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Anti-Fraud Efforts

Our Fight Against Insurance Fraud

Insurance fraud takes many forms, from inflating a claim to faking a disability. It occurs when individuals deceive an insurance company to collect money that isn't rightfully theirs.

Each year insurance fraud costs all types of insurance companies and their customers billions of dollars. In fact, the Coalition Against Insurance Fraud estimates that insurance fraud costs Americans at least $80 billion a year.

Northwestern Mutual is proactive in its effort to fight insurance fraud, and we are continually improving our procedures for prevention, detection and investigation of insurance fraud.

Passing on Costs, Passing on Savings

Each incident of fraud forces insurance companies to absorb unnecessary expenses. Those excess expenses can cause companies to raise premium rates. Or, in the case of mutual insurance companies, those expenses may result in lower dividend amounts for policyowners. Conversely, when fraud decreases, the money an insurance company saves can be passed on to its policyowners.

What Is Insurance Fraud?

According to The Coalition Against Insurance Fraud "Insurance fraud occurs when people deceive an insurance company or agent to collect money to which they are not entitled. Similarly, insurers and agents also can defraud customers, or even each other."

Some examples of insurance fraud include:

  • Intentionally failing to disclose significant medical conditions or other material facts on an insurance application.
  • Collecting disability benefits after returning to work.
  • A representative who bills a client personally without delivering a policy.
  • Unscrupulous health care providers who bill twice for the same service or for services not provided.
  • Attempting to collect life insurance benefits when the insured has not died.
  • A physician who assists a claimant by certifying an unfounded disability claim.
  • Taking a loan on a life insurance policy by an unauthorized individual.

What Is Being Done?

Northwestern Mutual has established a Special Investigations Unit (SIU) to investigate suspected fraud and to help local law enforcement officials prosecute offenders. The SIU works to detect, prevent and resolve all fraudulent activities perpetrated against Northwestern Mutual.

Additionally, many states actively prosecute insurance fraud through established fraud bureaus. We urge you to visit your state's department of insurance Web site for information about insurance fraud specific to your state. Also, the following organizations maintain Web sites that provide information about the problem of insurance fraud:

  • Coalition Against Insurance Fraud
  • National Fraud Information Center
  • National Healthcare Anti-Fraud Association
  • Health Insurance Association of America

What to do if you Suspect Fraud

If you suspect insurance fraud has been committed against Northwestern Mutual or Northwestern Long Term Care Insurance Company*, call our toll-free Fraud Detection Line at 1-877-607-2485 or email the SIU at antifraud@northwesternmutual.com. Or, contact your state's insurance fraud bureau.

Please provide the following information, if possible:

  • Name and address of the person or business.
  • The person's age
  • Name of the person's employer or business.
  • Details of the suspected fraud.
  • The person's relationship to Northwestern Mutual (employee, policyowner, insured, service provider, financial representative).
  • The type of policy in question (life, disability, group disability, long- term care, annuity).

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Copyright 2008, The Northwestern Mutual Life Insurance Company/Northwestern Mutual, Milwaukee, WI. All rights reserved. 720 East Wisconsin Avenue, Milwaukee, Wisconsin 53202-4797 - (414) 271-1444. The Northwestern Mutual Financial Network is a marketing name for the sales and distribution arm of The Northwestern Mutual Life Insurance Company, its affiliates and subsidiaries.