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:

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 2:

Question 3:

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 3:

Question 4:

Mrs. Court took out a life insurance policy on Jim, 20 years ago, when he was 3. Jim has a condition that leaves him unable to independently take care of himself as an adult. Jim lives with his parents who have P.O.A. (Power Of Attorney) over his affairs. Mrs. Court called the insurance company to change his beneficiary to Jim's Estate. The insurance company refused to process the paperwork until Mrs. Court furnished a copy of the POA.

Answer 4:

Question 5:

One day Ricky simply decided that paying for car insurance was not for him. He wasn�t going to do it any more. He let his auto insurance cancel but still needed to get his license plates renewed because he knew that the police will stop you if you don�t have the current sticker on your plates. The Revenue License office would not renew Ricky�s plates without a current Insurance ID card. So Ricky quickly went to his card, got the old one out of is glove box and carefully penned in the current date so he could get license plates.

Answer 5: