Achievements: Uniting the Fraud Fight

The Coalition was founded in 1993 as the nation’s only anti-fraud alliance speaking for consumers … insurance companies … public officials … and other partners. We’re widely considered a leading voice of the anti-fraud community, across all lines of insurance.

Membership

Coalition membership has more than doubled in the last five years to more nearly 190 organizations. Last year set a record for membership growth.

Government Affairs

Enact stronger fraud laws. The Coalition pursues strong state and federal anti-fraud laws. We regularly testify, write strong opinion letters and advise legislators throughout the U.S. We tracked more than 150 state fraud bills in 2018 — a record.

Model fraud law. At least 21 states have passed anti-fraud laws based on the Coalition’s model insurance-fraud law. It’s the most-comprehensive fraud model law ever created. Consumers and insurance personnel can be held criminally liable.

• Other Coalition model laws, suggested laws & regulatory guidelines cover frauds such as automobile scams … dishonest contractors … workers compensation … airbags … and scams by insurance agents.

Grassroots lobbying. The Coalition has pioneered anti-fraud grassroots lobbying with IASIU to launch online legislator-contact campaigns by fraud investigators in targeted states.

Help spur fraud bureaus. Initiated legislation that led to the creation of 12 state insurance fraud bureaus. They work with insurers, law enforcement and others to investigate and prosecute fraud.

Impact on Capitol Hill. Stepped-up prevention and deterrence against organized fraud rings and other schemes is vital for turning the corner on insurance fraud, the Coalition told a U.S. Senate Commerce committee in testimony. The Coalition was among select national anti-fraud leaders invited to testify.

• Association health plans are an open door for fraud under sole federal control, the Coalition told the U.S. Department of Labor in a strongly worded statement. The same warning was delivered in a meeting with the White House. A federal court declared the rule void in 2019.

• Co-founded the landmark Healthcare Fraud Prevention Partnership. This group is uncovering major medical scams that bilk public and private insurers alike, and saved U.S. taxpayers more than $300 million already.

Defend fraud fight in court. The Coalition files amicus court briefs that help influence landmark court decisions that can have a large impact on the fraud fight, and consumers. Among the amicus briefs: prevent personal bad-faith liability of fraud fightersdefend the fight against fraudulent bills illegal medical clinicssupport funding of state fraud prosecutors.

Voice of fraud to policymakers. The Coalition is a key advisor about all fraud issues to national groups such as the NAIC, NCOIL and NCSL. We bring a unique balance of insurer and consumer voices to America’s public-policy debates. In this vein, the Coalition also serves as a consumer rep to the NAIC, and presenter at the NAIC Insurance Summit.


Alerting the public

News coverage. Raise public awareness of insurance fraud — and how consumers can fight back — as a leading national expert to the news media. The Coalition is quoted in major news outlets such as the Wall Street JournalNew York TimesWashington Post USA TodayBusiness WeekForbes Fortune60 MinutesToday ShowGood Morning AmericaCBS NewsABC News.

Consumer videos. Everyday consumers deciding about defrauding their insurer or being victimized are shown in 30-second video spots for member use. … Make smart life decisions, urges another consumer video called Choices. Also available for member adoption.

Infographic. Insurance Fraud: Why Care?” tells an edgy, deterrent fraud story at a glance.

Mobile app. Mobile users can conveniently access the robust Coalition website anywhere, any time. The app is available free of charge.

Social media. Daily anti-fraud messages, cases and trends via Facebook and Twitter keep consumers continually informed. The podcast FraudFeed warns consumers about scams — staged crashes, contractors, crooked agents, much more.

Hall of Shame. Raise public awareness by promoting previous year’s worst insurance scammers.

Publish trends & news. The online Fraud News Weekly and Fraud News Daily reveal the newest fraud cases, legislation and trends. They’re the nation’s premier outlet for fraud news. ... Experts reveal fraud trends in the online leadership publication, Journal of Insurance Fraud in America.

Research

Conduct major national research. Numerous national studies and reports about insurance fraud, causes and how to combat fraud have been commissioned by the Coalition. Among the studies:

Insurer technology. More insurers are turning to advanced anti-fraud tech such as predictive analysis and even AI, says the Coalition’s latest study of insurer use of technology.

Life & disability. Some insurers sponsor robust anti-fraud programs, while others appear to lack commitment to detecting scams, a report on life-disability fraud reveals.

SIU benchmarking. Third edition of this study drills down into insurer anti-fraud metrics to help senior managers compare and refine their operations.

Consumer attitudes about fraud. Groundbreaking study helps fraud fighters understand why people do — and do not — tolerate insurance fraud.