Alinsco Insurance Company Fraud Prevention
Alinsco Insurance Company recognizes that insurance fraud exists in the insurance industry. As such, it is the policy and mission of the Company to strive to protect its customers and shareholders through the employment of an effective and diligent Anti-Fraud Plan.
In addition, the Company recognizes its responsibility to identify, evaluate and resolve questionable activity involving an employee or agent of the Company. This purpose and mission protects corporate assets from losses relating to theft, embezzlement and other questionable financial business practices.
The Company will work to foster open communication and support for other fraud control entities such as federal, state, and local law enforcement, federal and state fraud bureaus and the National Insurance Crime Bureau.
The purpose and goal of our Anti-Fraud Plan is to educate, detect, investigate and deter insurance fraud thereby reducing insurance costs.
As part of the Company's management process, the Alinsco Insurance Company's claim staff will endeavor to thoroughly review each claim and identify those claims exhibiting fraud related indications, red flag events and situations or behavior indicative of fraud schemes. As such, the Company's claim staff will act as the first phase in detecting questionable claims and will refer them to the appropriate investigative unit for further analysis. The investigative unit will also act in an advisory capacity to the underwriting department.
Special investigations will include the application of techniques and resources to resolve fraud issues. Investigative results are used to decide which course of action is warranted. Recommendations may include claim payment, claim reduction, claim denial or opportunity to withdraw claim, or the pursuit of restitution if the claim was paid, and possible law enforcement referral.
Special Investigation Unit (S.I.U.)
The Company has an S.I.U. department responsible for review, investigation, reporting, and the appropriate resolution of all suspected fraudulent insurance acts. This unit may recommend claim reduction, claim denial or opportunity to withdraw claim, or the pursuit of restitution if the claims was paid. This department may recommend the involvement of fraud control entities such as federal, state, and local law enforcement, federal and state fraud bureaus and the National Insurance Crime Bureau.
Insurance Fraud will not be accepted by Alinsco Insurance Company. Our personnel are dedicated to the prevention of insurance fraud and will aggressively review, analyze, monitor, investigate and prosecute to the fullest extent of the law fraudulent insurance acts. It is our position that the validity of such acts will receive the benefit of the doubt unless proven otherwise through complete investigation and evaluation toward their appropriate disposition. These acts in general are, but not limited to:
- Application Fraud
- Certificate of Insurance Fraud
- Fraudulent Insurance Claims
- Understating Rating Exposures such as Address, Drivers, Discounts, etc.
Further, we will comply with state statutes with respect to the reporting, investigation and preparation of Anti-Fraud Plans.
Suspected fraudulent insurance acts must be reported to the respective State Fraud Bureau where applicable. Those acts involving Alinsco Insurance Company should be referred to the company.
All suspected fraudulent insurance act referrals including supporting documentation should be forwarded to "Compliance Officer", Alinsco Insurance Company, 6032 Lake Worth Blvd., Suite 100, Fort Worth, Texas 76135