Insurance fraud is a felony.
Those who commit fraud are criminals
Easy money?
Hard time. Insurance fraud is a felony
5 years in state prison. $50,000 fine
The California Department
of Insurance Fraud Division together with district attorneys,
insurers and employers will investigate and prosecute persons
suspected of insurance fraud crimes.
What's
the big deal?
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The high cost
of doing business in California includes the high cost of
insurance fraud.
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"Some people
see nothing wrong in committing insurance fraud.
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"Insurance premiums
are too high. I deserve to get something back."
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"My employer's
insured; he can afford to cover this."
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"Insurance companies
are big organizations. What can it cost for one measly little
claim?"
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"Everybody does
it. What's the big deal?"
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The "BIG DEAL"
is that widespread insurance fraud ultimately translates into
higher premiums, which can result in elevated costs of goods
and services, and, ironically, layoffs, plant closures, and
out-of-state relocation.
Insurance fraud is a "growth
industry" costing Californians billions of dollars annually. Fraud
is about big money, and as long as that money is out there, someone
will be after it.
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If you are solicited
to
commit insurance fraud,
What may look like easy money
can lead to hard time behind bars.
Auto
Insurance Fraud
Every insured Californian
pays from $200 to $250 a year for inflated and fraudulent
auto claims (according to a Rand Corporation study).
Auto property fraud:
- False reports that parts of
vehicles have been damaged or lost
- False reports of vehicles stolen
or vandalized
Staged accidents:
- Creation of accidents that
exist only on paper
- Preplanned maneuvers that set
up an innocent party for a rearend collision
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Workers'
Compensation
Insurance Fraud
- From 10% to 30% of the
$10 billion in workers' compensation claims filed annually
in California are fraudulent, costing California businesses
and consumers a reported $1 billion to $3 billion per
year. Both medical mills and legal mills specialize in
recruiting so-called patients to bilk insurance carriers
for fraudulent or non-existent services.
- An employee knowingly files a
claim for an injury that did not occur at all, or for
an injury that did not occur on the job or in relation
to the job.
- An employee receives total temporary
disability benefits as a result of lying about outside
employment, re-employment, or their ability to work.
- A medical or legal provider bills
for services that were never provided.
- A medical or legal provider regularly
bills for more time than was actually spent seeing a client
or for more services than were actually provided.
- Kickbacks are given to insurance
representatives or employees as an inducement or reward
for the referral or settlement of a workers' compensation
claim.
Real Estate Fraud
- Report
suspected fraud involving recorded real estate documents
- The
California Legislature has placed an emphasis on fraud
against individuals where residences are in danger of,
or are in, foreclosure
Other Insurance Frauds
- False
health-related treatment claims
- Other
medical/legal provider claims
- False
life insurance claims
- Property
claims, including arson
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