Insurance fraud is a serious concern for AIG. Insurance fraud committed by third parties, or by AIG employees, adversely impacts the industry, AIG’s profitability, our insureds, business partners, consumers and the general public. Industry sources estimate that insurance fraud costs the insurance industry billions of dollars every year.
Insurance fraud can encompass any suspicious, fraudulent and/or illegal activity committed against AIG and related to AIG’s business. The most common types of suspicious activity and insurance fraud schemes are: claims fraud; underwriting/application fraud; provider fraud; premium fraud; producer / broker fraud and employee fraud.
Toward that end, AIG's Global Investigative Services maintains a Special Investigative Unit (SIU) consisting of a significant number of fraud investigators who are geographically dispersed and highly skilled at handling reports of suspicious insurance activity. The SIU investigates referrals, tips and leads as appropriate, and makes reports of suspected fraud to the authorities, as required, for further government investigation and potential prosecution. AIG takes its responsibility as a partner in this overall fight against insurance fraud very seriously. These anti-fraud efforts are designed to safeguard AIG’s corporate assets, preserve the Company’s reputation, improve deterrence of fraud in the industry, and generally benefits our customers and the public.
Any person who suspects that Insurance Fraud against AIG is occurring, has occurred or will occur, should report the matter to AIG’s Global Investigative Services via e-mail to SIU@aig.com or call (in the U.S.) 1-866-228-2436. to the extent tips and referrals are received, AIG takes every possible measure to keep all e-mails and calls confidential. AIG appreciates your critical assistance in this fight against insurance fraud.
Types of Insurance Fraud
Occurs where an insurance application or supporting documentation contains a material misrepresentation or omission of facts bearing on the nature or extent of the risk for which coverage is sought. It induces an underwriter to rely upon the misrepresentations and issue coverage or certain terms that otherwise would not have been issued had the true facts been known. It also may occur when insureds or producers issue false certificates of insurance to third parties who misrepresent the terms and conditions of an otherwise legitimate policy.
Occurs where an insured intentionally misrepresents facts related to the “exposure” upon which the underwriter has calculated, quoted and/or adjusted the premium in order to obtain a lower premium. For example, workers’ compensation premium fraud occurs when an insured misrepresents the amount of its remuneration, misclassifies its payroll and/or employees’ job functions, and/or misrepresents actual employees as independent contractors in order to exclude them for premium purposes.
Involves a legitimate or fabricated loss by the claimant, where the provider either fabricates the services provided, bills the carrier for more expensive services than was necessary or rendered, or makes referrals to other providers for unnecessary services.
Includes circumstances where a claimant has fabricated a loss, or has submitted a legitimate loss but intentionally misrepresents the nature or extent of the loss or associated damages.
Includes any scenario described above, if perpetrated primarily by a broker or agent, with or without the insured’s knowledge. It also includes instances where the producer steals the premium or had its license revoked or suspended but continues to engage in otherwise legitimate but unauthorized practices.
Occurs where any alleged misconduct or suspicious, fraudulent and / or illegal activity suspected of being committed against AIG by an employee who either acts alone, or in concert with other third parties.