據美國保險信息協會(Insurance Information Institute)的統計資料表明:2004至2005年間,保險人因財產保險&傷亡保險所遭受的損失約達到300億美元,保險欺詐的參與方大約有如下幾種:保險申請人;保單持有者;提出索賠的第三方以及一些專門從事保險欺詐的非法機構。一般的保險欺詐包括:虛報或刻意誇大損失;在保險申請上填寫虛假信息;虛構傷亡事故或損失以申請保險索賠等等。基於如此緊迫的形勢,美國40個州分別在州的保險部內設立了總計48個保險反欺詐局(The Fraud Bureau),專門負責對各保險公司反欺詐工作的指導、對重大欺詐案件的調查、消費者教育等事務,並將涉嫌犯罪的欺詐案件移送檢察機關進行審查起訴。
各個州保險反欺詐局的相關資訊如下表所示:
州 |
是否将保险欺诈列为犯罪行为 |
豁免险种 |
是否成立了保险反欺诈局 |
是否强制保险者制定反欺诈计划 |
是否强制汽车安装摄像机 |
Alabama |
X (1) |
X (2) |
|
|
|
Alaska |
X |
X |
X |
|
|
Arizona |
X |
X |
X |
|
|
Arkansas |
X |
X |
X |
X |
|
California |
X |
X |
X |
X |
|
Colorado |
X |
X |
X |
X |
|
Connecticut |
X |
X |
X (1), (3) |
|
|
Delaware |
X |
X |
X |
|
|
D.C. |
X |
X |
X |
X |
|
Florida |
X |
X |
X |
X |
X |
Georgia |
X |
X |
X |
|
|
Hawaii |
X (4) |
X (5) |
X (5) |
|
|
Idaho |
X |
X |
X |
|
|
Illinois |
X |
X |
|
|
|
Indiana |
X |
X |
|
|
|
Iowa |
X |
X |
X |
|
|
Kansas |
X |
X |
X |
X |
|
Kentucky |
X |
X |
X |
X |
|
Louisiana |
X |
X |
X |
|
|
Maine |
X |
X |
|
X |
|
Maryland |
X |
X |
X |
X |
|
Massachusetts |
X |
X |
|
X |
X |
Michigan |
X |
X |
|
|
|
Minnesota |
X |
X |
X |
X |
|
Mississippi |
X |
X (2) |
X (3) |
|
|
Missouri |
X |
X |
X |
|
|
Montana |
X |
X |
X (1), (3) |
|
|
Nebraska |
X |
X |
X |
|
|
Nevada |
X |
X |
X (3) |
|
|
New Hampshire |
X |
X |
X |
X |
|
New Jersey |
X |
X |
X |
X |
X |
New Mexico |
X |
X |
X |
X |
|
New York |
X |
X |
X |
X |
X |
North Carolina |
X |
X |
X |
|
|
North Dakota |
X |
X |
X |
|
|
Ohio |
X |
X |
X |
X |
|
Oklahoma |
X |
X |
X |
|
|
Oregon |
|
X |
|
|
|
Pennsylvania |
X |
X |
X |
X |
|
Rhode Island |
X |
X (1) |
X (1), (6) |
|
X |
South Carolina |
X |
X |
X (3) |
|
|
South Dakota |
X |
X |
X |
|
|
Tennessee |
X |
X |
X |
X |
|
Texas |
X |
X |
X |
X |
|
Utah |
X |
X |
X |
|
|
Vermont |
X (1) |
X |
|
|
|
Virginia |
|
X |
X (7) |
|
|
Washington |
X |
X |
X (1), (6) |
X |
|
West Virginia |
X |
X |
X |
|
|
Wisconsin |
X |
X |
|
|
|
Wyoming |
X |
X (2) |
|
|
|
以上代號的相關解釋如下:
(1) 僅限於員工賠償保險欺詐
(2) 僅限於縱火罪
(3) 保險反欺詐局設立在州總律師事務所(State Attorney General’s Office)
(4) 僅限於汽車保險欺詐和員工賠償保險欺詐
(5) 僅限於汽車保險欺詐
(6) 保險反欺詐局設立在州勞工局(State Department of Labor)
(7) 保險反欺詐局設立在州警察局(State Police Office)