Washington Insurance Fraud Laws
Created by FindLaw's team of legal writers and editors | Last reviewed June 20, 2016
In the state of Washington, insurance fraud can occur in several different ways including worker's compensation fraud, property fraud, and casualty fraud. Generally insurance fraud offenses can occur when someone tries to make money from insurance transactions through deception.
Examples of insurance fraud include:
- Being billed for services or equipment you didn't receive
- Offering free testing or screening in exchange for your Medicare number
- Charging for filling out claim forms
- A medical provider performing services that exceed what's medically necessary
- Offering or accepting referral fees from another provider for the referral
- Misrepresenting services that are billed to Medicare
- Waiving the 20 percent coinsurance or deductible
Who Enforces and Prosecutes Insurance Fraud Laws?
The Washington State Office of the Insurance Commissioner and local prosecutors handle insurance fraud cases under the state's penal laws. The Feds can also prosecute insurance fraud under a number of criminal statutes including as "mail fraud," "criminal racketeering" or other federal offenses.
How do I File a Complaint Against a Washington Insurance Company?
You can file an online complaint against insurance carriers and discount health plan providers, including reporting suspected insurance fraud.
|What is Prohibited||
Knowingly lying about, or concealing an important fact in connection with a insurance claim or payment made under an insurance policy. Applies to issuing fake insurance policies and rate-fixing. Also includes conspiring to do any of the above.
Possible civil penalties including fines, revocation of business license, etc.
|Who Can Be Prosecuted||Consumers, Providers (such a doctor and auto repair shop), and Insurance Companies, Adjusters and others|
|Types of Insurance Fraud||
Insurance Fraud Detection Reward Program
Individuals may apply for a reward for any tip that leads to an arrest and conviction.
• Mention the reward when reporting suspected insurance fraud.
|Examples of Insurance Fraud||
If you feel you have been victimized by insurance fraud, here is some contact information that can help you:
- Insurance Consumer Hotline at 800-562-6900
Because insurance fraud laws can sometimes get complicated, it may also be a good idea to consult an experienced criminal defense attorneys if you have questions about your specific situation.
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