Publications

The Louisiana Department of Insurance (LDI) has finalized amendments to Rule 13, Special Assessment; Creation of Dedicated Fund Account, following the passage of 2024's Senate Bill 369 to update how special assessment fees collected from insurers are allocated to support the state’s insurance fraud enforcement and awareness efforts. Under the new framework, $30,000 will be withheld annually for fee collection and Department operations, and $187,000 will be directed to insurance fraud detection, investigation, and public outreach. Remaining funds are distributed 75% to the State Police Insurance Fraud Investigation Unit, 15% to the Department of Justice’s Insurance Fraud Support Unit, and 10% to the Department of Insurance’s Section of Insurance Fraud. Any excess funds at year‑end will be refunded to insurers on a pro rata basis. This change clarifies the allocation process and strengthens the state’s ability to support coordinated insurance fraud efforts.

The Coalition will attend NAIC discussion as they consider a revised privacy protections model act. The Coalition Against Insurance Fraud will attend the NAIC Privacy Protections (H) Working Group call today as regulators review public comments on proposed Article V revisions to the Privacy of Consumer Financial and Health Information Regulation (Model #672), specifically related to disclosure to nonaffiliated third parties. This effort is part of the NAIC’s broader plan to use state insurance privacy protections regarding the collection, data ownership and use rights, and disclosure of information gathered in insurance transactions to draft a new or revised Privacy Protections Model Act. The discussion follows ongoing consideration over whether insurers should shift from an opt-out to an opt-in standard for non-servicing uses of consumer data, like marketing and third-party sharing. Consumer advocates favor opt-in, while insurers warn of operational challenges and uneven treatment compared to other financial sectors. Fraud prevention remains a critical point of agreement, with regulators and industry leaders aligned that data used for fraud detection, law enforcement, and regulatory compliance must remain exempt from any opt-out rights. This issue directly supports the Coalition’s legislative priorities to balance stronger consumer protections with the responsible use of data and technology for fraud prevention. Maintaining antifraud exemptions ensures SIUs and other fraud fighters can continue leveraging analytics and cross-agency collaboration to stop scams and protect policyholders. The Coalition will monitor today’s deliberations to ensure privacy reforms advance without weakening the data-driven fight against insurance fraud.

Coalition helps kick off FIFEC with a reminder that in the age of AI, strong cases still rely on investigative fundamentals. Last week, the Coalition Against Insurance Fraud helped open the 33rd Annual Florida Insurance Fraud Education Committee (FIFEC) Conference by reminding attendees that while AI is transforming fraud detection, strong cases still rely on a "back to the basics" reliance on fundamental investigative principles. Brent Walker, the Coalition’s Director of Government Relations, highlighted national efforts to get ahead of AI’s impact in insurance fraud investigations, including the Coalition’s AI survey with PwC, outreach to major AI companies, and continued advocacy for balancing consumer protections while protecting the anti-fraud use of data and technology. “AI use in fraud detection is just another lead and it still must be documented, supported by evidence, and grounded in investigative basics,” Walker told the audience of over 875 attendees from 30 states and Puerto Rico. FIFEC Chairman Edward Lopez echoed this sentiment in his closing remarks, stating, “Human interaction and face-to-face moments ignite ideas, reveal emerging trends, uncover patterns, and create partnerships. That’s the magic of attending FIFEC.” FIFEC Executive Vice Chair Anthony Parker added, “Personal interaction with such a diverse audience helps build and strengthen the vital relationships that are so important to our SIU work.” As FIFEC looks to its 34th year in 2026, the Coalition commends its all-volunteer board, who once again delivered a nationally respected training experience to educate, connect, and empower the insurance fraud-fighting community.

 FIFEC Executive Vice Chair Anthony Parker and Chairman Edward Lopez (left to right)

The Iowa Department of Insurance and Financial Services (DIFS) is urging residents to stay alert for scams and fraudulent contractors in the aftermath of severe storms and high winds in parts of the state. DFIS says scammers often exploit disaster situations to deceive and steal from affected communities. Following a disaster, residents may need to hire contractors for repairs. It's crucial to ensure these contractors are registered with the Iowa Department of Inspections, Appeals, & Licensing. Contractors cannot assess your property for insurance claims, so property owners should work directly with their insurance agents. DFIS says common scams include contractor fraud, where dishonest contractors, known as storm chasers, vanish after receiving payment without completing repairs. To avoid this, verify contractor credentials and avoid large upfront payments. Report any suspicious activity to the Iowa Attorney General’s Office at (888) 777-4590.

AICPA survey shows 37% of Americans face fraud post-disaster. The survey by the Harris Poll for the American Institute of CPAs (AICPA) highlights identity theft, government assistance fraud and loan scams among the common types of fraud experienced. It details the types of fraud experienced: identity theft at 14%; government assistance fraud at 11%; loan scams at 11%; vendor fraud at 10%; utility scams at 10%; charity fraud at 10%; insurance fraud at 10%; and contractor fraud at 8%.  The ACIPA survey also reveals that 48% of Americans lack personal insurance coverage for fraud-related losses during disaster recovery.  Among business owners, 64% have insurance protection against fraud-related losses, while 32% do not, with 4% unsure. 

Monterey County DA’s Office launches new fraud reporting tip line. Fraud affects everyone, whether it’s higher insurance rates, lost wages or even threats to homes. That’s why the Monterey County District Attorney’s Office has formed specialized teams focused on fighting fraud and protecting local residents from financial harm. These dedicated units target some of the most common — and costly — types of fraud that hit close to home: auto insurance scams, fake healthcare and disability claims, workers’ compensation fraud and real estate scams. The Workers’ Compensation Fraud Unit investigates people who try to cheat the system, including dishonest doctors, lawyers, employers and applicants. These scams drive up costs for employers and take resources away from honest workers. A prosecutor and two investigators work full-time to stop this type of fraud and hold offenders accountable.

Police issue urgent warning to drivers as officers crack down on new car scam. Motorists have been given a stark warning about a major clampdown on crash-for-cash scams across England. The City of London Police's Insurance Fraud Enforcement Department (IFED) has carried out a string of raids throughout London. The police action forms part of a focused investigation into suspected 'crash-for-cash' schemes connected to moped workshops. Officers executed five search warrants at two homes and four garages, situated in East and South London. The coordinated raids received backing from various partners: the Metropolitan Police Service (MPS) Motorcycle Safety Team, Home Office Immigration Enforcement, the Insurance Fraud Bureau (IFB), and the Driver and Vehicle Standards Agency (DVSA).

Jaime Huiracocha and Victor Murillo were arraigned Tuesday night in Queens Criminal Court on a criminal complaint charging them with insurance fraud and other related crimes that went viral last year. The allegations: Huiracocha planned the collisions by luring participants with promises of cash payouts while Murillo drove the vehicles involved in the crashes. The participants were told to send photos of the crash scene to a woman and directed to go to a different medical clinic in Glendale after the crash. In exchange, the individuals were allegedly promised thousands of dollars. There were four vehicles present, including a silver Honda Civic and a Red Kia. Huiracocha told the participants what vehicles to occupy, and the designated drivers had headphones to communicate with one another. All the vehicles entered the Belt Parkway and drove until the victim’s vehicle was identified. The victim, Aphasia Natasha, was driving northbound in the left lane of the Belt Parkway. The fraudsters cut in front of Natasha’s vehicle and then came to a stop, forcing her to step on her brakes to avoid a collision. The Honda quickly backed into Natasha’s vehicle, damaging both her car and the Honda. The occupants of the Honda held up what appeared to be a plastic tarp in the rear window area of the car that partially obstructed the victim driver’s view inside the Honda. Then Murillo and another occupant of the Honda allegedly switched seats. The dashcam footage would later go viral, and help to bring awareness to the crime. 

North Carolina charges Burke County resident with insurance fraud. Dylan Scott Smith was arrested and charged with one count of insurance fraud and two counts of obtaining property by false pretense. According to prosecutors: Smith filed an accident claim with Chubb Insurance, obtaining $15,041 for damage caused to his 2019 Honda Accord. Investigators determined this was a repeat claim Smith had previously collected from in 2023. Smith also allegedly used fraudulently obtained bank information from SunCoast General Insurance to make a premium payment to Chubb Insurance in the amount of $1,950. The incident occurred on May 28, 2024. Smith was arrested on July 1 and released on a $10,000 secured bond. He appeared in Burke County District Court on July 21.

New Bedford drug testing lab pleads guilty to $4.7M in MassHealth insurance fraud. Optimum Labs Inc. and owner William Owens of New Bedford, once named the city’s Small Business of the Year, have pleaded guilty to scamming MassHealth out of $4.7 million in false insurance claims. The crimes he is pleading guilty to: Optimum Labs was a toxicology company in New Bedford offering drug testing, including pre-employment or court-ordered testing, and walk-in services. The bulk of Optimum Labs’ business came from sober homes, testing urine to make sure residents remained sober. Between 2017 and 2022, the lab repeatedly billed MassHealth for this service. However, testing urine for sobriety is not medically necessary and not covered by MassHealth. In many cases the tests were also not ordered by doctors, nurses or other authorized prescribers. During this time, the lab also referred some of its urine testing to two other labs, in Rhode Island and Vermont, in exchange for a percentage of insurance reimbursements, a violation of the state’s anti-kickback law. The AG’s office said the company, which is no longer in business, cannot repay the $4.7 million it owes to the state, and was ordered by the court to pay $830,000 in restitution. Owens was sentenced to two consecutive 2.5-year sentences in the Suffolk County House of Correction, which was suspended for a probationary period of three years. While on probation, cannot have any involvement with MassHealth billing, sober homes and laboratories. He must also complete 150 hours per year of community service.  

City of Westminster Sues Ex-Cop for Insurance Fraud. Former officer Nicole Brown is being sued by the city for allegedly faking a disability and collecting over $600,000 in workers' compensation payments.  The allegations: Brown claimed she was no longer able to work after suffering an on-duty head injury in March 2022. But while Brown was on full disability, the city says she was living “an active lifestyle,” visiting Disneyland, going skiing, dancing at the Stagecoach country music festival, and running 5K races. The city alleges that Brown committed fraud with the help of her stepfather, Peter Gregory Schuman, who is a licensed attorney specializing in workers' compensation matters. On July 9, Westminster filed suit against Brown. Officials are hoping to recoup all of the money paid. In addition to the civil suit, Brown has been charged with 15 felony counts by the Orange County District Attorney’s Office. She faces up to 22 years in prison if convicted. Her stepfather has been charged with conspiring and soliciting someone in an unlawful act, which carries a sentence of up to eight years. 

Former Baltimore County insurance agent, financial advisor charged with obstruction of justice. Michael C. Okolo has been charged with obstruction of justice and fabricating physical evidence, marking the fourth set of criminal charges filed against him since September 2024. The charges against him: These new charges stem from a September 2024 indictment by a Baltimore County grand jury, which charged Okolo with felony theft and insurance fraud. In that case, it is alleged that Okolo received two partially completed checks from a client in 2016 for a life insurance policy and an annuity contract but instead made the checks payable to his business, deposited them, and used the funds for personal and business expenses. Okolo fabricated a “letter of instruction” that he then provided to his attorney. This letter, purportedly from a client and dated Feb. 20, 2016, allegedly authorized Okolo to deposit two checks totaling $36,500 into his business account while he sought insurance and annuity products for the client. The letter was disclosed to the state on May 1 to be used as evidence in an upcoming trial. Prosecutors contend the letter was fabricated, and the client neither wrote, authorized, nor signed it. The signature on the fabricated letter was allegedly cut and pasted by Okolo without authorization from a genuine letter the client sent to Okolo in April 2017, more than a year after the date on the alleged fabricated instruction. Furthermore, in a May 2017 letter to the Maryland Insurance Administration, Okolo had reportedly denied the existence of any written documentation for the client’s alleged instruction to deposit the checks into his accounts.
 

In June 2023, Matthew McGrath reported the theft of his truck, attached plow, salt spreader, and crack filler from an apartment complex. But GPS monitoring from a prior unrelated case revealed McGrath’s plot to reap insurance benefits by claiming the items were stolen. McGrath was found guilty of two charges, insurance fraud and attempted grand theft, by the Cuyahoga County Common Pleas Court in August 2023. He appealed the convictions, arguing that the evidence brought against him by the state wasn’t sufficient for a guilty verdict.

• Register to receive information about the GIFS and attend their Report to the Nations conducted in June of each year by using this link to establish your membership log-in credentials.
• Once you are approved, you are then invited to create your own professional profile on the Global Insurnace Fraud Directory. This is the first-ever world-wide listing of insurance fraud professionals. Only viewable by registered members of the GIFS, the Directory is open to all anti-fraud professionals including insurers, regulators, law enforcement and professional service providers.
• This year's Global Summit will be in Toronto Canada from October 19-22. Attendance at the Summit is by invitation only. If you are interested in being a part of this, or future,  Global Summits you are welcome to submit an application. Summit sponsorships are still available which include 2 complimentary registrations. To find out more about becoming a sponsor just send an email to director@globalfraud.org.