Fraud News

Kansas Couple Claims Hospital Billing Scheme Widespread

A $90 million billing scheme found last year at a rural Missouri hospital spread to as many as 10 other hospitals, according to lawsuit filed by a couple from suburban Kansas City. James and Phyllis Shaffer are suing Jorge Perez …

Fraud News: Arson and Workers’ Comp Scam

North Carolina Family Charged With Insurance Fraud Officials have filed multiple charges against a North Carolina couple and their daughter in connection with two cases of arson at homes of people the wife knew. The N.C. State Bureau of Investigation …

Police: Sicily Gangsters Crushed Limbs in Insurance Fraud Scam

Sicilian gangsters dropped 25-kilo (55-pound) cast-iron weights on the limbs of drug addicts, alcoholics and other vulnerable people to obtain insurance payments for fake car accidents worth hundreds of thousands of euros, police said Wednesday after making 11 arrests in …

California Workers’ Comp Changes Helping System, Division Chief Says

California’s workers’ compensation system has undergone numerous changes since the implementation of the sweeping reforms that started in 2013 with Senate Bill 863. In the last few years medical provider fraud has been addressed by subsequent new laws, a plague …

Maryland Insurance Administration Reports on Fraud Fight Success

The Maryland Insurance Administration (MIA) continues to investigate and prosecute individuals and businesses for committing insurance fraud. Insurance fraud, one of the most costly crimes in the country, costs Maryland consumers money in the form of higher premiums. During the …

News: Arson, Healthcare Fraud Convictions and Cop Guilty of Insurance Fraud

North Texas Woman Heading to Prison for Burning Down House A Dallas, Texas, woman with a history of filing 31 insurance claims against a dozen companies got burned when one turned out to be arson. Genevieve Thompson was sentenced this …

Sandy Worker Charged With Seeking Bribes From Storm Victims

A Pennsylvania man working at a Superstorm Sandy housing recovery center in New Jersey solicited thousands of dollars in bribes and fictitious fees from storm victims by telling them he could expedite and/or increase the amount of money they received, …

Judge Denies NFL’s Request for an Investigator to Review Fraudulent Concussion Claims

A federal judge denied a request from the NFL on Wednesday to appoint a special investigator to look into what the league says is extensive fraudulent claims on the $1 billion concussion settlement. Judge Anita Brody wrote in her federal …

Fraud News: Workers’ Comp Scam, Staged Burglary and Carjacking

Texas Healthcare Provider Sentenced for Workers’ Comp Fraud A Deer Park, Texas, healthcare worker has been sentenced for falsifying workers’ compensation claims. A Travis County District Court sentenced Enrique Colon to three years deferred adjudication and ordered him to pay …

Four Ways that AI Enables Insurers to Differentiate

Insurance companies are generating more data than ever before, and the value of that data is rapidly increasing as new products are able to properly analyze and make use of it. Beyond traditional analytics, one way that data can deliver …