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:

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 1:

Question 2:

Kim filed a claim stating that she fell on her neighbor's back porch on January 12, 2003 due to snow and ice. She hurt her left shoulder. When the insurance company reviewed her medical records, they found a note stating that the original injury happened before Thanksgiving 2002, when she fell at a roller skating rink. The doctor for the insurance company confirmed what the note indicated.

Answer 2:

Question 3:

Tammy filed a claim with her auto insurance company for hail damage two moths ago. The auto insurance company asked for proof of loss and specifically asked her to take pictures and mail them in. Tammy refused to take pictures because she felt that a claim adjuster should view her car and write her a check on the spot without questions asked. Her claim was denied due to lack of cooperation.

Answer 3:

Question 4:

Mr. Harris purchases insurance coverage for his car at 10:00 A.M. on September 1 from KC Auto Insurance Company. He stated to his agent and on his application that there is no damage to the car and no prior accidents. Mr. Harris called the insurance company at 10:30 A.M. and said that he was in an accident at 10:15 A.M. while leaving the parking lot of the insurance agent. The check that Mr. Harris wrote for the insurance coverage unfortunately bounced and was sent back to the company as an 'insufficient funds' transaction.

Answer 4:

Question 5:

Angela needs to make a few bucks quickly. She works at a one-hour photo shop after school. She has made a few fake ID�s in the past so that her friends can get into the R rated movies. She�s become very good at it too. Since she thinks no one gets hurt by sneaking into R rated movies, what damage has been done? � Right? But, Angela needs to make extra money fast for next weekend�s shopping trip to St. Louis. Why not try her hand at Insurance ID cards? Those little paper proof of insurance cards are easy to fake and Angela can whip out a dozen in no time with her scanner, Picture Shop editing program, and a color printer with good paper!

Answer 5: