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Insurance fraud: Tips to keep your business safe

August 15, 2022
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Producing a fraudulent certificate of insurance is a serious offense—in fact, it’s a class 5 felony. 

Luckily, if you know the tell-tale signs of an inauthentic certificate, It’s nearly impossible for fraud to go undetected.

Everyday insurance fraud

Picture this: A subcontractor forged a certificate of insurance to obtain work from a Denver construction company. 

How did they do it? Putting aside the familiar hammer and nails, they grabbed old-fashioned tools like paper, tape and whiteout.

The original document used to create the fraudulent version includes valid and verifiable information. The subcontractor edited out this information, either digitally or manually, and created a fraudulent version by inputting their own details on the new, inauthentic, and illegal version.

The subcontractor can make repeated photocopies of these versions to get the desired effect. With their new and illegal version, they can pass copies or electronic copies to unsuspecting businesses.

Luckily, the construction company's general manager is savvy and informed about identifying signs of insurance fraud. The manager brought the suspicious-looking certificate to the attention of the company’s insurance agent, who then contacted Pinnacol.

Following our Special Investigations Unit's (SIU) inquiry, the subcontractor pleaded guilty to forgery. As a felony, the subcontractor is sentenced to jail and three years of probation.

Businesses associated with insurance fraud risk being liable

Without valid certificates of insurance, your company could be liable for work-related subcontractor injuries. This makes it crucial for employers to be vigilant and always watch for fraud.

 

How to identify the signs of a fraudulent certificate

1. Examine the overall look of the certificate

An authentic certificate should look clean — with neat, crisp formatting lines and font. If it looks like a photocopy, it likely means you did not receive an original certificate. A third-party may have altered and photocopied an original certificate, providing you with an altered inaccurate version.

2. Take note of the print date 

The print date on a certificate is located on the top right of the document. If the print date falls outside of the policy's effective and expiration dates by more than three days, you may have a fraudulent version on your hands.

 

3. Ensure font consistency 

The certificate's font type and size should always be consistent in the following fields:

  1. Producer
  2. Insured
  3. Date
  4. Policy Number
  5. Policy Effective
  6. Policy Expiration
  7. Certificate Holder

  

4. Check for misspellings 

Check the certificate for spelling and grammar errors. Forgers often spell Pinnacol as “Pinnacle” or use “Pinnacle Insurance” rather than “Pinnacol Assurance.” 

 

5. Are the lines straight and clear?

If any of the printed fields are crooked, it’s a sign that the certificate was altered. Also be aware of faint lines, another indicator of fraud. 

 

6. Examine the policy number

When Pinnacol is the carrier, the policy number will consist of exactly seven digits.

 

Test your insurance fraud skills  

See if you can spot the signs of fraud on this sample certificate

When you think you’ve spotted all the red flags, review the accompanying answer key to see how you did. 

 

So, what can do your business do about fraudulent certificates of insurance? 

If you suspect a fraudulent certificate:

First, verify coverage by visiting the WC Coverage Verification Website found through the CDLE main page.

  1. Search by either employer's name, FEIN, or their address.
  2. You can adjust the coverage date to a date in the past, if necessary.
  3. Once you have found a matching result, click directly on their name in the results list. This will take you to the next page, where there will be details of the policy number and insurance coverage provider.

Pro tip: If you would like to know if a policy were to cancel, you can opt to be notified via email in real time.  

Here's how to do it: From the page showing the policy number and insurance coverage provider (step 3 above), in the upper-right corner, you can Track Policy. In the event their policy cancels for any reason, you will receive an email notifying you of the change.

If you are still unsure if you have a fraudulent certificate, our Customer Service Team would be happy to assist. We are available 8 a.m.-5 p.m., Monday-Friday, at 303.361.4000. En español: 303.361.4005

Finally, report the possible insurance fraud to Pinnacol either via phone or online.

If Pinnacol is listed as the carrier on the certificate in question, call our SIU team at 303.361.4000 or contact us online to report fraud.


Pinnacol Assurance assumes no responsibility for management or control of customer safety activities. Please ensure your business meets the requirements of all federal, state, and local laws, regulations, or ordinances related to workplace safety.

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