A whistleblower who "blows the whistle" on insurance company fraud is helping to keep the cost of insurance down for everyone. Many people have defrauded nearly every conceived type of insurance program, including:
- Medicare (the government healthcare program for the elderly and some disabled persons)
- Medicaid (the government healthcare program for individuals with low incomes)
- Tricare (health insurance for members of the military)
- VA Healthcare (Veterans Administration health insurance)
- HMOs (health maintenance organizations)
- Life insurance (faked deaths is just one type of insurance fraud in this category)
- Auto insurance (staged accidents and injuries have been documented in every state)
- Property insurance (a recent example is Hurricane Katrina fraud)
Insurance Fraud Is Not Rare
A simple definition of insurance fraud is lies or the concealing of information or the faking an event or injury in order to collect money from an insurance policy. It can be safely estimated that millions of dollars' worth of insurance fraud occurs each year in the U.S. A whistleblower who takes action against insurance fraud is helping keep the insurance system honest and within costs. This is known as -whistleblower insurance.-
Whistleblowers Can Help Save Millions of Dollars
For example, Florida's Medicaid program, one of the nation's largest, serves approx. 2.1 million people every month. Over $100 million in Medicaid overpayments is estimated to have been saved in Florida in a three-year period from 2006 to 2008 by increased vigilance on the part of state agencies (including the actions of whistleblowers). In 2008, Medicaid fraud investigations in the state resulted in 62 arrests.
A typical Medicaid fraud is illustrated by the case of Alexis Robinson, who was recently convicted of organized fraud and identity theft after submitting hundred of false claims to Florida's Medicaid program for over $515,000. He was sentenced to 15 years in prison.
Don't Tolerate Insurance Fraud
If you are aware of illegal insurance-related conduct on the part of your employer or someone else, it's a good idea to get legal counsel from a whistleblower lawyer who is well-versed in whistleblower law. There are whistleblower protection laws, but unfortunately, whistleblower laws are relatively recent and they do not cover every conceivable set of circumstances.
Contact a law firm in your area that represents individual whistleblowers - whether in the insurance industry or another context. You have legal rights that must be protected, and a knowledgeable whistleblower lawyer will help you proceed safely.
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