Frequently Asked Questions

What is the Insurance Fraud Bureau of Massachusetts?

The Insurance Fraud Bureau of Massachusetts (IFB) was created by law in 1990 to provide a means to investigate suspected cases of insurance fraud for criminal prosecution. The IFB is the only privately funded insurance fraud bureau in the country and is funded by the state’s automobile and workers’ compensation insurers through the Automobile Insurers Bureau (AIB) and the Workers’ Compensation Rating and Inspection Bureau (WCRIB). These two lines of insurance account for the majority of the cases handled by the IFB.

What types of cases are handled by the Insurance Fraud Bureau?

While automobile and workers’ compensation insurance account for the majority of the cases handled by the Insurance Fraud Bureau, the IFB is authorized to investigate all lines of suspected insurance fraud, and has investigated cases involving providers, property, disability, dental, marine and life insurance claims.

Who is required to report insurance fraud suspicions?

Generally, insurance company personnel who have reason to believe that a Massachusetts insurance transaction may be fraudulent, or who have knowledge that a fraudulent insurance transaction is about to take place, or has taken place in Massachusetts, are required by law to report the suspected fraud to the Insurance Fraud Bureau of Massachusetts within 30 days. Insurers and insurance personnel licensed under G.L.c. 175 and exempt from the licensing requirements of G.L.c 175 and others engaged in the business of insurance under the IFB enabling statute must comply with the mandated reporting provision.

Massachusetts St. 1990, c. 338 as amended by Section 99 of 398 Mass Acts 1991, Section 13 of 427 Mass Acts 1996, and Section 5 of 279 Mass Acts 2002

What constitutes fraud?

Fraudulent insurance transactions include but are not limited to, fraud and abuse of the system by attorneys, insurers, employers, medical providers, vocational rehabilitation providers, agents for attorneys or other service providers, claimants, or any other individuals or companies alleged to have engaged in unlawful acts of insurance fraud.

How does the IFB gather evidence?

In addition to information referred to the IFB, as provided by Massachusetts law the IFB may request the attendance and testimony of witnesses and the production of books and records relevant to an IFB investigation.

Does the IFB have an immunity provision?

As provided by Massachusetts law, in the absence of malice or bad faith, no insurer, member of the insurance fraud bureau or other person subject to the provisions of the reporting provision, shall be subject to civil liability for damages because of any statement, report or investigation made under the provision of the IFB statute.

What type of information does the IFB seek in a referral of alleged insurance fraud?

It is important that the referral is accompanied by sufficient documentation for the reviewer to make a decision whether to accept or decline a case for criminal investigation. Referrals that do not have sufficient information to make this determination are declined. Some cases may be declined solely for lack of sufficient documentation provided by the referral contact. For specifics on the referral process and the type of information sought, please refer to the IFB Referral Process and Procedures on the Referrals page of this website.

I’m a private citizen and have reported alleged suspicious insurance fraud activity to the IFB. What happens once I make the report?

The IFB tracks the suspected fraud and background information is gathered to verify the data submitted in the initial report of alleged fraud. If the IFB determines that another agency or insurance company is better suited to address the allegation, the information is forwarded to the agency or company. If the IFB initiates a criminal investigation information developed is part of a criminal investigation and may be referred to prosecutors and other law enforcement personnel.

I want to report another type of fraud or make a complaint. Who do I call?

• Identify Theft - call the Attorney General's Office Consumer Protection Division at 617.727.7780

• Welfare Fraud - call the Department of Transitional Assistance at 617.727.6950 or 1.800.FRAUD.99

• Unemployment Fraud - call the Executive Office of Labor and Workforce Development's Division of Unemployment Assistance at 1.800.354.9927

• MassHealth Fraud - call their hotline at 877.437.2830

• Medicare/Medicaid Fraud - call the Inspector General's Office at 1.800.HHS.TIPS

• Agent or Insurance Company complaints - call the Division of Insurance at 617.521.7794

• Workers' Compensation complaints about companies that do not have workers' compensation insurance coverage - call the Department of Industrial Accidents at 617.727.4900 or 877.965.2267 (877.96.LABOR)

• Attorney complaints - call the Board of Bar Overseers at 617.728.8750

• Physician complaints - call the Board of Registration of Medicine at 1.800.377.0550

• Physical Therapist or Chiropractor complaints - call the Division of Professional Licensure at 617.727.7406

• Body Shop complaints - call the Division of Standards at 617.727.3480

• Garaging complaints (for people with vehicles registered out of state who live in Massachusetts) - call the Registry of Motor Vehicles at 1.800.472.9829