What Is Clean Sheeting?
Clean sheeting is the fraudulent act of purchasing a life insurance policy without disclosing a pre-existing terminal illness or disease. This type of fraud is often done with the knowledge of the purchaser and the agent.
Understanding Clean Sheeting
In cases of clean sheeting, the policy is often sold shortly after it is purchased in a viatical settlement, but the money received is a lot less than what a legitimate settlement would yield. This is because there is a higher chance that the fraudulent policy will be rescinded. This type of fraud provides huge gains for the person who buys out the purchaser because they are able to buy the policy at a large discount, somewhere around 10% of the policy's face value.
- Clean sheeting is the fraudulent practice of purchasing a life insurance policy without disclosing a pre-existing terminal illness or disease.
- The policy's purchaser can claim the insured amount once the person with a pre-existing terminal illness dies.
- In clean sheeting, the policy's seller benefits from the lump sum payment received for the policy while the purchaser benefits from the heavily discounted price of the policy.
- Some states allow insurance companies to include a contestability clause of one or two years that allows them to refuse to pay out if the insured's death occurs during this time frame.
To Tell the Truth
Life insurance companies go to great lengths to make sure they are charging enough for the risks of each client. Thus, when applying for a life policy, a series of questions must be completed, usually online or by mail, that ask about smoking, blood pressure, dangerous hobbies, and family history, to name a few areas of inquiry.
A follow-up phone call asks the same questions then usually adds dozens of others, often with the language "have you" or "have you ever been." It's easy to forget (or lie) about an old injury or some other health problem, but the insurer will remember. Any omissions or inconsistencies with medical or other records may result in a denied claim or the return of the premiums paid.
An unscrupulous agent may suggest that there's no harm in telling a few white lies in this process. The agent will collect their commissions and move on. Meanwhile, those inaccuracies will remain and if you make a claim in the contestable period, the records will be gone over with a fine-tooth comb.
In insurance, an incontestability clause is a clause in most life insurance policies that prevents the provider from voiding coverage due to a misstatement by the insured after a specific amount of time has passed. A typical incontestability clause specifies that a contract will not be voidable after two or three years due to a misstatement.
Some states allow insurance companies to include a provision, stating that a one- or two-year contestability period must be completed within the lifetime of the insured. In this scenario, a life insurance company can refuse to pay benefits if a policyholder was so unwell when they applied for coverage that they died before the contestability period was over. Some states also allow the insurance company to void a policy if deliberate fraud is proven.
Example of Clean Sheeting
In 2001, a California couple was sentenced to 40 months in jail for clean sheeting. Lonnie Harwell and Penni Alexander-Harwell recruited terminally ill patients, primarily those that suffered from HIV/AIDS, to buy insurance policies without disclosing vital facts related to their health. The policies had low values, ranging from between $25,000 to $150,000, and were issued to individuals between 15-50 years of age. Most importantly, they did not require physical examination or bloodwork as prior conditions for issue.
The Harwells paid a percentage of the claimed amount as well as the premiums. The patients benefited from receiving the lump sum payments. After the patient's death, the Harwells claimed the insurance amount. They benefited from "stacking" several such policies together.
The Harwells had established a network for referrals of such patients with a $1,000 referral benefit. The California Department of Insurance (CDI) alleged that insurance companies issued more than $11.6 million worth of policies to such individuals.
How widespread is insurance fraud?
Insurance fraud that's not medical-related is estimated to cost insurers more than $40 billion dollars per year, according to the National Association of Insurance Commissioners. This ultimately costs the average U.S. family between $400 and $700 per year in premiums, the group said.
What are the potential consequences of participating in clean sheeting or other fraud?
Lonnie Harwell and Penni Alexander-Harwell were sentenced to 40 months in jail in 2001 for their clean sheeting scheme. The California couple recruited terminally ill patients to buy insurance policies without disclosing vital facts related to their health. The Harwells paid a percentage of the claimed amount as well as the premiums. The patients benefited from receiving the lump sum payments. After the patient's death, the Harwells claimed the insurance amount.