Important information about insurance fraud in Oklahoma.

If the cost to repair has been misrepresented to the insurance company by either the insured/claimant or the repair person, that generally constitutes fraud.

If the cost to repair has been misrepresented to the insurance company by either the insured/claimant or the repair person, that generally constitutes fraud.  It is possible that an insured may be paid to replace certain appearance items, but decide to live with the damaged and devalued items rather than replacing them.

Yes.

“Unfortunately, there are many unscrupulous contractors whose actions can damage the reputation and credibility of legitimate companies. Any efforts by contractors to increase both consumer and employee awareness of insurance fraud and its consequences are of great help.  If fraud is suspected of consumers, employees, or competitors, contractors are encouraged to contact the Anti-Fraud Unit immediately.”
- Rick Wagnon, B.S., M.S.M.Chief Investigator, Anti-Fraud Unit

If fraud is suspected, it should be reported to the Anti-Fraud Unit of the Oklahoma Insurance Department immediately.  This can be done by completing the form available at   http://www.ok.gov/oid/documents/Antifraud_complaint_form.pdf and mailing it to the address below.  You may also contact the Anti-Fraud Unit by email, fax, or phone.

THE LAW
*OK State Statutes Title 21 Sect. 1661 – Fraudulent Claim Upon Insurance Contract for Payment of Loss Any person who presents or causes to be presented any false or fraudulent claim, or any proof in support of any such claim, upon any contract of insurance, for the payment of any loss, or who prepares, makes or subscribes any account, certificate, survey affidavit, proof of loss, or other book, paper or writing, with intent to present or use the same, or to allow it to be presented or used in support of any such claim, shall be guilty of a felony punishable by imprisonment in the State Penitentiary not exceeding three (3) years, or by a fine not exceeding One Thousand Dollars ($1,000.00), or both.

*OK State Statutes Title 36 Sect. 363 – Reporting Suspected Fraud – Grant of Immunity A. Any insurer who has reason to believe that a person or entity has engaged in or is engaging in an act or practice that violates any statute or administrative rule of this state related to insurance fraud shall immediately notify the Anti-Fraud Unit of the Insurance Department. B. In the absence of fraud, bad faith, reckless disregard for the truth, or actual malice, no person, insurer, or agent of an insurer shall be liable for damages in a civil action or subject to criminal prosecution for supplying information about suspected insurance fraud to the Anti-Fraud Division of the Insurance Department or any other agency involved in the investigation or prosecution of suspected insurance fraud. The immunity provided in this subsection shall not extend to any person, insurer, or agent of an insurer for communications or publications about suspected insurance fraud to any other person or entity.

Source:

Rick Wagnon, B.S., M.S.M.
Chief Investigator, Anti-Fraud Unit
Oklahoma Insurance Department
2401 N.W. 23rd Street, Suite 28
Oklahoma City, OK 73152-3408
(405) 522-6180 Direct
(405) 651-7414 Cell
(405) 522-6779 Fax
rick.wagnon@oid.ok.gov