigative Unit focus on investigating, evaluating and pursuing fraudulent claims using current technology and research tools.
SFM's special investigators work closely with claims representatives and attorneys to thoroughly evaluate information from all perspectives. SFM also partners with external business resources at various state labor and commerce departments, as well as private investigation firms.