The Nebraska Insurance Fraud Prevention Division was created in 1995 with the mission to confront the problem of insurance fraud in Nebraska by prevention, investigation, and prosecution of fraudulent insurance acts in an effort to reduce the amount of premium dollars used to pay fraudulent claims. The Fraud Division is staffed by one criminal analyst and four full-time certified law enforcement investigators whose duties and responsibilities are to conduct investigations independent of, or in conjunction with, law enforcement agencies when the division has cause to believe that an act of insurance fraud has been or is currently being, committed.

During the calendar year of 2023, the division received 980 Suspected fraud referrals totaling approximately $14 million dollars in financial loss exposure. Of those referrals 733 (80%) were related to property casualty claims; 153 (16%) were related to Life Health claims and 33 (3%) were related to agent or internal fraud. The division encourages companies to record their financial exposure when submitting a suspected fraud referral. This would allow us to provide a more accurately reflection the loss exposure in Nebraska.

In 2023, Nebraska saw referrals from 57 out of its 93 counties, with 77% involving five counties surrounding the Lincoln and Omaha area. Forty four cases making their way through the court system, securing a conviction with zero dismissals. The courts ordered $106,920. in restitution for seventeen of the cases involving an actual financial loss. Twenty additional cases were submitted for prosecution.

The first half of 2024, the division has continued to see an increase in suspected fraud referrals. From January 1st to July 1st the division received 552 referrals and sixteen cases have been sent for prosecution. During the second half of the year the division expects to exceed to 1000 mark for the first time. These numbers reflect how insurance fraud continues to be a substantial risk to insures and a financial threat to consumers while attempting to secure reasonable premiums. Fighting against insurance fraud requires dedicated efforts from all involved in the business of insurance.

Every insurance company, agent, solicitor, or broker, and every person or party having knowledge of a violation or who suspects insurance fraud may have or is occurring within Nebraska is obligated to report violations under Nebraska Revised Statute 44-393.

https://ofrs.naic.org/

In addition, the Nebraska Producer Licensing Act mandates that any agent or insurer who terminates an agent for violations of acts defined under 44-4059 is obligated to submit a For Cause Termination to the Department of Insurance within 30 days.