Getting Ahead of Insurance Fraud Protects Your Business
What is insurance fraud?
Insurance fraud is any intentional misrepresentation or concealment of a material fact made to obtain an insurance benefit.
It takes many forms: intentional car accidents, false workers compensation claims, and staged slip-and-fall incidents. Whether you call them scams, cons or rip-offs, they are all forms of insurance fraud. Every year, billions of dollars are lost to fraudulent schemes – harms that impact both individuals and businesses.
Fraud schemes are rising in sophistication – leveraging organized crime and generative AI. Travelers leads the industry in proactive detection and early intervention.
The problem
Insurance fraud is a growing threat to your bottom line
Insurance fraud is a financial burden that impacts consumers and businesses of all kinds. Fraud schemes are becoming increasingly sophisticated, often involving organized crime rings that leverage evolving technology – including generative AI – to evade detection.
The potential consequences are real: higher claims costs, inflated premiums, and direct financial losses that affect your business every day.
$308.6B+
Annual cost of insurance fraud in the U.S. 1
40%
Of fraud occurs in the P&C sector. 2
$44B
Estimated annual cost of workers compensation fraud. 3
$20B
Annual cost of staged accident fraud.4
Real results in action
How Travelers early fraud detection saves customers millions
The following case studies represent just a few insurance scams to watch out for. It also shows how Travelers Investigative Services (TIS) proactively identifies and stops fraud – protecting businesses and deterring future offenses.
Types of insurance fraud
400-person trip-and-fall ring in NYC
Scheme: 400 recruited "patients" staged trip-and-fall accidents on construction sites to receive unnecessary treatments and surgeries.
Action: TIS contributed to the industry-wide investigation with support from our desk and field investigators.
Outcome: Multiple lawyers and a doctor prosecuted by local law enforcement; unneeded surgeries halted.
Fraudulent payments stopped.
Durable medical equipment billing scheme
Scheme: A national DME provider billed claimants for unnecessary medical supplies through systematic duplicate billing.
Action: Multi-jurisdictional investigation uncovering the full scope of the operation.
Outcome: Travelers filed a civil complaint alleging fraud against the DME company.
$26M+ in fraudulent billings prevented.5
Featured video
Fighting Fraud: Staged Accidents
Fraud is everywhere and we are seeing a rise in staged accident schemes. Fraud doesn’t usually show up in isolation, it shows up in patterns. Learn the key steps from Travelers on how we fight fraud.
(SPEECH)
[MUSIC PLAYING]
(DESCRIPTION)
Travelers logo.
Text: Fighting Fraud: Staged Accidents
(Description)
A man appears on screen
Text: Pranay Mittal, Vice President of Investigative Services at Travelers
(SPEECH)
Hi, my name is Pranay Mittal and I lead investigative services at Travelers. Fraud is everywhere and it’s changing fast. Let me give you a real-world example. We are seeing a rise in staged accidents.
(DESCRIPTION)
Two cars getting into a car accident appear on the screen in black and white.
(SPEECH)
These might be auto accidents.
(DESCRIPTION)
The image on the screen is shifted by a red bold line from the car accident to two men at a construction site. One man is on the ground holding his stomach in pain, and the other is running over to check on him.
(SPEECH)
Construction site incidents.
(DESCRIPTION)
The image on the screen is shifted again by a red bold line to the right, bringing up a new third view that illustrates a man falling next to a “Caution, wet floor” sign.
(DESCRIPTION)
Back to Pranay Mittal speaking.
(SPEECH) Or even slip and fall claims that are intentionally created to trigger an insurance pay out. Here’s the tricky part. When you look at these claims one at a time, they often look legitimate. But fraud – doesn’t usually show up in isolation, it shows up in patterns. In one recent situation, we identified 14 different claims that shared very similar characteristics.
(DESCRIPTION)
Text: Short-term rental vehicles. A man typing on a laptop with three boxes showing documents are on the screen.
(DESCRIPTION)
Text: Nearly identical accident descriptions. Text: No medical treatment at the scene.
Text: Extensive treatment at the same medical facility. More documents, along with a triangle with an exclamation mark image show up on the screen illustrating caution or fraud.
(SPEECH)
Short-term rental vehicles, nearly identical accident descriptions, no medical treatment at the scene, followed by extensive treatment at the same medical facility.
(DESCRIPTION)
Back to Pranay Mittal speaking.
(SPEECH)
And, no single claim raised a red flag on its own.
(DESCRIPTION)
The screen moves to a red background with transactions and numbers showing, then moves to a woman investigating claims on a computer.
(SPEECH)
It was only through advanced analytics that we were able to connect the dots. Once identified our investigators stepped in. They reviewed claim details, medical records, public information and other data sources to build a complete picture. And when appropriate, we don’t just deny a claim, we may take legal action and shut down fraudulent operations altogether.
(DESCRIPTION)
The screen moves back to Pranay Mittal speaking.
(SPEECH)
This kind of response creates real deterrence in the marketplace, which helps protect our customers from insurance fraud.
(DESCRIPTION)
Travelers logo
Text: Learn more about how Travelers protects against insurance fraud. travl.rs/investigative-services (c) 2026, The Travelers Indemnity Company. All rights reserved. Travelers and the Travelers Umbrella logo are registered trademarks of the Travelers Indemnity Company in the U.S. and other countries. One Tower Square, Hartford, CT 06183. This material does not amend, or otherwise affect the provisions of any insurance policy issued by Travelers. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy provisions, and any applicable law. Availability of coverage referenced in this can depend on underwriting qualifications and state regulations.
Our approach
Staying ahead of scams with advanced fraud detection & experienced investigators
With one of the largest insurance fraud investigation capabilities in the industry, Travelers combines advanced detection technology with experienced investigators to proactively and precisely identify suspicious claims – enabling "always on" monitoring across all customers.
Advanced analytics for early detection
- Real-time, in-house monitoring across all claims from first notice of loss through resolution.
- AI and machine learning models process billions of data points to flag suspicious behavior – sometimes within hours of notice of loss.
- Industry-leading Organized Fraud Detector uncovers sophisticated fraud networks that evade traditional detection.
- AI can help investigators to accelerate fraud investigations and reach faster resolutions.
Specialized resources that intervene early
- All Claim professionals trained in fraud recognition.
- 300+ in-house investigators with specialization in organized schemes, medical fraud, fire, underwriting and cargo theft.
- Geographic specialization to identify and track regional fraud patterns and emerging schemes.
- Proactive Anti-Fraud Services to help customers build a strong internal anti-fraud culture.
Know your fraud hotspots
Industry-specific insurance fraud examples where Travelers' expertise makes the difference
Travelers has deep knowledge and experience across the fraud landscape, with specialization in the highest-risk sectors. Here are common fraud risks identified by our specialists.
Property management
- Staged accidents in common areas, stairwells, and parking lots.
- Fraudsters exploiting claims of negligent upkeep.
- Varying maintenance standards creating fraud opportunities.
Retail
- Slip-and-fall staging in high-traffic locations.
- Employee–customer collusion schemes.
- Oversight gaps from managing multiple locations.
Transportation
- Owner-operator misclassification schemes.
- Double-brokering scams and identity theft.
- Cargo theft and identity fraud targeting fleet operations.
- Documentation challenges with a mobile workforce.
Our track record
Travelers insurance fraud prevention results
Insurance fraud is a financial burden that impacts consumers and businesses of all kinds. Fraud schemes are becoming increasingly sophisticated, often involving organized crime rings that leverage evolving technology – including generative AI – to evade detection.
The consequences are real: higher claims costs, inflated premiums and direct financial losses that affect your business every day.
3X
More workers compensation fraud investigations are being performed in high-risk industries.7
19%
Annual increase in detecting organized fraud leads over the past five years, including a record 30 proactive fraud litigation filings in 2025.8
$3M+
Slip, trip and fall fraudulent payments prevented in 2024.9
Industry leadership & fraud prevention
A key influencer in the industry response to insurance fraud
Travelers employees hold senior and board-level positions with regional and national organizations – including the National Insurance Crime Bureau (NICB) and the Coalition Against Insurance Fraud (CAIF) – to shape the industry's collective response to fraud.
Report Insurance Fraud
Available 24 hours a day, every day.
If you suspect that fraud has been committed, you can report it confidentially here.*
National insurance crime bureau - 800.TEL.NICB
While we will make every effort to protect your identity, please note that in some instances – such as the need for conducting a thorough investigation or because of compliance with legal requirements – confidentiality may not be guaranteed. If you prefer, you may consider submitting your report anonymously.
*Travelers’ Fraud Line is available 24 hours a day, 7 days a week. The Fraud Line is the appropriate place to report fraud. Please note that we do not monitor or respond to reports sent to Travelers employees’ personal email, phone or social media accounts.
Related services
Investigative services
Understand how our investigative unit works to prevent fraud and loss.
Sources
1,2 The Impact of Insurance Fraud on the U.S. Economy. Coalition Against Insurance Fraud (2022).
3 Eyes of the World - Using Data & AI to Fight Workers’ Compensation Insurance Fraud - Workers Compensation 2025 Focus Report. Conning p.3,9,10.
4 Insurance Information Institute, 2025.
5 Travelers Claim Data. 2024.
6 Travelers Claim Data for New York Metropolitan area, Jan. 1, 2025 - Dec. 31, 2025.
7 Travelers Workers Compensation Claim Data: Opportunistic investigations five-year average (2020-2024). (Metrics considering successful Investigation when the claim closed as fully controverted or partially controverted).
8 Travelers Claim Data: 19% increase is the five-year CAGR (2020-2024) and Affirmative Litigation TIS Legal Data, Jan. 1, 2025 - Dec. 31, 2025.
9 Travelers General Liability Claim data, 2024.