Insurance Fraud & Workers Compensation Fraud

What is Insurance Fraud? Insurance Fraud is when a person or people provide false information to an insurance company in order to gain something of value that he or she would not have received if the truth had been told‚ they’ve committed insurance fraud. Here are some examples of Insurance Fraud Investigations:

 

Stolen Vehicle

There are two ways that criminals perpetrate the stolen vehicle insurance fraud scam. When a car owner sells his car to a body shop to be disassembled for parts and then reports the car as stolen. The second most common way criminals commit car fraud is to sell the car to an overseas buyer, make the transaction without any paperwork and then they ship the car internationally before reporting the vehicle stolen.

 

Vehicle Accidents

In some cases, the driver and victim are the only ones in on the scheme. In other cases, the driver, victim, insurance investigators and even some of the bystanders that give statements are in on the fraud. The value of the vehicles is greatly inflated and the insurance payoff is for two totaled vehicles at the end.

Vehicle Damage

Some will report a small vehicle accident, get an estimate for damages, collect the insurance check and then not get the vehicle fixed. This is the most common form of vehicle insurance fraud. The people doing it see no harm in it, but the money the insurance company pay out comes from the premiums that are paid by other customers.

Health Insurance Billing Fraud

Health care professionals will at times get in on the insurance fraud act. One form is for health care providers to bill health insurance companies a higher than normal fee for a standard procedure, or to bill for services that were never received.

Staged Home Fires

One of the most common form of homeowners insurance fraud is the staged fire or act of vandalism. The homeowner either removes important family items before the fraud takes place, or the homeowner makes sure the insurance company knows the value of the expensive items and then has them destroyed.

Storm Fraud

There are people that will take advantage of any situation including a major storm. A form of fraud that happens in the wake of major storms is homeowners will either enhance the storm damage to get more of a settlement, or the homeowner will take advantage of how busy the insurance company is and call in a claim even if there was no storm damage.

Fake Death

This form of insurance fraud is common. There are those that will take out a life insurance policy on themselves and place their spouse as the beneficiary. After several months, the  fakes their death and the spouse is paid the death benefit.

Renter’s Insurance

Those who rent may take out a renter’s insurance policy to cover the cost of their possessions. Before moving or when financial times get bad, the insured will sell their possessions and then report them stolen to collect the insurance money.

Workers Compensation Fraud

There are many ways people commit workers compensation fraud:

  1. Employee get injured off the job, but say they’re hurt at work so their workers comp covers the medical bills.
  2. A worker has a minor injury on the job, but insists their back is seriously hurt. By saying this, it allows the worker to collect more workers compensation money and allows them to stay off the job longer than they would if they did not inflate their injuries.
  3. Some simply invent injuries because they are tough to disprove, and are easier to get away with.
  4. There are times where a worker may have an old injury that never healed and will claim they just got hurt on the job.
  5. When a worker stays at home longer after an injury and pretending to be disabled even though they’ve had enough time to heal is called Malingering.

Workers compensation insurance helps to protect those who are hurt on the job. This valued employee benefit pays for medical expenses, lost wages and other expenses while a worker heals.

 

Most employers and employees are very honest. Only a small number scam this coverage for personal profit, but the damage they cause is enormous. Workers comp fraud is a large crime in America today. Tens of billions of dollars in false claims and unpaid premiums are stolen every year. Scams are forcing premiums higher draining business profits and costing honest workers their pay and jobs.

Are you or your company a victim of insurance fraud or workers compensation fraud, are you in danger of losing a significant amount of money? Our private investigators can help you gather the evidence you need for court. Our private investigators are qualified, experienced and highly dedicated to you and your company. Call us today. If you have suspicions, contact us. We are readily available to assist you in putting this unfortunate situation behind you.

Call us today at (855) 828-8280 or (786) 426-7387 for a FREE Consultation.