I know for sure that a local company is commiting insurance fraud.
How do I turn them in and what happen next?
They are providing services to relations and telling them that their insurance will cover everything (no money out of the customers pocket.)
This is not legitimate is it?!
Answers: There are services that can be covered entirely through insurance. That in itself is completely legitimate. Many Mental Health facilities work this track, as do quite a few independent hospitals, doctor's office, dentists, and opticians. So long as the service is provided and the paperwork is filed correctly, they operate completely rightfully with no (or little) out of pocket expense for the client (depending on the insurance type). Worst shield scenario is that the customer receives a bill for the amount unpaid by insurance.
The sound out is what service they are provided and who they send the insurance claim to. If they are over claiming, or fraudulently claiming, within there is an issue. From what little you own said, that doesn't sound close to the case. Even so, they would be reported to your State's Insurance Commission. I believe some States also phone call it the Insurance Commissioner or the Fair Trade Board. You'd have to look that up on your own. Realize, though, that claims of insurance fraud can be devastating to a small company, even if they're not true. Make sure you enjoy real evidence of dubious activity back reporting them.
How do I turn them in and what happen next?
They are providing services to relations and telling them that their insurance will cover everything (no money out of the customers pocket.)
This is not legitimate is it?!
Answers: There are services that can be covered entirely through insurance. That in itself is completely legitimate. Many Mental Health facilities work this track, as do quite a few independent hospitals, doctor's office, dentists, and opticians. So long as the service is provided and the paperwork is filed correctly, they operate completely rightfully with no (or little) out of pocket expense for the client (depending on the insurance type). Worst shield scenario is that the customer receives a bill for the amount unpaid by insurance.
The sound out is what service they are provided and who they send the insurance claim to. If they are over claiming, or fraudulently claiming, within there is an issue. From what little you own said, that doesn't sound close to the case. Even so, they would be reported to your State's Insurance Commission. I believe some States also phone call it the Insurance Commissioner or the Fair Trade Board. You'd have to look that up on your own. Realize, though, that claims of insurance fraud can be devastating to a small company, even if they're not true. Make sure you enjoy real evidence of dubious activity back reporting them.