Insurance Fraud Quiz

What is Fraud?
According to Missouri Statute §375.991 RSMo., a person commits a "fraudulent insurance act" if he or she knowingly makes a statement or written document for a claim or insurance application which that person knows to contain material false information or conceals information concerning a material fact.
What is a policy dispute?
A policy dispute can be many things. You may have a policy dispute if it is questionable that you had coverage at the time of an accident. A policy dispute could be a disagreement about how an insurance company handles your claim (Mo. Reg. 20 CSR 100). Or, a policy dispute could be if your claim is denied because of a misrepresentation that is not material to the loss covered on the policy (§376.580 RSMo).
This quiz is developed for example purposes only. The questions and answers in this quiz are not to be construed as an opinion or position taken by the Missouri Department of Insurance. If you believe that you have a claim that should be paid, you may wish to ask the Consumer Affairs Section of the Missouri Department of Insurance for assistance by calling 1-800-726-7390 or check us out on line.

Question 1:

Mr. Harrison damaged his vehicle at 9:00 A.M on September 1. Mr. Harris purchased insurance coverage for that same car at 10:00 A.M. on September 1, stating that there was no damage to the car and no prior losses (accidents or damage). Mr. Harris then reported that his car was damaged at 9:00 A.M on September 2.

Answer 1:

Question 2:

Stacie applied for auto insurance coverage to Country Auto Insurance Company. When the agent asked for information about all drivers in the home, Stacie failed to disclose information about her son. According to the underwriting standards of Country Auto Insurance Company, her son's membership in Stacie's household caused the household ineligible for coverage due to the revoked status of his driver's license. Stacie also did not tell the company that she had an accident two months ago and that her husband had a speeding ticket a year back.

Answer 2:

Question 3:

Bob's home caught fire on January 1. The St. Louis fire investigator classified the fire as accidental due to a short circuit in the garage. A Cause & Origin Examination of the collapsed structure was conducted at the request of Bob's insurance company. There were positive identifiers for accelerants on both floors of the house. Also, the remains of the house were dug out to assist with the evaluation of the $300,000 claim for the contents of Bob's house. At the bottom of the basement stairs was a red plastic container containing a liquid with an odor similar to gasoline. After an interview with Bob's in-laws, it appears that half of his furniture is being kept at Bob's brother's house in Kansas City.

Answer 3:

Question 4:

Jake Donaldson alleges that he cut his gum on a piece of glass, which was found in his grilled chicken sandwich on April 23. After six months of requests, Protection Casualty Company has not received medical records to substantiate Mr. Donaldson's claim. Prior to leaving the restaurant on April 23, one of the members of the group with Jake at the time said to the shift manager, "don't worry, he does this all the time to try and get free food".

Answer 4:

Question 5:

Todd applied for coverage on March 11th to Country Auto Insurance Company. The Country Auto Insurance Company agent forgot to ask about all the members of Todd's household. When Country Auto Insurance ran a standard application investigation, the company found that his stepdaughter lives part time in the house and she had a revoked status of her driver's license. The agent went back and advised Todd that he forgot to ask about other drivers in the house and he will need to exclude his stepdaughter from driving any of his cars since she has access to the vehicles part of the time.

Answer 5: