Fraud News

13 Indictments Handed Down in Massive California Workers’ Comp Fraud Scam

An investigation into what’s being called one of the largest cases of workers’ compensation healthcare insurance fraud in California Department of Insurance history led to 13 indictments announced today against seven Southern California-based medical professionals. This is the second wave …

Another Trial in Deadly Indiana House Blast Tied to Insurance Fraud

The half brother of a man serving two life sentences in a deadly 2012 Indianapolis house explosion that devastated a subdivision is facing a weekslong trial for his alleged role in the blast, which prosecutors say was a scheme to …

As Medical Provider Fraud Evolves so Should the Investigation

Healthcare fraud related financial losses amount to tens of billions of dollars each year, according to the National Health Care Anti-Fraud Association. As medical claims fraud in the property/casualty sector has evolved so too has the process to uncover it, …

CAIF’s 2015 Insurance Fraud Hall of Shame Inductees

Blown up houses, staged wrecks and bogus spine surgeries were among the damage inflicted by nine convicted scammers newly selected to the Insurance Fraud Hall of Shame. They were enshrined by the Coalition Against Insurance Fraud. The Hall of Shame …

Luxury Hotel Cleaning Firm Owners Working in Nevada, California Charged With $7M Fraud

The owners of a janitorial company serving luxury hotels in Southern California and Nevada are charged with running a $7 million workers’ compensation insurance and tax evasion scam, prosecutors announced Monday. Hyok “Steven” Kwon and Woo “Stephanie” Kwon were arrested …

Property Casualty Medical Fraud, Waste Rampant

Fraud continues to be problem for the insurance industry and medical fraud, in particular, is growing according to Andy Tolsma, solutions manager for the P&C Medical Fraud payments accuracy division for Verisk Health. Industrywide 10 percent of all P&C have …

Florida Man Arrested For Stealing Nearly $100,000 From Elderly Hurricane Sandy Victim

A Naples, Fla., man was arrested earlier this month for allegedly stealing two insurance claim payments totaling more than $96,000 from an elderly New Jersey business owner. The Florida Division of Insurance Fraud, which operates under the direction of Chief …

Fantasy Sports Sites Target of Lawsuit Citing Fraud

Fantasy sports companies FanDuel and DraftKings are coming under further pressure as a player in Kentucky accused them of negligence and fraud in a lawsuit. Adam Johnson, a daily fantasy player from Jefferson County, says in the suit that players …

California Awards $34 Million to Fight Workers’ Compensation Fraud

Insurance Commissioner Dave Jones has awarded $34.9 million in grants to 37 district attorney offices representing 42 counties in California to combat workers’ compensation insurance fraud. The grants are funded through employer assessments, and they support law enforcement efforts in …

South Florida Beloved by Retirees and Fraudsters

Psssst – Need a phony ID? A fraudulent tax refund? Insurance money from a sham car crash? Florida may have just what you’re looking for. Since the first settlers hacked their way into the mangrove tangles and drained much of …