Insurance fraud is any deliberate deception committed against or by an insurance company, insurance agent, or consumer for the purpose of unjustified financial gain. This occurs during the process of buying, using, selling, and underwriting insurance.
The Insurance Fraud Prevention Division is a certified law enforcement division 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.
Mandatory Reporting of Suspected Fraud (Insurance Companies and Producers) - Neb. Rev. Stat. § 44-393
Insurance Fraud Act
- 44-6601 - Act
- 44-6602 - Purpose
- 44-6603 - Terms, defined
- 44-6604 - Fraudulent Insurance Acts; enumerated
- 44-6605 - Immunity from Civil Liability
- 44-6606 - Insurance Fraud Prevention Division; Powers and Duties; Public Inspection; Limitations; Fee
- 44-6607 - Civil Penalty; Costs; Section, How Construed
- 44-6608 - Act, How Construed.
Crimes and Punishments, Article 6, Offenses Involving Fraud
- 28-631 - Fraudulent Insurance Act; Penalties
Mission
The mission of the Insurance Fraud Prevention Division is 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.
Division Creation
The purpose of the Insurance Fraud Act is to confront the problem of insurance fraud in Nebraska by:
- Detecting insurance fraud
- Developing fraud prevention programs
- Investigating complaints of suspicious insurance activity
- Seeking prosecution of individuals committing insurance fraud
- Obtaining restitution of fraudulently obtained benefits
The ultimate goal is to reduce the amount of premium dollars used to pay fraudulent claims.
Insurance Company Fraud Contact Form
Please complete the form below and return it to the Nebraska Department of Insurance by March 1. This form may be submitted with your premium tax forms or mailed to P. O. Box 95087, Lincoln, NE 68509-5087; faxed to 402.742.8313; or emailed to DOI.FraudPrevention@nebraska.gov.
While the Nebraska Department of Insurance does not require the filing of a fraud plan, it recognizes the importance of reducing operational risk through fraud awareness. As such, the Department would like to provide some guidance to carriers who wish to strengthen their fraud controls by creating and implementing an internal fraud policy.
During a market conduct and/or a financial examination, the Nebraska Department of Insurance may request a carrier to provide a summary of its anti-fraud activities and the corresponding results. Pursuant to Neb. Rev. Stat. § 44-5906 (8)(a), an anti-fraud summary provided to the Department in the course of an examination conducted under the Insurers Examination Act shall be given confidential treatment by the Department shall not be subject to subpoena, shall not be made public by any person except to the extent provided in Neb. Rev. Stat. § 44-5906(7), and shall not be public records subject to disclosure under public records request outlined in Neb. Rev. Stat. § 84-712 to 84-712.09.
Anti-fraud policies outline specific procedures appropriate to the lines of insurance the carrier writes in Nebraska, with the following suggestions, at a minimum:
- Preventing, detecting, and investigating all forms of insurance fraud covering insurance that the carrier is authorized to write in Nebraska, including, but not limited to:
- Fraud involving the carrier's employees or agents;
- Claims fraud; and
- Security of the carrier's data processing systems
- Fraud involving the carrier's employees or agents;
- Educating appropriate employees on fraud prevention and detection, the Nebraska Mandatory Fraud Reporting Statute, Neb. Rev. Stat. § 44-393, and the carrier's anti-fraud policy.
- Informing policyholders about insurance fraud and how to prevent it
- Encouraging the reporting of suspected incidents of insurance fraud to the Insurance Fraud Prevention Division of the Nebraska Department of Insurance.
- Encouraging legal pursuit of restitution for financial loss caused by insurance fraud where appropriate.
- Designating or identifying the person responsible for oversight and implementation of the carrier's anti-fraud policy.
Nebraska Department of Insurance
Insurance Fraud Prevention Division
1526 K Street, Suite 200
Lincoln, NE 68509-5087
Telephone: 402-471-2201
Facsimile: 402-742-8313
Email: DOI.FraudPrevention@Nebraska.gov
Kimberly P. Church, SCLA, CIFI, AHFI
Fraud Division Chief
Telephone: 402-471-4999 & 402-471-8334
Email: Kimberly.Church@Nebraska.gov
John McGahan
Fraud Investigator
Telephone: 402-471-1842
Email: John.McGahan@Nebraska.gov
Charles P. Starr, SCLA, CIFI, AHFI
Fraud Investigator
Telephone: 402-471-8334
Email: Charles.Starr@Nebraska.gov
Robert Branch Jr.
Fraud Investigator
Telephone: 402-471-8333
Email: Robert.Branch@Nebraska.gov
Connie C. Drake
Administrative Assistant
Telephone: 402-471-8336
Email: Connie.Drake@Nebraska.gov
Videos
Fraud Court Action
In 2024, the Insurance Fraud Prevention Division received Suspected Fraud Referrals involving suspected violations of the Fraudulent Insurance Act 28-631 in 60 of the 93 Nebraska counties. Throughout the year, thirty-two arrest affidavits were submitted to the various county attorneys with a 100% felony filing rate. Below are samples of a few of those cases.
State v. Antonio Vallejos
Fraud Type: Past-Posting / Misrepresentation
Antonio Vallejos purchased an auto insurance policy that later lapsed for non‑payment and remained inactive for approximately five months. During this lapse period, Vallejos was involved in a motor vehicle accident. About an hour later, a payment was made online to reinstate the policy.
Vallejos then filed a liability claim and reported that the accident occurred after he reinstated his coverage. Evidence showed that photographs of the accident were taken before the reinstatement payment was made. Vallejos repeated this inaccurate timeline in several recorded interviews. The insurer confirmed the time the policy was accessed, paid for, and reinstated, while the photographs provided by the claimant clearly supported that the crash had already taken place.
The insurer denied the claim and, in accordance with state reporting requirements, submitted a suspected fraud referral to the Insurance Fraud Prevention Division. A full investigation by the Division verified that Vallejos misrepresented the timing of the accident and of his reinstatement payment, confirmed that consumer harm had occurred, and documented the financial exposure created for the insurer.
Vallejos later acknowledged that he made the reinstatement payment after the accident and admitted he had provided incorrect information. He was charged with a felony count of Insurance Fraud.
The Buffalo County Attorney offered Vallejos a plea agreement for an amended count of Attempted Insurance Fraud, a Class I misdemeanor. Vallejos pled No Contest and was sentenced to a $500 fine, $52 in court costs, 12 months of probation, and restitution of $1,000 to the Insurance Fraud Prevention Division and $1,000 to the claimant.
State v. Jason Kilburn
Fraud Type: Altered Insurance Document / Misrepresentation
Jason Kilburn appeared at the Douglas County Treasurer’s Office to register his vehicle, an action that requires valid automobile insurance under Nebraska law. During the registration process, Kilburn submitted an insurance card that appeared suspicious. The insurance company later confirmed the document was altered, and the Treasurer’s Office confiscated the card.
In compliance with Nebraska’s mandatory reporting statutes, the Treasurer’s Office submitted a suspected fraud referral to the Insurance Fraud Prevention Division. An investigation by the Division confirmed that Kilburn had been in possession of an altered insurance card and was not able to provide proof of valid financial responsibility. The findings were forwarded to the City of Omaha Prosecutor’s Office in an arrest affidavit. A warrant was issued, and Kilburn was subsequently taken into custody.
Kilburn was charged with Insurance Fraud, a Class I misdemeanor, and No Proof of Financial Responsibility, a Class IV misdemeanor. He later plead No Contest to an amended charge and was sentenced to a $500 fine and $52 in court costs.
State v. Trinisha Covington, Darien Sledge, and Kristopher Wayne
Fraud Type: Staged Accident / Misrepresentation
Trinisha Covington rented a U‑Haul truck and obtained insurance coverage for the rental. Shortly after leaving the dealership, she was involved in a collision and the police responded. The next day, Sledge contacted the insurer to file injury claims for himself and his passengers, including Darien Sledge and Kristopher Wayne. Covington also reported injuries. Over the following weeks, Sledge and Wayne made multiple calls to check the status of their claims.
The insurer hired an independent adjusting firm to investigate. During an interview, Covington admitted the collision was intentionally staged and implicated Wayne as arranging the plan, and that she was promised $2,000 for her participation. Covington confirmed that all involved parties were aware of the plan to stage the accident and file fraudulent bodily injury claims.
The insurer ultimately paid $4,494.94 for damage to the U‑Haul and $3,025.06 for the independent investigation, resulting in an actual loss of $7,520. Additional potential losses were avoided when the fraudulent injury and property‑damage claims were withdrawn. In compliance with state reporting requirements, the insurer submitted a suspected fraud referral to the Insurance Fraud Prevention Division.
A full investigation by the Division verified the staged nature of the crash, confirmed that misrepresentations had been made, and documented the financial impact of the attempted fraud. Covington later reaffirmed her original admission and acknowledged she had falsely represented herself as the driver of the U‑Haul at the time of the wreck.
All three individuals were criminally charged with felony Insurance Fraud, arrested and later plead to reduced charges with an order to pay restitution for their roles in the staged‑accident scheme. Final sentencing is pending.
