Claims Frequent Questions

Insurance Fraud

Fighting Fraud

What is Amica's Special Investigative Unit (SIU)?

Amica's Special Investigative Unit (SIU) is an investigative and informational resource that performs a number of functions. The SIU team's work includes examining claims for fraud, sponsoring training sessions for law enforcement agencies, and conducting educational presentations for community organizations.

What constitutes insurance fraud?

There are a variety of methods used by people to commit insurance fraud. The most common methods include:

  • Staged automobile accidents
  • Fraudulent automobile thefts
  • Inflated losses
  • Fraudulent injury claims
  • Staged automobile accidents
  • Application fraud

Who commits insurance fraud?

People who commit insurance fraud come from all walks of life regardless of their individual economic status. Perpetrators of insurance fraud range from organized groups that often target innocent policyholders simply because they "look like" they have insurance to unscrupulous medical and legal providers to the "one-timer" who inflates a legitimate loss.

How serious is the problem?

Amica is one of 1,000 insurance companies that supports the National Insurance Crime Bureau (NICB), an organization that combats insurance fraud and vehicle theft. Our continued vigilance along with our cooperative efforts with agencies such as NICB and state insurance departments has resulted in a reduction in the payment of fraudulent claims.

Reporting Fraud

How can I detect an insurance fraud scheme?

Some common schemes are:

  • Staged automobile accidents

Without warning, the vehicle in front of you stops abruptly. Suddenly, you find yourself a responsible party for a rear-end collision. In some cases, this scenario may not have been an accident at all. In fact, your late model automobile may have attracted the attention of an insurance fraud criminal simply because you have auto insurance.

  • Solicitation of provider services

There have been reported instances of people who approach victims of authentic automobile accidents and solicit for the services of a particular medical or legal provider. In some states, this practice is unlawful.

  • Parking lot schemes

While attempting to back out of a parking space in a busy mall parking lot, another automobile stops and the driver courteously waves you out. As you begin to back out of the space, the other vehicle unexpectedly appears behind you and your car impacts with the side of the other automobile. The other driver denies waving you out and later makes property damage and injury claims against your policy.

  • "Jump-in" passenger accident scheme

Unfortunately, you are involved in an automobile accident. As you exchange documents, you notice that he is the only person in his automobile. Several weeks later you receive notice that the two other occupants of the vehicle are claiming injury.

How can I help stop insurance fraud and avoid becoming a victim?

Taking a few simple precautions can make a world of difference for you and your insurer. When an accident occurs, take these steps:

  • Call the police

Always call the police to the scene of an accident. They are trained to investigate accidents and file the necessary reports. Obtain the officer's name and report number for future reference. Activate your emergency flashers and move to a safe position until the arrival of the police. Your personal safety and that of others is of paramount importance at an accident scene

  • Document the accident scene

Whenever possible make quick notes to yourself: the time, date, location of the accident, and weather conditions; the name, address, date of birth, and telephone number of the other vehicle operator; names of all passengers in the other vehicle; description of the vehicle including the make, model, color, and registration number; name, address, and telephone number of witnesses.

  • Report accidents to your insurer

An accident should be reported to your insurance company as soon as possible to expedite the claims process.

  • Report schemes

If you are approached by a person who offers to include you in an insurance fraud scheme, notify the Amica SIU or your claims customer service representative.

How do I contact Amica's Fraudline or report an incident of fraud online?

Reducing insurance fraud is everyone's business. If you have information that may be helpful to Amica in combating insurance fraud, please call the Amica toll-free Fraudline at 1-877-407-3344 (available 24 hours a day) or complete our Online Fraud Report Form. All calls to the Amica Fraudline or the use of the Electronic Reporting Form are completely anonymous and confidential.