COVID-19 Insurance Fraud: 5 Things You Need to Know

Published: 17 April 2020

Expect to see an increase in home, auto and healthcare fraud schemes due to COVID-19.

In times of crisis, fraud tends to spike. In the last week of March, Google searches for “how to start a fire” grew 125 per cent compared to the same week in 2019. With so many people losing their jobs suddenly, some may turn to insurance fraud, such as arson or staged automobile accidents, to stay afloat.

Experts from the International Association of Special Investigation Units (IASIU), the National Insurance Crime Bureau (NICB) and the Coalition Against Insurance Fraud recently shared their predictions about COVID-19 insurance fraud trends. Here’s what you need to know.

1. You’ll See a Spike in Fraudulent Claims

With so many people laid off from work due to the virus, opportunistic fraud will increase, the experts suggested. People have bills to pay and might not know where else to turn for quick cash.

One example of this is staged auto accidents. Two people who know each other might work together to plan a car “accident.” Then, they won’t stay at the scene or go to the hospital for injuries, claiming that they don’t want to put themselves at risk of contracting COVID-19. This makes it harder to verify details and gather evidence and, in turn, nearly impossible to detect as a fraudulent auto claim.

Fraudulent home and property claims will likely also increase. Matthew Smith, executive director of the Coalition Against Insurance Fraud, notes that people feel “trapped and like they’re going to lose their life savings if they are not able to meet their financial obligation . . . so the decision is made, unfortunately, to try to burn and get rid of the property or the vehicle so that they can use that insurance payment for more pressing financial needs.”

2. Seniors are Being Targeted

Many COVID-19 insurance fraudsters are capitalizing on fear. Because both old age and some pre-existing conditions increase the risk of death from COVID-19, scammers target the elderly with their fraudulent safety solutions.

Fraudsters will use the phone and internet to promise anything to get you to trust them with your sensitive information, explains Joe Wehrle, Chief Executive Officer of the National Insurance Crime Bureau (NICB). 

Some existing schemes that exploit seniors’ fear of the unknown include:

  • Selling counterfeit PPE or COVID-19 drugs
  • Opening or advertising fraudulent healthcare facilities
  • Going door-to-door offering fraudulent COVID-19 testing, either for payment or ending in a robbery
  • Selling fake lists of COVID-19 infected people in a specific neighbourhood/geographic area

3. Many COVID-19 Insurance Fraud Schemes are Web-Based

As more people are social distancing and self-isolating, fraudsters are focusing their efforts on phone and web-based schemes, according to the experts.

A common scam is setting up phishing websites to steal personally identifiable information including credit card information and healthcare data. The sites lure in victims by either masquerading as a legitimate website (such as a medical professional or the CDC) or by promising a solution to a COVID-19 fear.

Fraudsters may also steal data by sending malware through email. Attaching files or links to fraudulent test results, healthcare records or virus information are common, such as these scam emails claiming to be from the World Health Organization.

4. Look Out for Fraudulent Vendors and Fees

Another way that fraudsters are exploiting fearful people is creating fake vendors and fees for existing businesses.

For example, a towing company may charge a victim extra (and fraudulent) disinfecting and storage fees so their workers don’t contract the virus. The victim’s auto insurance then loses funds for services that were never rendered. Alternatively, the victim has to pay for the fake fees out of pocket, when the fraudsters promised they were covered by insurance.

Fraudsters are also selling fake insurance products, including short-term coverage should the victim contract COVID-19. This type of scam hurts the victim financially (and maybe medically), plus it takes potential business away from legitimate insurance providers.

5. New Healthcare Fraud Schemes

Healthcare fraud schemes make up a large portion of COVID-19 insurance fraud. People want to protect their health, so they will do and pay almost anything to ensure their family’s safety.

In one scheme, fraudsters pretend to be public health officials or medical professionals. They inform their victims that they have tested positive for the novel coronavirus and that they have to share their sensitive data (such as birthdate or Medicare card number) to obtain a prescription.

Then, the fraudster might sell the data to other criminals or to someone who needs access to healthcare. They could also use the data to obtain healthcare services for themselves, or to acquire medical supplies or pharmaceuticals to sell.

Fraudsters also go to grocery stores and pharmacies claiming to be doctors or nurses. They charge the employer or the employees to check employees for symptoms or test for COVID-19, saying their insurance will cover the cost.

Combating COVID-19 Insurance Fraud

COVID-19 insurance fraud covers different industries and is a worldwide problem. Bruce Dorris, President and CEO of the Association of Certified Fraud Examiners says that “the looming economic downturn we can expect to see has a number of long-lasting implications. One important one being an explosion of fraud in the coming years — and organizations need to brace themselves.”

The best way to do that is to anticipate new scams. Looking at emerging fraud schemes and seeing how insurance could play into them can help boost your detection and prevention efforts.