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# InsuranceFraud.org

## Sitemaps

- [XML Sitemap](https://insurancefraud.org/sitemap.xml): Contains all public & indexable URLs for this website.

## Posts

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## Pages

- [Homepage](https://insurancefraud.org/)
- [State Insurance Fraud Bureaus](https://insurancefraud.org/state-insurance-fraud-bureaus/) - Fraud bureaus are state agencies that detect, investigate and prevent insurance scams. All bureaus invite citizens to phone in hot tips about suspected scams. Some bureaus also let you report scams from their websites. Most fraud bureaus deal with all kinds of insurance fraud, but some investigate only certain kinds, such as workers compensation or
- [Advocacy Efforts](https://insurancefraud.org/advocacy-efforts/) - The Coalition Against Insurance Fraud leads nationwide legislative and regulatory advocacy efforts to advance anti-fraud protections across all lines of insurance. Guided by our annual legislative priorities, the Coalition works with state and federal lawmakers, regulators, and stakeholders to support impactful anti-fraud bills, laws and regulations. Our advocacy includes submitting letters of support or opposition,
- [Officers, Directors & Board](https://insurancefraud.org/officers-directors-board/) - Board of Directors AIGPaul Sylvester, Regional Head of Fraud & Recovery – North America General InsuranceJacqueline Nguyen, SIU Manager Allstate Insurance CompanyRamine Poureshmenantalemy, SIU Operations ManagerAl Capparella, SIU Design Sr Manager American Council on Consumer InterestsBrenda J. Cude, Ph.D, Professor EmeritaJennifer Breitenbach, Assistant to the Editor American Family InsuranceBetsy Gabbei, Senior Manager, SIUJosh Moe, Manager
- [About the Coalition](https://insurancefraud.org/about-us/) - Learn about the Coalition Against Insurance Fraud: our mission, history, leadership, and the principles guiding our work to fight fraud.
- [Members](https://insurancefraud.org/coalition-members/) - *Coalition Board Members are shown in bold. Academic Colorado State University Global CampusFranklin UniversityIndiana University of PennsylvaniaMarshall University, Center for Business & Economic ResearchSouthern Utah UniversityUniversity of Wisconsin-Oshkosh Associate 4WARNAdvantage InvestigationsAgeroAllied Universal Becker & CompanyCarpe DataCarpenters/Contractors Cooperation Committee, IncCCC Intelligent Solutions CDI CanvassingCenter for Contract Compliance (CCC)Charlee.aiClearspeedCommand InvestigationsContego CostFirst Corp.CoventBridgeDelta GroupDemotech, Inc.Diligence International Group, LLCEquifaxEthos
- [Join Us](https://insurancefraud.org/join-us/) - Join the 320+ Organizations Fighting Insurance Fraud Membership is open to organizations, not individuals. Ready to apply? Is your organization a Coalition member? Log in to access your benefits. Apply Now Member Login Who We Are Since 1993, the Coalition Against Insurance Fraud has united insurers, government agencies, consumers, and industry partners around one mission:
- [Join Us - ARCHIVED](https://insurancefraud.org/join-the-coalition-archived/)
- [Staff](https://insurancefraud.org/staff/) - For Media Inquiries - Please click here.
- [Webinar & FraudPod Library](https://insurancefraud.org/podcasts-videos/) - Download PowerPoint 2024 Webinars 2023 Webinars 2022 Webinars 2021 Webinars FraudPod: Episode 8 - James Rumph, Nationwide Insurance FraudPod: Episode 7 - Celeste Dodson, IASIU President Property Casualty 360 - Insurance Speak FraudPod: Episode 6 - Curtis Graham, Deputy Motorist Course FraudPod: Episode 5 - Celebrating 30 Years FraudPod: Episode 4 - Workers' Compensation Fraud
- [Public Interest Members](https://insurancefraud.org/public-interest-members/) - To learn more about each of our Public Interest partners, click on the logos below. We value the ongoing support of our Coalition partners as we grow stronger together. Please Note: By clicking on a Public Interest Member logo link, you will be directed to a website outside of www.insurancefraud.org. Outside organizations may hold views
- [Association Members](https://insurancefraud.org/association-members/) - Meet Our Association MembersExplore the organizations represented below. Each logo highlights a member making a meaningful contribution to combating insurance fraud. We are grateful for the dedicated support of our Association Members, whose commitment strengthens our collective efforts and progress. Please Note: Clicking on any of the logos will take you to an external website
- [Committees & Task Forces](https://insurancefraud.org/committees/) - Coalition committees and task forces include a diverse mix of insurers, government leaders, public interest groups, associations, associates, and law firms. Coalition members may join one or more of these groups to drive a positive impact in the fight against insurance fraud. To join a committee or task force, contact the Coalition at memberservice@insurancefraud.org. For
- [Associate Members](https://insurancefraud.org/associatemembers/) - Explore our Associate Members below, each logo offers a window into an organization making a real impact across the insurance fraud landscape. We deeply appreciate the steadfast support of our committed Associate Members, which fuels our collective growth. If you are inspired to join, please contact Associate Member Task Force Chair Frank Sztuk at fsztuk@deltagroup.net
- [Government Affairs Network](https://insurancefraud.org/government-affairs-network/) - Summary The Coalition is working to strengthen its Government Affairs Network to support timely communication regarding legislative developments, advocacy initiatives, and other antifraud issues impacting the industry. To support that mission, the Government Affairs Committee has created a Government Affairs Engagement Survey to collect contact information for individuals within member organizations involved in government affairs,
- [Government & Law](https://insurancefraud.org/government-law/) - State Regulations, Statutes, and Pending Legislation
- [Amicus Program](https://insurancefraud.org/amicus-program/) - The anti-fraud voice to America’s courts The Coalition files amicus curiae (“friend of the court”) briefs as a voice to federal and state courts on key anti-fraud issues. These decisions set national precedents. Important decisions greatly strengthen or damage how we combat fraud. Outcomes directly affect consumers and insurers alike. Over more than 20 years
- [Victim Impact Resources](https://insurancefraud.org/victim-impact-statement-program/) - Summary The Coalition Against Insurance Fraud’s Victim Impact resource equips victims of insurance fraud with the tools and resources needed to craft meaningful and effective victim impact letters. These letters help courts better understand the full financial, emotional, and societal consequences of insurance fraud, supporting more informed sentencing and stronger accountability. Through guidelines and sample
- [Workers' Compensation Resources](https://insurancefraud.org/workers-comp-resources/) - Note: The Coalition provides a collection of resources to help members address workers’ compensation fraud. From case studies to investigative tools and best practices, these materials offer practical insights to support prevention and detection efforts. Members are free to use these tools, and if you would like any resource aside from the reports co-branded for
- [Member Testimonials](https://insurancefraud.org/membertestimonials/) - Change the opening lines to say: The fight against insurance fraud requires strong, united partnerships. Explore firsthand accounts from our valued members detailing their experiences working alongside the Coalition. Their insights highlight the impact of our collective efforts and why organizations across the country trust us to lead the charge in outreach, advocacy, and research.
- [Fraud Stats](https://insurancefraud.org/fraud-stats/)
- [Newsroom](https://insurancefraud.org/newsroom/) - Stay informed on the latest insurance fraud news, trends, and analysis. The Coalition Against Insurance Fraud provides daily updates to help you understand the changing landscape of insurance crime. Use this hub to access the nation's most comprehensive fraud resources.
- [Fraud: Why Care?](https://insurancefraud.org/fraud-why-care/) - Part 1 of 3 - A Glimpse Into The World Of Insurance Fraud Part 2 of 3 - The Coalition's Role In Fighting Insurance Fraud Part 3 of 3 - Consumer Attitudes Are Changing
- [Report Fraud](https://insurancefraud.org/report-fraud/) - The Coalition Against Insurance Fraud does not accept reports of insurance fraud or scams directly. You can use this list of trusted organizations to report suspicious activity. These resources help you take action, which protects everyone. To report insurance fraud directly to a state fraud bureau, please click here to use the National Association of
- [Long Term Care Fraud Resources](https://insurancefraud.org/long-term-care/) - As the demand for long-term care services continues to rise with an aging population, fraud schemes are evolving in both scale and sophistication. Long-term care (LTC) fraud is an emerging threat that jeopardizes care for some of society’s most vulnerable individuals. The impact extends beyond higher costs for insurers and policyholders. LTC fraud also erodes
- [Sign up for Member Communications ](https://insurancefraud.org/news-publications/) - Sign up to receive email updates on fraud schemes, emerging trends, legislative developments, expert analysis, webinar announcements, and membership meeting information directly from our team. Sign Up
- [Membership Guide](https://insurancefraud.org/membership-guide/) - Our StorySince its founding in 1993, the Coalition has brought together a powerful alliance starting with just 16 organizations representing consumers, insurers and government agencies, all united by a shared mission to combat insurance fraud. What began as a bold collaboration has grown into a network of more than 300 organizations working together to make
- [Publications](https://insurancefraud.org/publications/) - Be informed, updated, in the know. The latest fraud news, trends and analysis from the Coalition. It’s all here with insightful daily updates. America’s largest hub on the pulse of insurance fraud.
- [Videos & Infographics](https://insurancefraud.org/videos-infographics/) - The Coalition provides a complete “toolkit” to help members promote their anti-fraud message. Videos and infographics may even be customized with your logo and URL. Contact info@insurancefraud.org. Infographics Click image to view full infographic Click here to download LTC Protect Your Loved One Infographic Front & Back Click here to download LTC Fraud Schemes Infographic
- [State Laws Table](https://insurancefraud.org/government-law/key-state-laws/) - Key State Laws Click here to print.
- [Member Alerts](https://insurancefraud.org/member-alerts/) - The Coalition Against Insurance Fraud’s Member Alerts page features timely, relevant updates shared with our membership on topics that matter most. Alerts may include emerging trends, noteworthy cases, research findings, events, tools, and other developments that help members stay informed, prepared, and proactive. View 2025 Member Alert Archives 9/15/2025 Social Media Competition 8/20/2025 Insurer Infiltration
- [2025 International Fraud Awareness Week Consumer Resources](https://insurancefraud.org/2025-international-fraud-awareness-week-resources/) - The Coalition is celebrating International Fraud Awareness Week by providing new downloadable resources to support your education and outreach. Download PDFs What’s Fraud Awareness Week and Why Should You Care? Insurance Fraud Warning Signs How to Report Fraud The Future of Fraud is Here: Why AI and Digital Scams Are Your Next Big Threat Test
- [Law Firm Members](https://insurancefraud.org/law-firm-members/) - Explore our current Law Firm Members below, click on any logo to discover more about each organization. We sincerely appreciate the unwavering support of our elite Coalition Law Firm members, which fuels our growth and also the success of our Amicus Curiae program. Please Note: By clicking on any of the Law Firm logo links
- [Legislative Priorities](https://insurancefraud.org/legislative-priorities/) - The Coalition Against Insurance Fraud develops legislative priorities, annually, through its Government Affairs Committee, in collaboration with other committees and member input. Approved by the Executive Committee and circulated to the membership, these priorities: align with the Coalition's goal to combat all forms of insurance fraud, reduce costs for consumers and insurers, and promote fairness
- [2024 Midyear Membership Meeting](https://insurancefraud.org/2024-midyear-meeting-overview/) - We are absolutely thrilled to announce the successful conclusion of the 2024 Coalition Against Insurance Fraud event in Kansas City, MO! The event saw an outstanding turnout, with over 100 dedicated members and their organizations coming together to share their extensive expertise on insurance fraud matters. This gathering proved to be an incredible opportunity for
- [2024 Annual Membership Meeting](https://insurancefraud.org/2024-annual-membership-meeting/) - We are absolutely delighted to announce the successful conclusion of the 2024 Coalition Against Insurance Fraud Annual Meeting, held in the historic and vibrant Arlington, Virginia, at the Renaissance Arlington Capital View Hotel! This year’s event was nothing short of extraordinary, with an incredible 184 attendees representing 113 organizations, all united by a shared commitment
- [2025 Midyear Membership Meeting](https://insurancefraud.org/2025-midyear-membership-meeting-2/) - A Powerful Gathering at the 2025 Coalition Midyear Meeting in Chicago Earlier this week, the Coalition Against Insurance Fraud hosted one of its most dynamic and well-attended Midyear Meetings in history, held June 9 and 10 at the iconic Palmer House Hotel in Chicago, IL. With the city’s historic backdrop adding to the energy, 158
- [2025 Annual Membership Meeting](https://insurancefraud.org/2025-annual-membership-meeting-2/) - We are pleased share that the 2025 Coalition Against Insurance Fraud Annual Meeting concluded successfully in Arlington, Virginia, at the Renaissance Arlington Capital View Hotel. Nearly 180 members attended on December 2–3, including 37 first-time attendees and 7 new members since June, one of our strongest turnouts yet. The meeting provided a great opportunity for
- [Coalition Midyear Membership Meeting](https://insurancefraud.org/coalition-annual-membership-meeting/)
- [Committees & Task Force In-Person Schedule](https://insurancefraud.org/committees-task-force-in-person-schedule/) - Tuesday, December 2, 2025 Meeting Schedule All meetings will be held in the Studio C and Studio D meeting rooms on the third floor of the Renaissance Capital View Hotel. If you have any questions before the upcoming meetings, feel free to reach out to the co-chairs. *All times are EST. Meeting Schedule Task Force
- [Member Login](https://insurancefraud.org/login/) - If your company is a member of the Coalition, you have full access to all of our resources. To get started, simply create your profile—it only takes a few minutes. Once completed, you’ll unlock everything the Coalition has to offer. If you are not associated with a member company, you can still access the consumer resources
- [<br>Member Only Content](https://insurancefraud.org/member-only-content/) - If your company is a member of the Coalition, you have full access to all of our resources. To get started, simply create your profile—it only takes a few minutes. Once completed, you’ll unlock everything the Coalition has to offer. If you are not associated with a member company, you can still access the consumer resources
- [Scam Alerts](https://insurancefraud.org/scam-alerts/)
- [Long Term Care Scams](https://insurancefraud.org/long-term-care-scams/)
- [Long Term Care Fraud Schemes](https://insurancefraud.org/long-term-care-fraud-schemes/) - Common LTC Fraud Schemes Targeting Vulnerable Seniors Place Holder - Waiting for Michelle's Opening Paragraph. Place Holder - Waiting for Michelle's Opening Paragraph. Place Holder - Waiting for Michelle's Opening Paragraph. Place Holder - Waiting for Michelle Opening Paragraph. Place Holder - Waiting for Michelle Opening Paragraph. Place Holder - Waiting for Michelle Opening Paragraph.
- [Media Request Form](https://insurancefraud.org/media-request-form/) - The Coalition Against Insurance Fraud welcomes media inquiries and takes great pride in serving as a resource for members of the media. Areas of Expertise: Insurance fraud trends and statistics Emerging fraud schemes and technologies Anti-fraud and consumer protection best practices Legislative and regulatory developments To protect the reputation of the organization and trust of
- [2024 International Fraud Awareness Week](https://insurancefraud.org/international-fraud-awareness/) - Take A Glimpse Into The World Of Insurance Fraud – Do you want the right words to explain insurance fraud to your family and friends? Share this!A Glimpse Into The World Of Insurance Fraud - (Length: 5m:23s) Learn About Changing Consumer Attitudes – As technology use for fraud schemes is ramping up, so are the consumer numbers who think
- [2025 International Fraud Awareness Week](https://insurancefraud.org/2025-international-fraud-awareness-week/) - In preparation for International Fraud Awareness Week, the Coalition is providing new downloadable resources to support member education and outreach. These include clear, accessible written materials and engaging, thought-provoking graphics for social media. Members are welcome to edit the Word documents as needed to align with their organization’s messaging and communication goals. Download Word Documents
- [Arrests and Convictions](https://insurancefraud.org/arrests-and-convictions/)
- [Research Studies & Reports](https://insurancefraud.org/research/) - The Coalition is the nation’s leader in conducting research to measure the multiple important aspects of insurance fraud. Our research helps decision-makers and consumers better understand the extent of insurance fraud, its root causes, and how to better combat this crime. • 2016 tech study• 2014 tech study• 2012 tech study • 2007 Four Faces•
- [Insurer Infiltration](https://insurancefraud.org/insurer-infiltration/) - Note: The Coalition provides a collection of resources to help members address workers’ compensation fraud. From case studies to investigative tools and best practices, these materials offer practical insights to support prevention and detection efforts. Members are free to use these tools, and if you would like any resource aside from the reports co-branded for
- [Meeting Registration](https://insurancefraud.org/2025-annual-membership-meeting/) - Need a guest room? Reserve your guest room at the Coalition's discounted rate of $219 by November 9!
- [2025 Midyear Membership Meeting](https://insurancefraud.org/2025-midyear-membership-meeting-3/) - A Powerful Gathering at the 2025 Coalition Midyear Meeting in Chicago Earlier this week, the Coalition Against Insurance Fraud hosted one of its most dynamic and well-attended Midyear Meetings in history, held June 9 and 10 at the iconic Palmer House Hotel in Chicago, IL. With the city’s historic backdrop adding to the energy, 158
- [News Updates](https://insurancefraud.org/newsupdates/) - Be informed, updated, in the know. The latest fraud news, trends and analysis from the Coalition. It’s all here with insightful daily updates. America’s largest hub on the pulse of insurance fraud.
- [Key Word Search](https://insurancefraud.org/key-word-search/) - Search insurance fraud state regulations, statutes, and pending legislation below.
- [Model Acts](https://insurancefraud.org/model-acts/) - The Coalition develops model acts to guide pursuing state laws to better shield consumers and insurers from scams. Dozens of states have adopted Coalition models in whole or part. Questions? Email Brent Walker or call 301-821-6145. Insurance Fraud Act Most-inclusive state model insurance fraud law ever developed. Defines fraud — including attempted fraud, and fraud by insurer
- [Upcoming Membership Meetings](https://insurancefraud.org/upcoming-membership-meetings/) - Registration Opens Early September - Official Date Will Be Announced In Fraud News Weekly in August.
- [Money Laundering](https://insurancefraud.org/money-laundering/) - Note: Please scroll down to view all information provided on this page. Money Laundering Through Insurance Products What Is Money Laundering? Money laundering is the process of making illegally obtained funds (dirty money) appear legal and legitimate (clean money). Criminals accomplish this by disguising the origins of where they got the funds, changing the form
- [Scattered Spider Alert](https://insurancefraud.org/scattered-spider-alert/) - This alert may extend beyond your immediate area of responsibility. As a heads-up, we strongly encourage you to share it with colleagues in technology, cybersecurity, staff training, and communications. Their involvement will be essential in helping your organization prepare for and respond to potential risks. Scattered Spider Poses Growing Cyber Threat to Insurance Industry Insurance
- [KNOW BEFORE YOU GO](https://insurancefraud.org/know-before-you-go/) - ‘Know Before You Go’ Venue Transportation Event In the Area Venue Palmer House17 E. Monroe St.Chicago, IL 60603 312.726.7500 Visit the Hotel's Website Map/Directions The Palmer House offers an ideal location in the heart of downtown Chicago Theatre District. Many exciting attractions are just a short stroll or cab ride away. Walk to The Art
- [Media Requests](https://insurancefraud.org/media-requests/)
- [TEST: Upcoming Meetings](https://insurancefraud.org/test-upcoming-meetings-2/) - Join your colleagues at ​the Coalition’s Midyear Meeting where subject matter experts from across the fraud-fighting industry will dig into new trends and cutting-edge topics. Start planning your trip! (A full agenda is coming soon) Monday, June 9 In-person Committee and Task Force Meetings: (See link for times/locations) Welcome Reception (light Hors d'oeuvres and cocktails): 5:00pm-7:00pm Tuesday,
- [Upcoming Meetings](https://insurancefraud.org/upcoming-meetings/)
- [Four Faces - 2017](https://insurancefraud.org/four-faces-2017/) - Consumer attitude study: Americans concerned about fraud, yet ethics mixed Nearly four of five adult Americans say they’re concerned about insurance fraud to varying degrees, says Four Faces of Insurance Fraud, the Coalition’s 2017 national survey of consumer attitudes. The survey of 2,733 consumers builds on Four Faces studies in 1997 and 2007. The study also places
- [Contact us](https://insurancefraud.org/contact-us/) - Join the Coalition: Get Connected The Coalition is the national hub for the anti-fraud community. We unite diverse organizations to support the fraud fight … share data and trends … and expand vital fraud fighting connections. Insurers, consumer groups, government agencies and other partners know the Coalition is a valuable investment. Nearly 300 organizations are members. Interested
- [Fraud Tracker](https://insurancefraud.org/fraud-tracker/)
- [Test Redirect](https://insurancefraud.org/test-delay-redirect/)
- [Sponsorship Opportunities](https://insurancefraud.org/meeting-sponsorship/) - The Coalition thanks you for your interest in sponsoring our signature Midyear and/or Annual Meeting event! All sponsors will be recognized on our promotional materials, at the start and end of the meeting and most especially during our 15-minute break period. We will have static or rotating slides thanking our sponsors and include your company
- [Membership Application](https://insurancefraud.org/membership-application/)
- [YourMembership](https://insurancefraud.org/yourmembership/) - >
- [DEI Statement](https://insurancefraud.org/dei-statement/) - STATEMENT ON DIVERSITY, EQUITY AND INCLUSION The Coalition recognizes both the profession and manner of fighting against insurance fraud have changed dramatically since our founding in 1993. We equally acknowledge and embrace the fact our nation continues to change as well. The Coalition is committed to being a leader in shaping and improving the fight
- [01 – Sample Page](https://insurancefraud.org/sample-page/) - H2. Text Block Sed ut perspiciatis unde omnis iste natus error sit voluptatem accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo. Nemo enim ipsam voluptatem quia voluptas sit aspernatur aut odit aut fugit, sed quia consequuntur magni dolores eos qui ratione voluptatem
- [Interactive Map](https://insurancefraud.org/interactive-map/)
- [2022 Annual Meeting Registration](https://insurancefraud.org/2022-annual-meeting-registration/) - All Coalition members are invited to attend and participate in our Annual and Midyear Meetings. Complimentary attendance is offered to 2 attendees per member. Due to an increased number of requests to send additional attendees, the Coalition's Executive Committee has approved a registration fee of $750 for each additional attendee. If you have any questions, please
- [Test Page](https://insurancefraud.org/test-page-2/) - Testing
- [2022 Midyear Meeting](https://insurancefraud.org/2022-midyear-meeting-registration/) - All Coalition members are invited to attend and participate in our Annual and Midyear Meetings. Complimentary attendance is offered to 2 attendees per member. Due to an increased number of requests to send additional attendees, the Coalition's Executive Committee has approved a registration fee of $750 for each additional attendee. If you have any questions, please
- [2021 IASIU Meeting Registration](https://insurancefraud.org/2021-iasiu-meeting-registration/)
- [2021 Annual Meeting Registration](https://insurancefraud.org/2021-annual-meeting-registration/)
- [Testing](https://insurancefraud.org/testing/)
- [Testing CSV](https://insurancefraud.org/testing-csv/)
- [regulations](https://insurancefraud.org/regulations/)
- [](https://insurancefraud.org/slip-and-trip/) - Slip-and-trip shakedown bilks innocent businesses Bryan Duncan spearheaded a sprawling $31.7-million slip-and-fall ring in New York City. It was one of the largest such insurance shakedowns ever. Call Duncan chairman of the hoard. The bloated crime ring spread like spackle: Duncan helped recruit hundreds of low-income New Yorkers — off the streets and from homeless shelters —
- [](https://insurancefraud.org/fake-poisoning/) - Food fight: Fake poisoning extorts insurance payouts Fraudster falsely claims was sickened by spoiled food at restaurants, food stores Jacqueline Masse started a food fight. She lost. Masse was reeled in as the court’s fresh catch-of-the-day on the fraud entrée menu. The Hampton, N.H. woman trolled restaurants and grocery stores for nearly four years. Masse falsely
- [](https://insurancefraud.org/son-has-mother-shot/) - Rapper’s death riff: Son has mother shot for life insurance Rising rapper wanted fast cash to flaunt bling-based lifestyle for fans Fame would flow to youthful Chicago rapper Qaw’mane Wilson. He just needed to boost his rise to the top as “Young QC” by flashing over-the-top wealth and bling to his fans. Meanwhile, Wilson’s mother
- [](https://insurancefraud.org/surgery-glam-scam-exposed/) - Beauty surgery glam scam exposed as skin-deep Doc disguises cosmetic surgery as medically urgent in $50-million insurance theft plot Israel packed celebrity skin doctor David Morrow back to the U.S. to serve 20 years of federal jail time. He’d sliced and diced his way to an attempted $50-million defrauding of insurers for glam-boosting nose jobs and
- [](https://insurancefraud.org/patients-falsely-diagnosed/) - Arthritis anxiety: Patients falsely diagnosed, treated Doctor inflicts painful arthritis chemo, injections on healthy patients Patients descended into despair and depression when Dr. Jorge Zamora-Quezada told them they suffered from degenerative arthritis that could force them into a sad life of increasing pain and limited mobility. Except for one problem. Many patients didn’t even have
- [](https://insurancefraud.org/starves-disabled-man/) - Caregiver starves disabled man in Medicare con Denies life-giving medicine and meals, then launches deadly coverup Carl DeBrodie was born with a severe developmental disability that left him unable to even speak. Yet he was a gentle soul with a ready smile — and a yen for coleslaw. The Kansas City, Mo.-area man lived in
- [](https://insurancefraud.org/moguls-bribery-plot-short-circuits/) - Wired: Insurance mogul’s bribery plot short-circuits Empire implodes when insurance commissioner is wired, records bribery bellyflop Dubious insurance and investment dealings made Greg Lindberg a billionaire. The self-made mogul then tried to bribe North Carolina’s insurance commissioner to cool off regulatory heat on his shaky operations. Instead, commissioner Mike Causey went to the FBI, and
- [](https://insurancefraud.org/sex-relapse-and-fraud-in-unsober-sober-homes/) - Sex, relapse and fraud in unsober sober homes Addicted patients given drugs, sexually abused in $175-million rehab ripoff Christopher Bathum styled himself as the “Rehab Mogul” — a healing guru with an almost cult-like following among his addicted residents. He built a fast-growing network of sober homes called Community Recovery, mostly in the Los Angeles
- [](https://insurancefraud.org/fakes-combat-heroics-to-steal-disability/) - Sham Navy SEAL fakes combat heroics to steal disability Claimed trauma and Silver Star medal, yet never served in military What a hero, Richard Meleski bleated about his harrowing combat exploits as a Navy SEAL in Beirut, Lebanon. “18 hr hostile takeover. Became POW, during this tour. Beaten, shot, head injury, tortured. Hospitalized in Germany
- [](https://insurancefraud.org/binge-burning-false-flooding-wreck-homes-in-texas/) - Binge burning, false flooding wreck homes in Texas Rundown old homes over-insured and ruined to inflate insurance payouts If serial home arson is an addiction, Patrick Wayne Bronnon belonged in rehab. He unleashed a frenetic $1.7-million billing bender of torched and flooded homes with a blast radius that spread through southeast Texas. The Port Arthur
- [04 - Fraud Tracker](https://insurancefraud.org/04-fraud-tracker/)
- [Advanced Search](https://insurancefraud.org/advanced-search/) - Easily search the entire website for specific information about insurance fraud. Enter any or all of the fields below. Note that many information sources are available only to employees of member-organizations who are registered for special access.
- [Your Profile](https://insurancefraud.org/your-profile/) - [pmpro_member_profile_edit]
- [Employee Registration](https://insurancefraud.org/employee-registration/)
- [03 - Regulations, Statutes, Legislation](https://insurancefraud.org/03-regulationsstatuteslegislation/)
- [Thank you!](https://insurancefraud.org/thank-you/) - Thank you for registering for our upcoming meeting!
- [Thank you for your Registration!](https://insurancefraud.org/thank-you-for-your-registration/) - Thanks for your Registration! We will get in touch with you shortly.
- [05-Private Page](https://insurancefraud.org/05-private-page/)

## Legal Pages

- [Privacy Policy](https://insurancefraud.org/wpautoterms/online-privacy-policy/) - As part of our commitment to protecting your privacy, this statement is designed to provide you with information regarding how the Coalition Against Insurance Fraud may use — and process — the information you share when you use the Insurancefraud.org website. Information is also collected when you communicate with us or utilize any

## Publications

- [Fraud News Weekly (FNW) Friday, June 12, 2026](https://insurancefraud.org/publications/fraud-news-weekly-fnw-friday-june-12-2026/) - Fraud News Weekly (FNW) - Friday, June 12, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly (FNW) Friday, June 5, 2026](https://insurancefraud.org/publications/fraud-news-weekly-fnw-friday-june-5-2026/) - Fraud News Weekly (FNW) - Friday, June 5, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly (FNW) Friday, May 29, 2026](https://insurancefraud.org/publications/fraud-news-weekly-fnw-friday-may-29-2026/) - ͏ ‌ Fraud News Weekly (FNW) - Friday, May 29, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - Friday, May 22, 2026](https://insurancefraud.org/publications/fraud-news-weekly-fnw-friday-may-22-2026/) - Fraud News Weekly (FNW) - Friday, May 22, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - Friday, May 15, 2026](https://insurancefraud.org/publications/fraud-news-weekly-friday-may-15-2026/) - Fraud News Weekly - Friday, May 15, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - Friday, May 8, 2026](https://insurancefraud.org/publications/fraud-news-weekly-fnw-may-8-2026/) - Fraud News Weekly - Friday, May 8, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - Friday, May, 1, 2026](https://insurancefraud.org/publications/fraud-news-weekly-friday-may-1-2026/) - Fraud News Weekly - Friday, May 1, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - Friday, April 24, 2026](https://insurancefraud.org/publications/fraud-news-weekly-friday-april-24-2026/) - Fraud News Weekly (FNW) - Friday, April 24, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - Friday, April 17, 2026](https://insurancefraud.org/publications/fraud-news-weekly-friday-april-17-2026/) - Fraud News Weekly (FNW) - Friday, April 17, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - April 3, 2026](https://insurancefraud.org/publications/fraud-news-weekly-april-3-2026/) - Fraud News Weekly (FNW) Friday, April 3, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - April 10, 2026](https://insurancefraud.org/publications/fraud-news-weekly-april-10-2026/) - Fraud News Weekly (FNW) Friday, April 10, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - March 27, 2026](https://insurancefraud.org/publications/fraud-news-weekly-march-27-2026/) - Fraud News Weekly (FNW) - Friday, March 27, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - March 20, 2026](https://insurancefraud.org/publications/fraud-news-weekly-march-20-2026/) - Fraud News Weekly (FNW) - Friday, March 20, 2026 ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌ ͏ ‌
- [Fraud News Weekly - March 13, 2026](https://insurancefraud.org/publications/fraud-news-weekly-march-13-2026/) - Fraud News Weekly - Friday, March 13, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - February 27, 2026](https://insurancefraud.org/publications/fraud-news-weekly-february-27-2026/) - Fraud News Weekly (FNW) - Friday, February 27, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - March 6, 2026](https://insurancefraud.org/publications/fraud-news-weekly-march-6-2026/) - Fraud News Weekly (FNW) - March 6, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - February 20, 2026](https://insurancefraud.org/publications/fraud-news-weekly-february-20-2026/) - Fraud News Weekly (FNW) - February 20, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - February 13, 2026](https://insurancefraud.org/publications/fraud-news-weekly-february-13-2026/) - Fraud News Weekly (FNW) Friday, February 13, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - February 6, 2026](https://insurancefraud.org/publications/fraud-news-weekly-february-6-2026/) - Fraud News Weekly (FNW) - February 6, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - January 30, 2026](https://insurancefraud.org/publications/fraud-news-weekly-january-30-2026/) - Fraud News Weekly (FNW) Friday, January 30, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - January 23, 2026](https://insurancefraud.org/publications/fraud-news-weekly-january-23-2026/) - Fraud News Weekly (FNW) Friday, January, 23, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - January 16, 2026](https://insurancefraud.org/publications/fraud-news-weekly-january-16-2026/) - Fraud News Weekly - Friday, January 16, 2026 View this email in your browser --> Contact: Phone: 202.393.7330 Email: coalition@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - January 9, 2026](https://insurancefraud.org/publications/fraud-news-weekly-january-9-2026/) - 2026 Legislative Priorities, Commercial Vehicle Dashboard Camera Initiative, Coalition Executive Committee Re-Elections View this email in your browser --> Contact: Phone: 202.393.7330 Email: info@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your preferences or unsubscribe from this list.
- [Fraud News Weekly - December 19, 2025](https://insurancefraud.org/publications/fraud-news-weekly-december-19-2025/) - California’s SIU Compliance Unit Rolls Out Upgraded Report Portal, AI Tools Drive New Fraud Patterns, Historic Lutsen Lodge Owner Charged With Arson View this email in your browser --> Contact: Phone: 202.393.7330 Email: info@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your
- [Coalition 2025 Hall of Shame](https://insurancefraud.org/publications/coalition-2025-hall-of-shame/) - View previous Hall of Shamers: 2024, 2023, 2022, 2021, 2020
- [Coalition 2024 Hall of Shame](https://insurancefraud.org/publications/the-dirty-dozen-2024-hall-of-shame/) - View previous Hall of Shamers: 2023, 2022, 2021, 2020
- [Fraud News Weekly - December 12, 2025](https://insurancefraud.org/publications/fraud-news-weekly-december-12-2025/) - UPDATE: 2025 Annual Meeting Content Now Available, Coalition Engages Key Regulators At The NAIC Annual Meeting, And New Warning On Insurance Scams View this email in your browser --> Contact: Phone: 202.393.7330 Email: info@insurancefraud.org Address: 1012 14th Street, NW Suite 610 Washington, DC 20005 www.InsuranceFraud.org Want to change how you receive these emails? You can update your
- [Fraud News Weekly - December 5, 2025](https://insurancefraud.org/publications/fraud-news-weekly-december-5-2025/) - 2025 Annual Meeting Success, AI Rewriting Insurance Playbook, Upcoming December 18th Webinar Friday, December 5, 2025 New Hampshire Insurance Department shared insights into agent and broker misconduct via webinar and issued a bulletin reminding insurers to report
- [Fraud News Weekly - November 21, 2025](https://insurancefraud.org/publications/fraud-news-weekly-november-21-2025/) - International Fraud Awareness Week Comes To An End, State Regulators Discuss Big Data, And Action Is Being Urged On Workers’ Compensation Fraud Friday, November 21, 2025 This past week was a huge success in promoting insurance fraud awareness across our social media platforms; however, you know that five days of awareness is
- [Fraud News Weekly - November 14, 2025](https://insurancefraud.org/publications/fraud-news-weekly-november-14-2025/) - IFAW Begins Sunday, The Coalition Welcomes Celeste Dodson, And The Coalition's Social Media Competition Update Friday, November 14, 2025 As professionals in the fight against insurance fraud, you know the serious impact it has on businesses, communities, and individuals. You’ve no doubt educated those around you, but we want to equip you
- [Fraud News Weekly - November 7, 2025](https://insurancefraud.org/publications/fraud-news-weekly-november-7-2025/) - Two days left for Annual Meeting room rate discount, Minnesota Enacts Anti-Kickback Statute, And NICB Launches National Campaign Friday, November 7, 2025 The Coalition supports the Washington Office of the Insurance Commissioner’s (OIC) 2026 proposal to modernize the state’s Insurance
- [Fraud News Weekly - October 31, 2025](https://insurancefraud.org/publications/fraud-news-weekly-october-31-2025/) - Social Media Competition Member Message, Louisiana Updates Anti-Fraud Rules, and New LexisNexis CLE dates Friday, October 31, 2025 Colorado reminds insurers of their responsibilities in preventing repair shop deductible waivers. The Colorado Division of Insurance issued Bulletin B-5.54 to remind insurers of
- [Fraud News Weekly - October 24, 2025](https://insurancefraud.org/publications/fraud-news-weekly-october-24-2025/)
- [Fraud News Weekly - October 17, 2025](https://insurancefraud.org/publications/fraud-news-weekly-october-17-2025/) - Social Media Competition Underway, Calif. Gov. Signs Coalition Backed Bill, Coalition Q3 2025 Highlights Friday, October 17, 2025 California Governor signs a Coalition-backed bill into law, closing a workers’ comp kickback loophole. California has enacted Assembly Bill 1398 to close a loophole that limited prosecution of workers’ compensation
- [Fraud News Weekly - October 10, 2025](https://insurancefraud.org/publications/fraud-news-weekly-october-10-2025/) - Register Today For The WC Webinar On Oct. 16 At 2 PM, Coalition Continues Planning For Legislative Priorities, Register For The 2025 Annual Meeting Friday, October 10, 2025 Florida House panel discussion highlighted lawmaker concerns regarding the use of Artificial Intelligence (AI) in insurance decision-making. This
- [Fraud News Weekly - October 3, 2025](https://insurancefraud.org/publications/fraud-news-weekly-october-3-2025/) - New GenAI Study Available Now, Upcoming Coalition Webinar-Register Today, States Lead On AI Oversight As Federal Guidance Evolves Friday, October 3, 2025 Federal court upholds Iowa law stopping roofers in the Hawkeye State from acting as public adjusters. A federal
- [Fraud News Weekly - September 26, 2025](https://insurancefraud.org/publications/fraud-news-weekly-september-26-2025/) - Register Now For The Midyear Meeting, The Coalition Urges Passage of Antifraud Workers' Comp Bills, and Empathy and AI In Fraud Detection Friday, September 26, 2025 Insurance consumer organization highlights insurance consumer protection with Coalition presentation on generative AI and fraud. The Insurance
- [Fraud News Weekly - September 19, 2025](https://insurancefraud.org/publications/fraud-news-weekly-september-19-2025/) - Coalition Webinar Now Available Online, Michigan Passes 6 Anti-Fraud Bills, and Watch Out For Watch Insurance Fraud Friday, September 19, 2025 Michigan House overwhelmingly passed a six-bill package to strengthen insurance fraud penalties and reporting. The Michigan House
- [Fraud News Weekly - September 5, 2025](https://insurancefraud.org/publications/fraud-news-weekly-september-5-2025/) - Checkout The Coalition Social Media Competition, NAIC developing a playbook to tackle homeowners insurance, Doctor Jailed For Amputating His Own Legs Friday, September 5, 2025 California reminds insurers of the September 15th SIU Annual Report filing deadline. The California Department of Insurance has issued an additional reminder that the 2024 SIU Annual
- [Fraud News Weekly - August 29, 2025](https://insurancefraud.org/publications/fraud-news-weekly-august-29-2025/) - Coalition Social Media Competition Begins Soon, Join Our Platforms, Leaders Share Insights at IASIU 2025, Annual Meeting Registration Opens Sept. 2 Friday, August 29, 2025 Attention Coalition Members We want to invite our members to follow us on our social media platforms and let you know that an exciting social media
- [Fraud News Weekly - August 22, 2025](https://insurancefraud.org/publications/fraud-news-weekly-august-22-2025/) - The Newest Coalition AI Study Webinar Available Now, Texas Reminds Consumers Of Public Adjuster Rules, And Iowa Warns Residents About Contractor Fraud Friday, August 22, 2025 The Coalition was featured on a NAMIC podcast focused on staged commercial vehicle accidents. Staged auto accidents are spiking nationwide, with the National Insurance Crime Bureau
- [Fraud News Weekly - August 15, 2025](https://insurancefraud.org/publications/fraud-news-weekly-august-15-2025/) - Coalition Shares Consumer Insights At NAIC Meeting, Over 400 Registered For The Coalition's Upcoming AI Webinar, and How AI Helps Fraud Analysis Friday, August 15, 2025 Coalition shares insurance consumer insights and an organizational update at NAIC 2025 Summer Meeting. The Coalition Against Insurance Fraud delivered two presentations, this week, at the
- [Fraud News Weekly - August 8, 2025](https://insurancefraud.org/publications/fraud-news-weekly-august-8-2025/) - Federal Versus State Action On AI Regulation, Utah Construction Fraud Nets Thousands Of Complaints, Register for the Coalition AI Study Webinar Friday, August 8, 2025 Federal action on AI innovation is balanced by continuing state-level efforts to regulate insurer use of AI. The White House’s “America’s AI Action Plan” outlines a national
- [Fraud News Weekly - August 1, 2025](https://insurancefraud.org/publications/fraud-news-weekly-august-1-2025/) - Coalition Helps Kick Off FIFEC Conference, Over A Third Of Americans Impacted By Post-Disaster Fraud, Drug Testing Lab Pleads Guilty To $4.7M Fraud Friday, August 1, 2025 Louisiana adjusts the allocation of special assessment fees for insurance fraud efforts. The Louisiana Department of Insurance (LDI) has finalized amendments to Rule 13, Special Assessment;
- [Fraud News Weekly - January 10, 2025](https://insurancefraud.org/publications/fraud-news-weekly-january-10-2025/) - Florida court ruling bolsters anti-fraud efforts, The rising tide of insurance fraud, Man charged with attempted murder faces insurance fraud charges Friday, January 10, 2025 Dear Members, For those unable to attend the 2024 Annual Meeting, we would like to share an important update. Based on valuable membership feedback, The Coalition
- [Fraud News Weekly - January 17, 2025](https://insurancefraud.org/publications/fraud-news-weekly-january-17-2025/) - CDI fraud team on the lookout for illegal activities, Mike Causey lays out priorities for 2025, Staged U-Haul crash driver hit with lawsuit Friday, January 17, 2025 The Coalition in partnership with Shift Technology is presenting an exciting resource in the fight against insurance fraud! In partnership with Shift Technology, we've conducted
- [Fraud News Weekly - January 24, 2025](https://insurancefraud.org/publications/fraud-news-weekly-january-24-2025/) - Patty Kuderer sworn in as insurance commissioner, Commissioner Causey announces a record $144 million saved, Kinston couple faces fraud charge Friday, January 23, 2025 Governor Walz creates new Financial Crimes and Fraud Section to fight Minnesota’s rising fraud epidemic. Minnesota Governor Tim Walz has issued Executive Order 25-01 to address that state's growing
- [Fraud News Weekly - January 31, 2025](https://insurancefraud.org/publications/fraud-news-weekly-january-31-2025/) - Coalition participates in Kentucky insurance meeting, NY DMV says auto fraud on the rise, and Elderly man convicted of $20 million fraud Friday, January 31, 2025 NAIC names 2025 Consumer Liaison Representatives. The National Association of Insurance Commissioners (NAIC) has named 42 consumer liaison representatives for 2025, including 38 returning members from
- [Fraud News Weekly - February 7, 2025](https://insurancefraud.org/publications/fraud-news-weekly-february-7-2025/) - Congressman introduces bill to abolish Federal Insurance Office, Insurer records 10% jump in detected fraud in 2024, and Insurance agent sentenced Friday, February 7th, 2025 Louisiana insurance commissioner challenges ruling on fraud case. Louisiana Insurance Commissioner Tim Temple is pushing back against a recent ruling that found his department lacked jurisdiction to penalize
- [Fraud News Weekly - February 14, 2025](https://insurancefraud.org/publications/fraud-news-weekly-february-14-2025/) - 2 states issue AI bulletins, TDI prosecutors embed in Texas district attorney offices, and NCDOI charges Hamlet man with insurance fraud Friday, February 14th, 2025 Coalition submits letter supporting Kansas bill to strengthen the Sunflower State's fraud laws. The Coalition Against Insurance Fraud has submitted a letter to the Kansas House Judiciary Committee
- [Fraud News Weekly - February 21, 2025](https://insurancefraud.org/publications/fraud-news-weekly-february-21-2025/) - NCOIL adopts Motor Vehicle Glass Model Act, How is AI reshaping fraud detection, Upcoming Coalition webinar on California's wildfires presented by CDI Friday, February 21, 2025 Coalition-backed bill to strengthen Kansas fraud laws passes House, now headed to Senate. A major step forward in Kansas' fight against insurance fraud, HB 2323, legislation supported
- [Fraud News Weekly - February 28, 2025](https://insurancefraud.org/publications/fraud-news-weekly-february-28-2025/) - The Coalition engages college students on insurance fraud awareness, How can you stop a Medicare scam, Federal jury finds chiropractor guilty of fraud Friday, February 28, 2025 The Coalition took part in the event to connect carrier SIU investigators with their government affairs colleagues. This week, the Coalition was invited to participate
- [Fraud News Weekly - March 7, 2025](https://insurancefraud.org/publications/fraud-news-weekly-march-7-2025/) - The Coalition attends the IFM Conference, ‘Bandit’ tow companies target LA wildfire victims, and Uber calls for insurance reforms as fraud Friday, March 7, 2025 NAIC Privacy Protections Working Group debates Opt-In vs. Opt-Out standards but agrees on antifraud exemptions. The NAIC Privacy Protections (H) Working Group met last week to discuss over
- [Fraud News Weekly - March 14, 2025](https://insurancefraud.org/publications/fraud-news-weekly-march-14-2025/) - The Coalition attends TDI advisory board, Man files an insurance claim 30 minutes after buying a new policy, register for the Midyear Meeting Friday, March 14, 2025 The Coalition attends an advisory board meeting on Texas' basic insurance fraud training program for law enforcement. This week, Brent Walker, Coalition director of government
- [Fraud News Weekly - March 21, 2025](https://insurancefraud.org/publications/fraud-news-weekly-march-21-2025/) - Updated: The Coalition at Texas IAAI, Sign up for CDI Wildfires Webinar, Advertise with the Coalition Updated: Friday, March 21, 2025 The Coalition presented insurance fraud awareness to arson investigators at the Texas IAAI Conference 2025. The Coalition presented insurance fraud awareness to arson investigators at the Texas IAAI Conference 2025. The Coalition
- [Fraud News Weekly - March 28, 2025](https://insurancefraud.org/publications/fraud-news-weekly-march-28-2025/) - CDI webinar success, Preparing for the growing fraud threat, and a couple faces disability insurance fraud investigation Friday, March 28, 2025 The Coalition hosted the California Department of Insurance during a webinar on their Enforcement Branch Wildfire Fraud Unit response and SIU compliance best practices. “The California Wildfires: CDI’s Fraud Response &
- [Fraud News Weekly - April 4, 2025](https://insurancefraud.org/publications/fraud-news-weekly-april-4-2025/) - AI Images fuel new wave of fraud, The future of fraud prevention, and Twin Falls bail agent convicted of insurance fraud Friday, April 4, 2025 The Coalition opposes a Texas Senate bill that could open the floodgates for insurance fraud. Texas Senate Bill (SB) 1791, which would mandate insurer payouts when a policyholder
- [Fraud News Weekly - April 11, 2025](https://insurancefraud.org/publications/fraud-news-weekly-april-11-2025/) - Kentucky enacts new towing regulations, Insurance tips to avoid fraud, Sunken vehicle leads to two arrests, NEW Workers' Comp Webinar Friday, April 11, 2025 The Coalition stands with Illinois stakeholders to support Chicago towing ordinance. The Coalition Against Insurance Fraud has co-signed a letter of support for a Chicago towing ordinance that would
- [Fraud News Weekly - April 18, 2025](https://insurancefraud.org/publications/fraud-news-weekly-april-18-2025/) - New bill would make staged crashes a federal crime, American drivers warned about red flags, Montco insurance agent fraudulently doctored policies Friday, April 18, 2025 Legislation would empower police to enforce Pennsylvania’s towing law and better protect stranded motorists. A legislative proposal in Pennsylvania aims to strengthen enforcement of Act 110 of
- [Fraud News Weekly - April 25, 2025](https://insurancefraud.org/publications/fraud-news-weekly-april-25-2025/) - Chicago cracks down on rogue towing, Six companies involved in breaking workers comp laws, and Global Insurance Fraud Summit’s Report to the Nations Friday, April 25, 2025 Coalition backs North Carolina bills targeting fraud in the bail bond system to protect consumers and surety companies. The Coalition Against Insurance Fraud has voiced
- [Fraud News Weekly - May 9, 2025](https://insurancefraud.org/publications/fraud-news-weekly-may-9-2025/) - Maryland scrutinizes insurer use of aerial imagery, FBI issues new health scam warning, New Coalition Money Laundering Alerts Now Available Friday, May 9, 2025 Coalition’s Government Affairs Committee receives legislative update as state sessions wind down. The Government Affairs Committee met earlier this week to review legislative developments and key advocacy milestones as
- [Fraud News Weekly - May 16, 2025](https://insurancefraud.org/publications/fraud-news-weekly-may-16-2025/) - May 19th Coalition Midyear Meeting registration deadline, View the detailed agenda, The Utah IFD earns top recognition, FBI warns of new fraud scam Friday, May 16, 2025 The Coalition attends the New York Property & Casualty Legislative Action Day with focus on fraud-fighting priorities. The Coalition took part in
- [Fraud News Weekly - May 23, 2025](https://insurancefraud.org/publications/fraud-news-weekly-may-23-2025/) - Louisiana leverages NAIC data, New interview featuring Executive Director Michelle Rafeld, and Former police officer charged with workers' comp fraud Friday, May 23, 2025 House lawmakers urge U.S. Attorney General to prioritize staged accident fraud task force to combat rising insurance scams. Following the introduction of the Staged Accident Fraud Prevention Act (HR
- [Fraud News Weekly - May 30, 2025](https://insurancefraud.org/publications/fraud-news-weekly-may-30-2025/) - Coalition Attends NAIC Working Group, Wyoming Considers Health Insurance Fraud Concerns, California Couple Arrested For Staging Carjacking Friday, May 30, 2025 NAIC survey shows most health insurers are already using AI, including for fraud detection, and regulators may soon follow with stricter oversight. The National Association of Insurance Commissioners (NAIC) released a
- [Fraud News Weekly - June 6, 2025](https://insurancefraud.org/publications/fraud-news-weekly-june-6-2025/) - Kentucky Enacts Key Fraud And Towing Laws, Reporting Medicare Fraud, $10M Staged-Crash Scheme, Register For The Coalition's June 18th Webinar Today Friday, June 6, 2025 Coalition urges the NAIC to add Long Term Care insurance fraud as a dedicated category to online reporting. This week, in a letter to the NAIC’s Antifraud
- [Fraud News Weekly - June 13, 2025](https://insurancefraud.org/publications/fraud-news-weekly-june-13-2025/) - The Midyear Meeting in review, Coalition urges top AI firms to help combat fraud, Uber alleges insurance fraud scheme in Florida Friday, June 13, 2025 Coalition urges top AI firms to help combat surge in AI-powered insurance fraud schemes. As announced during its 2025 Midyear Member Meeting, the Coalition Against Insurance Fraud
- [Fraud News Weekly - June 20, 2025](https://insurancefraud.org/publications/fraud-news-weekly-june-20-2025/) - South Carolina briefing reveals need for anti-fraud reform, New research article from Coalition officer, and Insurance agent facing 72 felony charges Friday, June 20, 2025 Louisiana Commissioner recaps 2025 legislative highlights, including anti-fraud bills. In his recent letter, Louisiana Department of Insurance Commissioner Tim Temple summarized Louisiana’s 2025 legislative session. It focused
- [Fraud News Weekly - June 27, 2025](https://insurancefraud.org/publications/fraud-news-weekly-june-27-2025/) - NCOIL Raises Concerns Over AI Moratorium, The Rise of Fake Insurance Agents, Prosecutor Of The Year Submission Now Being Accepted Friday, June 27, 2025 NAPIA celebrates 75 years of advancing the public adjusting profession, protecting consumers, and supporting the fight against fraud through partnership and purpose. As the National Association of
- [Fraud News Weekly - July 3, 2025](https://insurancefraud.org/publications/fraud-news-weekly-july-3-2025/) - Texas Enacts AI Law, FBI Issues A New Healthcare Scam Warning, And The Coalition Launched The Generative AI Study This Week Thursday, July 3, 2025 Texas enacts AI law as federal AI moratorium is struck from U.S. bill. Texas has enacted the Responsible Artificial Intelligence Governance Act (TRAIGA), effective January 1, 2026,
- [Fraud News Weekly - July 11, 2025](https://insurancefraud.org/publications/fraud-news-weekly-july-11-2025/) - Pennsylvania’s New Digital Forgery Law Takes Aim At AI, Experts Give Advice Amid Increasing Insurance Rates, Couple Sentenced For $20 Million Scheme Friday, July 11, 2025 Coalition’s Government Affairs Committee begins 2026 legislative priority planning with early insights and member input. Members shared the policy trends that they are watching closely. A
- [Fraud News Weekly - July 18, 2025](https://insurancefraud.org/publications/fraud-news-weekly-july-18-2025/) - New Coalition Webinar Aug 21st., NCOIL Lawmakers Consider An AI Model Law, and Fraud Alert Regarding Fake Medicare Accounts Friday, July 18, 2025 NCOIL lawmakers consider an AI model law as NAIC regulators propose an AI evaluation tool and considers its own model. State lawmakers are stepping further into AI policy with
- [Fraud News Weekly - July 25, 2025](https://insurancefraud.org/publications/fraud-news-weekly-july-25-2025/) - New Hawai'i Insurance Commissioner Appointed, 500 NYC Cabs Installing Cameras To Fight Fraud, and Insurance Adjuster Charged With Fraud Friday, July 25, 2025 Coalition addresses insurance fraud and storm chaser reform at the National Council of Insurance Legislators (NCOIL) Summer Meeting in Chicago. The Coalition Against Insurance Fraud recently participated in the
- [Fraud News Weekly - December 20, 2024](https://insurancefraud.org/publications/fraud-news-weekly-december-20-2024/) - Missouri Governor announces the retirement of DCI Director, John Doak named chair of Coalition Committee, Yonkers man indicted for arson and fraud Friday, December 20, 2024 Washington state insurance fraud fighters accredited for highest professional standards of policing. Washington Insurance Commissioner Mike Kreidler’s Criminal Investigations Unit (CIU) has earned accreditation from the Washington Association
- [Fraud News Weekly - December 13, 2024](https://insurancefraud.org/publications/fraud-news-weekly-december-13-2024/) - The Annual Meeting in review, 2025 Legislative Priorities, and the 2024 Hall of shame Friday, December 13, 2024 The Coalition's Executive Committee approves 2025 Legislative Priorities. This week, during the Coalition's annual membership meeting, the Executive Committee reviewed, discussed, and approved a final draft of the Coalition's legislative priorities for 2025. Each year,
- [Fraud News Weekly - December 6, 2024](https://insurancefraud.org/publications/fraud-news-weekly-december-6-2024/) - NCOIL hosts its Annual Meeting, Former Executive Director Matthew Smith wins award, and Psychiatrist sues their own hospital for fraud Friday, December 6, 2024 Coalition attends a "Meet the Regulator" event and presents at the Texas Committee on Insurance Fraud. Coalition director of government relations, Brent Walker, recently visited the Lone
- [JIFA: Synthetic Fraud: With Synthetic Fraud Already in Their Ecosystem, Insurers Need to Think More Like Banks](https://insurancefraud.org/publications/jifa-synthetic-fraud/) - By Clark Frogley, Global Head of Fraud Solutions, Quantexa | December 6, 2024 After spending years raking in billions from synthetic fraud schemes targeting companies in the banking and automotive industries, criminal actors have set their sights on fresh game: insurers. This move is not surprising when you consider how much money moves around in
- [Fraud News Weekly - November 22, 2024](https://insurancefraud.org/publications/fraud-news-weekly-november-22-2024/) - Oklahoma issues AI guidance for insurers, International Fraud Awareness Week, and a Mother sets her house on fire with her 11-year-old daughter inside Friday, November 22, 2024 Coalition attends the NAIC Fall National Meeting. Insurance regulators from around the country, along with other interested parties, including the Coalition Against Insurance Fraud, gathered
- [Fraud News Weekly - November 15, 2024](https://insurancefraud.org/publications/fraud-news-weekly-november-15-2024/) - New Jersey has a new Insurance Commissioner, Opportunistic fraud on the rise, Viral auto fraud video leads to charges Friday, November 15, 2024 Coalition joins global anti-fraud leaders in Singapore for the 2024 Global Insurance Fraud Summit. The Coalition Against Insurance Fraud once again joined top anti-fraud leaders at the 2024 Global Insurance
- [Fraud News Weekly - November 8, 2024](https://insurancefraud.org/publications/fraud-news-weekly-november-8-2024/) - New Mexico Governor issues antifraud proclamation, Thank you to our second TrendTalk Panelists, and a whole crop of crop fraud Friday, November 8, 2024 Federal lawmakers urge state insurance regulators to monitor fraudulent practices by insurers after Hurricanes Helene and Milton. The U.S. House Committee on Oversight and Accountability is urging state
- [Fraud News Weekly - November 1, 2024](https://insurancefraud.org/publications/fraud-news-weekly-november-1-2024/) - White House memorandum on AI, Auto insurance fraud on the rise, Jersey Shore doctor sentenced Friday, November 1, 2024 Florida’s new tools to combat post-storm fraud protect policyholders and align with the Coalition's legislative priorities. Florida's Department of Financial Services (DFS) has launched the ‘Check My Contract’ portal and enacted Emergency Rule 69BER24-4
- [Fraud News Weekly - October 25, 2024](https://insurancefraud.org/publications/fraud-news-weekly-october-25-2024/) - NJSIA Annual Conference, Strategies for preventing fraud in government health policies, and insurance fraud caught on camera goes viral Friday, October 25, 2024 The NJSIA Annual Conference showcased fraud-fighting strategies, hosted the Coalition as the keynote. The New Jersey Special Investigators Association (NJSIA) hosted its 33rd Annual Fraud Awareness Seminar this week
- [Fraud News Weekly - October 18, 2024](https://insurancefraud.org/publications/fraud-news-weekly-october-18-2024/) - Amicus Curiae webinar a huge success, Fraudsters on the rise, and the Coalition welcomes Heidi Krumenauer Friday, October 18, 2024 The Coalition hosted a webinar to highlight the benefits of its Amicus Curiae Program. This week, a panel of experts gathered to share their unique perspectives on the value of the
- [Fraud News Weekly - October 11, 2024](https://insurancefraud.org/publications/fraud-news-weekly-october-11-2024/) - Federal efforts target abuses in litigation finance, NICB works with U.S. Customs to stop stolen vehicles, and Forest Lake insurance agent convicted Friday, October 11, 2024 Federal effort targets hidden abuses in litigation finance with new disclosure requirements. A federal push led by Rep. Darrell Issa aims to unmask hidden funding arrangements that
- [Fraud News Weekly - October 4, 2024](https://insurancefraud.org/publications/fraud-news-weekly-october-4-2024-2/) - Commissioner of the Indiana Department of Insurance to step down, Twin brother doctors arrested for fraud, Florida deploys 12 anti-fraud teams Friday, October 4, 2024 The NAIC Privacy Protections Drafting Group met to consider amendments related to third party arrangements on a consumer information model act. This week, the National Association of
- [JIFA: The Productivity Paradox:  Balancing Quality and Efficiency in Fraud Investigations](https://insurancefraud.org/publications/jifa-the-productivity-paradox-balancing-quality-and-efficiency-in-fraud-investigations/) - By Jala Attia, President & Founder, Integrity Advantage/Professor at University of New Haven | October 9, 2024 In the complex world of fraud investigations, the importance of quality work cannot be overstated. But quality is hard to measure. As a result, many organizations default to productivity metrics, hoping that productivity will somehow equate to quality.
- [Fraud News Weekly - October 4, 2024](https://insurancefraud.org/publications/fraud-news-weekly-october-4-2024/) - Commissioner of the Indiana Department of Insurance to step down, Twin brother doctors arrested for fraud, Florida deploys 12 anti-fraud teams Friday, October 4, 2024 The NAIC Privacy Protections Drafting Group met to consider amendments related to third party arrangements on a consumer information model act. This week, the National Association of
- [Fraud News Weekly - September 27, 2024](https://insurancefraud.org/publications/fraud-news-weekly-september-27-2024/) - Insurance Advocacy groups meet in Austin, Drivers consider fraud more, and three New Yorkers charged in insurance fraud scheme Friday, September 27, 2024 The Coalition provided both verbal and written comment on NCOIL's Transparency in Third Party Litigation Financing Model Act. In follow up from last week, Brent
- [Fraud News Weekly - September 20, 2024](https://insurancefraud.org/publications/fraud-news-weekly-september-20-2024/) - Scam jam events raise fraud awareness, Upcoming Coalition AMICUS webinar, Insurance fraud cases continue to rise, and Physician settles fraud case Friday, September 20, 2024 The Coalition will provide comment on NCOIL's Transparency in Third Party Litigation Financing Model Act. During an interim virtual meeting of the National Council
- [Fraud News Weekly - September 13, 2024](https://insurancefraud.org/publications/fraud-news-weekly-september-13-2024/) - SIU Annual Report dead approaches, Arizona cracks down on Medicaid fraud, Tow Truck company owner hit with 2nd insurance fraud case Friday, September 13, 2024 The New Mexico Office of Superintendent of Insurance (OSI) will begin collecting the Insurance Fraud Fee through a program offered by the National Association
- [Fraud News Weekly - September 6, 2024](https://insurancefraud.org/publications/fraud-news-weekly-september-6-2024/) - N.C. Commissioner shares how fraud costs us $105 Billion a year, Mesa woman stole $22.5M from Medicaid, and an upcoming Coalition webinar Friday, September 6, 2024 The Coalition urges California Governor to sign a bill that supports its state's insurance fraud detectives. California's Assembly Bill 2872, designed to address
- [Fraud News Weekly - August 30, 2024](https://insurancefraud.org/publications/fraud-news-weekly-august-30-2024/) - Federal bill proposes to crack down on fraud, upcoming Verisk webinar, and fater son fraud duo receive bed as payment for staged car fire Friday, August 30, 2024 CRITERIA PROSECUTOR OF THE YEAR The Prosecutor of the Year Award honors prosecutors who go above and beyond in securing notable insurance-fraud convictions. Federal, state
- [Fraud News Weekly - August 23, 2024](https://insurancefraud.org/publications/fraud-news-weekly-august-23-2024/) - North Carolina ramps up anti-fraud efforts, how to protect yourself from Medicare fraud, and an upcoming Coalition series "TrendTalk" Friday, August 23, 2024 CRITERIA PROSECUTOR OF THE YEAR The Prosecutor of the Year Award honors prosecutors who go above and beyond in securing notable insurance-fraud convictions. Federal, state and local prosecutors are eligible.
- [Fraud News Weekly - August 16, 2024](https://insurancefraud.org/publications/fraud-news-weekly-august-16-2024/) - Coalition Attends NAIC, Coalition reaches out to NAIC’s CEO, WV issues AI Bulletin, Kate Gordon New Coalition GC Friday, August 16, 2024 CRITERIA PROSECUTOR OF THE YEAR The Prosecutor of the Year Award honors prosecutors who go above and beyond in securing notable insurance-fraud convictions. Federal, state and local prosecutors are eligible.
- [Fraud News Weekly - August 9, 2024](https://insurancefraud.org/publications/fraud-news-weekly-august-9-2024/) - Michigan issues an AI Bulletin, Warnings abound of contractor fraud, Therapist ordered to pay up for defraud Medicaid Friday, August 9, 2024 CRITERIA PROSECUTOR OF THE YEAR The Prosecutor of the Year Award honors prosecutors who go above and beyond in securing notable insurance-fraud convictions. Federal, state and local prosecutors are eligible. Honorees
- [Fraud News Weekly - August 2, 2024](https://insurancefraud.org/publications/fraud-news-weekly-august-2-2024/) - Minnesota enacts new law to combat employer misclassification fraud, AARP releases fraud alerts, and New Canaan man guilty of defrauding Medicaid Friday, August 2, 2024 CRITERIA PROSECUTOR OF THE YEAR The Prosecutor of the Year Award honors prosecutors who go above and beyond in securing notable insurance-fraud convictions. Federal, state and local prosecutors are
- [Fraud News Weekly - July 26, 2024](https://insurancefraud.org/publications/fraud-news-weekly-july-26-2024/) - IASIU Annual Conference, Texas issues warnings about post hurricane scams, and insurers pocket $50 Billion from Medicare Friday, July 26, 2024 Join industry leaders and innovators in Nashville from August 25-28 for the IASIU 2024 Annual Conference—an unparalleled opportunity for networking and learning. Engage with global experts in investigation, best practices,
- [Fraud News Weekly - July 19, 2024](https://insurancefraud.org/publications/fraud-news-weekly-july-19-2024/) - CDI to host virtual workshops, Louisiana auto insurance reform meeting, Former insurance commissioner sentenced for healthcare fraud Friday, July 19, 2024 CRITERIA PROSECUTOR OF THE YEAR The Prosecutor of the Year Award honors prosecutors who go above and beyond in securing notable insurance-fraud convictions. Federal, state and local prosecutors are eligible. Honorees must secure a
- [Coalition Quarterly: Second Quarter](https://insurancefraud.org/publications/cq-second-quarter/) - Click here to read the full newsletter
- [Fraud News Weekly - July 12, 2024](https://insurancefraud.org/publications/fraud-news-weekly-july-12-2024/) - Friday, July 12, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [JIFA: Transnational organized crime and its impact on the insurance industry ](https://insurancefraud.org/publications/jifa-transnational-organized-crime/) - By Dennis Toomey, Director of Insurance Fraud and Financial Crimes Practice, PwC | July 2, 2024 Transnational organized crime and its impact on the insurance industry If mentioning international vehicle crime calls to mind a highly detailed video game instead of the insurance industry, you’d be forgiven. Yet, insurance and organized transnational vehicle crime are
- [Fraud News Weekly - June 28, 2024](https://insurancefraud.org/publications/fraud-news-weekly-june-28-2024/) - Friday, June 28, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - June 21, 2024](https://insurancefraud.org/publications/fraud-news-weekly-june-21-2024/) - Friday, June 21, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - May 31, 2024](https://insurancefraud.org/publications/fraud-news-weekly-may-31-2024-2/) - Friday, May 31, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - June 14, 2024](https://insurancefraud.org/publications/fraud-news-weekly-june-14-2024/) - Friday, June 14, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [Fraud News Weekly - May 17, 2024](https://insurancefraud.org/publications/fraud-news-weekly-may-17-2024/) - Friday, May 17, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - May 10, 2024](https://insurancefraud.org/publications/fraud-news-weekly-may-10-2024/) - Friday, May 10, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [Fraud News Weekly - April 26, 2024](https://insurancefraud.org/publications/fraud-news-weekly-april-26-2024/) - Friday, April 26, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [CQ: 30th Anniversary - Fall Edition](https://insurancefraud.org/publications/cq-30th-anniversary-fall-edition/) - Click here to read the full newsletter
- [Coalition Quarterly - First Quarter](https://insurancefraud.org/publications/coalition-quarterly-first-quarter/) - Click here to read the full newsletter
- [Fraud News Weekly - April 12, 2024](https://insurancefraud.org/publications/fraud-news-weekly-april-12-2024/) - Friday, April 12, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [Fraud News Weekly - March 29, 2024](https://insurancefraud.org/publications/fraud-news-weekly-march-29-2024/) - Friday, March 29, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [Fraud News Weekly - February 23, 2024](https://insurancefraud.org/publications/fraud-news-weekly-february-23-2024/) - Friday, February 23, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - February 16, 2024](https://insurancefraud.org/publications/fraud-news-weekly-february-16-2024/) - Friday, February 16, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [JIFA: Building A Trauma Informed Enforcement Approach](https://insurancefraud.org/publications/jifa-building-a-trauma-informed-enforcement-approach/) - By California Labor Commissioner, Lilia García-Brower | December 14, 2023 California has some of the strongest wage theft laws1 in the Nation, but enforcing the laws continues to present significant barriers that sometimes prevent holding perpetrators accountable. Research demonstrates common characteristics among workers who experience prevalent violations: they are female, foreign-born, unfamiliar with protections, and
- [FraudBlog: Inevitable Convergence between Cybersecurity and Fraud fighting in the Future of Insurance](https://insurancefraud.org/publications/fraudblog-inevitable-convergence/) - By Maxence Bizien | January 30, 2024 The digital revolution has become a priority in insurers' strategies, marked by the proliferation of mobile applications and the creation of client spaces to facilitate remote interactions. Despite initial, occasionally unsuccessful forays into big data and artificial intelligence, insurance companies are shifting towards more pragmatic solutions while maintaining
- [Fraud News Weekly - February 9, 2024](https://insurancefraud.org/publications/fraud-news-weekly-february-9-2024/) - *|MC:SUBJECT|* *|MC_PREVIEW_TEXT|* Friday, February 9, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [FraudBlog: Unmasking Auto Fraud: Cloning, Salvage, and Title Washing](https://insurancefraud.org/publications/fraudblog-unmasking-auto-fraud-cloning-salvage-and-title-washing/) - By George Ripley, Donegal Insurance Group | February 16, 2024 The automotive world, a realm of innovation and mobility, also harbors a darker side—auto fraud. This illegal practice takes on various forms, with vehicle cloning, salvage fraud, and title washing emerging as key players in this deceptive game. The impact extends beyond individual consumers, reaching
- [JIFA: Life Insurance Wagering Contracts And Identity Fraud: A Deadly Combination](https://insurancefraud.org/publications/jifa-life-insurance-wagering-contracts-and-identity-fraud-a-deadly-combination/) - By: Kevin C. Glasgow, FLMI, FLHC, CLU®, CFE, Diligence International Group, LLC Nicolas A. Novy, Esq. Cozen O’Connor February 12, 2024 Overview Life wagering contracts are nothing new – they have been around since the advent of life insurance. While illegal, wagering contracts represent an extremely lucrative way to earn a profit with a relatively
- [Fraud News Weekly - February 2, 2024](https://insurancefraud.org/publications/fraud-news-weekly-february-2-2024/) - Friday, February 2, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - January 26, 2024](https://insurancefraud.org/publications/fraud-news-weekly-january-26-2024/) - Friday, January 26, 2024 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [FraudBlog: Pearls + Metal = 30th Anniversary Celebration](https://insurancefraud.org/publications/fraudblog-pearls-metal-30th-anniversary-celebration/) - By Kendra Smith | August 10, 2023 While drafting this blog, I wanted to highlight the Coalition's 30th "Silver" year milestone. Silver represents expanding awareness, enhancing intuition, and increasing compassion, persistence, and strength. These qualities capture every ounce of the Coalition's mission from 30 years ago to today. I wonder if the Coalition's charter members
- [Fraud News Weekly - January 19, 2024](https://insurancefraud.org/publications/fraud-news-weekly-january-19-2024/) - | Friday, January 19, 2024
- [Fraud News Weekly - January 12, 2024](https://insurancefraud.org/publications/fraud-news-weekly-january-12-2024/) - Friday, January 12, 2024
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- [Insurance Fraud Hall of Shame — 2021](https://insurancefraud.org/publications/insurance-fraud-hall-of-shame-2021/) - Mask up fast and hide while you can; a new set of viral spreaders have arrived. Let’s un-welcome the newest members of the Insurance Fraud Hall of Shame. The No-Class of 2021 was chosen by the Coalition Against Insurance Fraud. The Shamers are this year’s most notorious convicted insurance fraud criminals. The barons of bleak
- [Fraud News Weekly - December 8, 2023](https://insurancefraud.org/publications/fraud-news-weekly-december-8-2023/) - * Friday, December 8, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
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- [CQ: 30th Anniversary - Summer Edition](https://insurancefraud.org/publications/cq-coalition-30th-anniversary/) - Click here to read the full newsletter
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- [Fraud News Weekly - August 18, 2023](https://insurancefraud.org/publications/fraud-news-weekly-august-18-2023/) - Friday, August 18, 2023
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- [JIFA: Applying OSINT Techniques to Identify and Mitigate VIN Tampering Fraud ](https://insurancefraud.org/publications/jifa-applying-osint-techniques-to-identify-and-mitigate-vin-tampering-fraud/) - By Steve Adams | August 31, 2023 What is a VIN and How Insurers Can Use Them A VIN, or Vehicle Identification Number1, is a unique 17-digit alphanumeric code found on every car, truck, and motorcycle from 1981 to the present. This code is structured to provide the world identification number, the vehicle's description, and
- [Fraud News Weekly - August 11, 2023](https://insurancefraud.org/publications/fraud-news-weekly-august-11-2023/) - Friday, August 11, 2023
- [Fraud News Weekly - August 4, 2023](https://insurancefraud.org/publications/fraud-news-weekly-august-4-2023/) - Friday, August 4, 2023
- [FraudBlog: Diversity In Action](https://insurancefraud.org/publications/fraudblog-diversity-in-action/) - BY Jim Brown | June 26, 2023 Closing up well over 25 years on the Coalition’s Board is a wonderful chance (and prompt) to reminisce and contemplate what makes the Coalition one of the most unique, memorable, and positive experiences. Among the numerous unique (though related) aspects of the Coalition that makes it so noteworthy,
- [Fraud News Weekly - July 28, 2023](https://insurancefraud.org/publications/fraud-news-weekly-july-28-2023/) - Friday, July 28, 2023
- [CQ: Coalition Hard At Work](https://insurancefraud.org/publications/cq-2nd-quarter-2023/) - Click here to read the full newsletter
- [Fraud News Weekly - July 21, 2023](https://insurancefraud.org/publications/fraud-news-weekly-july-21-2023/) - Friday, July 21, 2023
- [FraudBlog: The Anti-Fraud Playbook](https://insurancefraud.org/publications/fraudblog-the-anti-fraud-playbook/) - By Sophia Carlton, CFE | June 17, 2021 Fraud is happening, all the time and at every organization. Prior to the pandemic, insurance fraud (non-health insurance) was estimated to be a $40 billion dollar a year criminal enterprise that costs the average U.S. family between $400 and $700 per year in increased insurance premiums, according
- [FraudBlog: How fraudsters are using social networks to scam the French insurance industry](https://insurancefraud.org/publications/fraudblog-how-fraudsters-are-using-social-networks-to-scam-the-french-insurance-industry/) - BY Maxence Bizien, ALFA | May 1, 2023 Insurance fraud has been on the rise in France, and social networks have become one of the main facilitators of this type of criminal activity. Fraudsters are using social media platforms like Facebook and Snapchat to advertise their services to potential clients, primarily individuals looking to earn
- [FraudBlog: Why Now?](https://insurancefraud.org/publications/fraudblog-why-now/) - BY Matthew J. Smith, Esq. | June 12, 2023 At the Midyear meeting, my retirement as the Coalition’s executive director was announced. A decision I actually made more than a year ago when I shared my plans with our Executive Committee leadership at our 2022 Midyear Meeting. This is the best job I have ever
- [Fraud News Weekly - July 14, 2023](https://insurancefraud.org/publications/fraud-news-weekly-july-14-2023/) - Friday, July 14, 2023
- [Fraud News Weekly - July 7, 2023](https://insurancefraud.org/publications/fraud-news-weekly-july-7-2023/) - Friday, July 7, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - June 30, 2023](https://insurancefraud.org/publications/fraud-news-weekly-june-30-2023/) - Friday, June 30, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [CQ: It begins - 30 years in the making!](https://insurancefraud.org/publications/cq-1st-quarter-2023-it-begins-30-years-in-the-making/) - Click here to read the full newsletter
- [Fraud News Weekly - June 23, 2023](https://insurancefraud.org/publications/fraud-news-weekly-june-23-2023/) - Friday, June 23, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - June 16, 2023](https://insurancefraud.org/publications/fraud-news-weekly-june-16-2023/) - Friday, June 16, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - June 9, 2023](https://insurancefraud.org/publications/fraud-news-weekly-june-9-2023/) - Friday, June 9, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - June 2, 2023](https://insurancefraud.org/publications/fraud-news-weekly-june-2-2023/) - Friday, June 2, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - May 26, 2023](https://insurancefraud.org/publications/fraud-news-weekly-may-26-2023/) - Friday, May 26, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - May 19, 2023](https://insurancefraud.org/publications/fraud-news-weekly-may-19-2023/) - Friday, May 19, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - May 12, 2023](https://insurancefraud.org/publications/fraud-news-weekly-may-12-2023/) - Friday, May 12, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - May 5, 2023](https://insurancefraud.org/publications/fraud-news-weekly-may-5-2023/) - Friday, May 5, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - April 28, 2023](https://insurancefraud.org/publications/fraud-news-weekly-april-28-2023/) - Friday, April 28, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [FraudBlog: Auto Insurance Fraud Schemes & How to Combat Them](https://insurancefraud.org/publications/fraudblog-auto-insurance-fraud-schemes-how-to-combat/) - BY Dean Cornelison, Skopenow | March 7, 2023 There are many types of auto insurance fraud schemes, ranging from simple exaggerations to elaborate conspiracies. To rise to this challenge and effectively combat auto insurance fraud, insurance carriers should leverage the power of automated Open-Source Intelligence (OSINT) solutions. In this blog post, we’ll discuss some of
- [Fraud News Weekly - April 21, 2023](https://insurancefraud.org/publications/fraud-news-weekly-april-21-2023/) - Friday, April 21, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - April 14, 2023](https://insurancefraud.org/publications/fraud-news-weekly-april-14-2023/) - Friday, April 14, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - April 7, 2023](https://insurancefraud.org/publications/fraud-news-weekly-april-7-2023/) - Friday, April 7, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - January 6, 2023](https://insurancefraud.org/publications/fraud-news-weekly-january-6-2023/) - Friday, January 6, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - January 13, 2023](https://insurancefraud.org/publications/fraud-news-weekly-january-13-2023/) - Friday, January 13, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - January 20, 2023](https://insurancefraud.org/publications/fraud-news-weekly-january-20-2023/) - Friday, January 20, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - January 27, 2023](https://insurancefraud.org/publications/fraud-news-weekly-january-27-2023/) - Friday, January 27, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - February 3, 2023](https://insurancefraud.org/publications/fraud-news-weekly-february-3-2023/) - Friday, February 3, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - February 10, 2023](https://insurancefraud.org/publications/fraud-news-weekly-february-10-2023/) - Friday, February 10, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - February 17, 2023](https://insurancefraud.org/publications/fraud-news-weekly-february-17-2023/) - Friday, February 17, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - February 24, 2023](https://insurancefraud.org/publications/fraud-news-weekly-february-24-2023/) - Friday, February 24, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - March 3, 2023](https://insurancefraud.org/publications/fraud-news-weekly-march-3-2023/) - Friday, March 3, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - March 10, 2023](https://insurancefraud.org/publications/fraud-news-weekly-march-10-2023/) - Friday, March 10, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - March 17, 2023](https://insurancefraud.org/publications/fraud-news-weekly-march-17-2023/) - Friday, March 17, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - March 24, 2023](https://insurancefraud.org/publications/fraud-news-weekly-march-24-2023/) - Friday, March 24, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [Fraud News Weekly - March 31, 2023](https://insurancefraud.org/publications/fraud-news-weekly-march-31-2023/) - Friday, March 31, 2023 This email was sent to *|EMAIL|* why did I get this? unsubscribe from this list update subscription preferences *|LIST:ADDRESSLINE|*
- [FraudBlog: Inflating Insurance Fraud? History Shows We Should Be Concerned](https://insurancefraud.org/publications/fraudblog-inflating-insurance-fraud-history-shows-we-should-be-concerned/) - BY Matthew Smith, Esq. | March 22, 2022 On the heels of the COVID pandemic, Americans now face the highest levels of inflation in 40 years. According to the U.S. Bureau of Labor Statistics inflation accelerated to 7.9% in February. Energy costs, gasoline, vehicles and food all are showing the highest rates of price increases
- [FraudBlog: Fighting Insurance Fraud Is Not "Gotcha!"](https://insurancefraud.org/publications/fraudblog-fighting-insurance-fraud-is-not-gotcha/) - BY Matthew Smith, Esq. | April 5, 2022 I am not in favor of the same person authoring two blogs in a row. All Coalition members are invited to participate in “FraudBlog” to share their views, insights and opinions. My attendance at a recent major insurance conference banquet though caused me to violate my own
- [FraudBlog: A Meeting to Remember](https://insurancefraud.org/publications/fraudblog-a-meeting-to-remember-anti-fraud-leaders-from-across-the-country-gathered-to-shape-the-future-of-the-coalition-and-the-anti-fraud-fight/) - A Meeting to Remember BY A.D. DuVall | June 14, 2022 Last week on June 6-7, the Coalition Against Insurance Fraud held its first in-person Midyear Meeting since 2019 – gathering over 120 attendees from across the country! Over the course of the event, we hosted 28 speakers and panelists with expertise on the latest
- [FraudBlog: Fraud Cost Everyone - Why Should You Care](https://insurancefraud.org/publications/fraudblog-fraud-cost-everyone-why-should-you-care/) - BY Kevin C. Glasgow, FLMI, FLHC, CLU®, CFE & Paul Marquez, Vice President, Diligence International Group, LLC | October 6, 2022 Fraud costs everyone, and especially the honest insured – the cost: $308.6 Billion in premiums that needn’t have been paid. Protecting applicants and claimants from high costs is the responsibility, and some would argue
- [FraudBlog: It all turns on a single word. Why insurers should care about a recent high-profile federal trial](https://insurancefraud.org/publications/fraudblog-it-all-turns-on-a-single-word-why-insurers-should-care-about-a-recent-high-profile-federal-trial/) - BY Matthew J. Smith, Esq., Coalition Against Insurance Fraud | October 17, 2022 A key charge in the obstruction of justice trial arising from the infamous dossier on Donald Trump’s alleged ties to Russia was thrown out last Friday by a federal judge. Igor Danchenko is on trial charged with lying to the FBI about
- [FraudBlog: A Great 2022 Annual Meeting Is Now In The Record Books](https://insurancefraud.org/publications/fraudblog-a-great-2022-annual-meeting-is-now-in-the-record-books/) - BY Joseph Matos, Coalition Against Insurance Fraud | December 23, 2022 The 2022 Annual Conference is now in the record books and what a gathering it was. Closing out the year with a magical wave of first-time moments for the Coalition was nothing less than spectacular. Breaking another attendance record as we continue to grow
- [FraudBlog: A New We](https://insurancefraud.org/publications/fraudblog-a-new-we/) - BY Tracy M. Thompson, Esq., Coalition Against Insurance Fraud | February 15, 2023 Just three months ago, I retired from being a prosecutor after 30 years of service. When I used to daydream about what retirement would look like for me, it always included going to the beach and reading all the books I didn’t
- [JIFA: Life Insurance Fraud: More Than Just Pseudocide](https://insurancefraud.org/publications/jifa-life-insurance-fraud-more-than-just-pseudocide/) - By Joe Brady | March 27, 2023 Premium schemes widespread, complex There are two kinds of death fraud: One is for life insurance money, the other is simply to disappear. The vast array of reasons someone commits these crimes is not so much shocking as it is compelling. The greed and desperation it takes to
- [FraudBlog: The Logic May be "Fuzzy," but the Results Clearly Help Find Fraudsters](https://insurancefraud.org/publications/fraudblog-fuzzy-logic-is-finding-fraudsters/) - BY Gary Saarenvirta | September 7, 2021 Tackling fraud has never been more critical or difficult. What’s more, the COVID-19 pandemic has undoubtedly shifted the fraud landscape. Fraudsters are becoming increasingly sophisticated with the arrival of new technologies. According to insurance experts, fraud increases during times of economic hardship. For example, in a survey conducted
- [FraudBlog: Third-Party Solicitation: A Growing Fraud Risk for Consumers & Insurers](https://insurancefraud.org/publications/fraudblog-third-party-solicitation-a-growing-fraud-risk-for-consumers-insurers/) - BY Alan Haskins | November 9, 2021 The vast majority of automobile and property claims are filed, adjusted, and paid in a timely manner –– just as intended. However, there is one factor that causes more disruption in the claims handling process than any other outside factor. That is third-party solicitation. The (unnecessary) involvement
- [FraudBlog: A Fraud Tweet a Day Keeps the Scammers at Bay](https://insurancefraud.org/publications/fraudblog-a-fraud-tweet-a-day-keeps-the-scammers-at-bay/) - BY Elijah Mercer | August 26, 2021 You would be surprised what comes across the Coalition’s social media timelines. As the Coalition’s social media manager I literally see individuals on platforms like Twitter admit their intentions to commit fraud in real time. Here’s an example of a typical exchange: @RandomTwitterUser: “I’m about to commit insurance fraud @GEICO.” @Insurance_Fraud: “Bet.
- [FraudBlog: Sharing the Spotlight: A Formula for Success](https://insurancefraud.org/publications/fraudblog-sharing-the-spotlight-a-formula-for-success/) - BY Tracy M. Thompson & Nicole Liebau | July 28, 2021 Tracy M. Thompson Professional organizations are often treated as an afterthought –– nice to participate in, but the focus should remain on the responsibilities of your day-to-day responsibilities. As New Jersey’s Insurance Fraud Prosecutor, I’m pulled in multiple directions, and no two weeks are
- [FraudBlog: Nuclear Verdicts & Insurance Fraud](https://insurancefraud.org/publications/fraudblog-nuclear-verdicts-insurance-fraud/) - BY MATTHEW J. SMITH, Esq. | July 1, 2021 The Coalition tries very hard to “stay in our lane” of fighting insurance fraud. We normally shy away from broader issues in the world of insurance, or at least until they impact the anti-fraud effort. One of today’s “buzzwords” in the area of insurance appears to
- [FraudBlog: Shifting health policies muddy the fraud fighting waters](https://insurancefraud.org/publications/fraudblog-shifting-health-policies-muddy-the-fraud-fighting-waters/) - Shifting health policies muddy the fraud fighting waters BY ARINZE IFEKAUCHE | May 18, 2021 As part of my regular responsibilities as the Coalition’s Communications Director, I source news clippings for distribution on our Fraud News Daily listserv. The clips normally cover the usual fraud stories from around the country: arson fires, uninsured motorists applying
- [FraudBlog: Fighting Contractor Fraud: A lifelong mission](https://insurancefraud.org/publications/fraudblog-fighting-contractor-fraud-a-lifelong-mission/) - Fighting Contractor Fraud: A lifelong mission BY PHAE MOORE | June 1, 2021 Her name was Addie Lee. She was loving, giving, beautiful and strong. She was also elderly, poor, and raising 6 grandchildren on her own. Every time it rained, the family took turns emptying buckets of water that collected beneath her leaking roof,
- [FraudBlog: Don’t Fall Victim to Contractor Fraud](https://insurancefraud.org/publications/fraudblog-dont-fall-victim-to-contractor-fraud/) - Don’t Fall Victim to Contractor Fraud BY Tasha Carter, Florida’s Insurance Consumer Advocate | April 21, 2021 One of the biggest contributors to increased insurance rates is fraud. Insurance fraud costs more than $40B annually, which increases the average family’s insurance premiums between $400 and $700 a year. As Florida’s Insurance Consumer Advocate, it is
- [FraudBlog: Help Unwanted: Safety precautions needed for vax appointment volunteers](https://insurancefraud.org/publications/fraudblog-help-unwanted-safety-precautions-needed/) - Help Unwanted: Safety precautions needed for vax appointment volunteers BY Frank Sztuk | March 30, 2021 There’s been plenty of reporting on technologically inclined volunteers stepping up to help seniors, first responders, and other priority groups navigate the complex rollout of the Covid-19 vaccine. Many eligible for the shot have expressed frustration -- and others,
- [FraudBlog: When Will Things Return to Normal?](https://insurancefraud.org/publications/fraudblog-when-will-things-return-to-normal/) - When Will Things Return to Normal? BY Kendra Smith | March 9, 2021 This is my first blog since joining the Coalition’s team 14 years ago. My role as Operations Manager over the years has been rewarding, challenging and AWESOME. I joined the Coalition in 2007. It was a time when President Bush had announced
- [FraudBlog: Fraud fighters should commit to fostering diversity and inclusion](https://insurancefraud.org/publications/fraudblog-how-fraud-fighters-can-commit-to-fostering-diversity-and-inclusion-2/) - Fraud fighters should commit to fostering diversity and inclusion “Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without.” – William Sloane Coffin Jr. BY A.D. DuVall | February 17, 2021 As a woman of color and a human resource professional,

## Regulations

- [California-SIU Education-Section 2698.39 Anti-Fraud Training](https://insurancefraud.org/regulations/california-siu-education-section-2698-39-anti-fraud-training/) - Section 2698.39 Anti-Fraud Training Requirements for training provided by and for the SIU shall include: (a) The insurer shall establish and maintain an ongoing anti-fraud training program, planned and conducted to develop and improve the anti-fraud awareness skills of the integral anti-fraud personnel. (b) The insurer shall designate an SIU staff person to be responsible
- [Maine-Title 24-Mandatory Reporting](https://insurancefraud.org/regulations/maine-title-24-mandatory-reporting/) - Title 24-A: MAINE INSURANCE CODE Chapter 23: TRADE PRACTICES AND FRAUDS §2186. Insurance fraud prevention Reporting of fraudulent insurance acts. Fraudulent insurance acts must be reported in accordance with this subsection. A. An insurer shall, annually on or before March 1st or within any reasonable extension of time granted by the superintendent, file with the superintendent
- [New Hampshire-Fraud Plan-Section 417:30 & 4601.05](https://insurancefraud.org/regulations/new-hampshire-fraud-plan-section-41730-4601-05/) - 417:30. Insurer Antifraud Initiatives. I. Except for insurance companies writing only credit, home warranty, travel, or title insurance, every insurance company licensed to write direct business in this state shall have antifraud initiatives reasonably calculated to detect, prosecute, and prevent fraudulent insurance acts, including a written antifraud plan. This plan shall be furnished to the
- [California-Title 10-SIU requirement](https://insurancefraud.org/regulations/title-10-investment/) - Chapter 5. Insurance Commissioner Subchapter 9. Insurance Fraud Article 2. Special Investigative Units Amend 2698.30. Definitions. As used in this article, the following definitions shall apply: (a) "Act" means any violation of California Code of Regulations, Title 10, Chapter 5, Section 2698.30-42, inclusive. (b) "Authorized governmental agency (agencies)" shall have the same meaning as used
- [New York-Fraud Plan-Section 409](https://insurancefraud.org/regulations/new-york-fraud-plan-section-409/) - Fraud prevention plans and special investigations units. (a) Every insurer writing private or commercial automobile insurance, workers' compensation insurance, or individual, group or blanket accident and health insurance policies issued or issued for delivery in this state, except for insurers that write less than three thousand of such policies, issued or issued for delivery in
- [Alabama-Mandatory Reporting-§ 27-12A-21.  Mandatory reporting requirements.](https://insurancefraud.org/regulations/alabama-mandatory-reporting-§-27-12a-21-mandatory-reporting-requirements/) - § 27-12A-21. Mandatory reporting requirements. (a) Persons engaged in the business of insurance, having knowledge or a reasonable belief that insurance fraud is being, will be, or has been committed, shall provide to the department such information that is required by, and in a manner prescribed by, the department. As used in this section, "persons
- [West Virginia-Mandatory Reporting-Section 33-41-5](https://insurancefraud.org/regulations/west-virginia-mandatory-reporting-section-33-41-5/) - §33-41-5. Reporting of insurance fraud or criminal offenses otherwise related to the business of insurance. (a) A person engaged in the business of insurance having knowledge or a reasonable belief that fraud or another crime related to the business of insurance is being, will be or has been committed shall provide to the commissioner the
- [Wisconsin-Mandatory Reporting-Sec. 102-125 - Fraudulent Claims Reporting](https://insurancefraud.org/regulations/wisconsin-mandatory-reporting-sec-102-125-fraudulent-claims-reporting/) - Workers compensation only. Sec. 102-125 - Fraudulent Claims Reporting “(1) If an insurer or self-insured employer has evidence that a claim is false or fraudulent in violation of Sec. 943.395 and if the insurer or self-insured employer is satisfied that reporting the claim to the department will not impede its ability to defend the claim,
- [Tennessee-Fraud Warning-56-53-111](https://insurancefraud.org/regulations/tennessee-fraud-warning-56-53-111/) - Chapter No. 356 – Enacted 2001 Legislative Session Section 12 (b) (1)(A) No later than six (6) months after the effective date of this act, all applications for insurance, and all claim forms regardless of the form of transmission provided and required by an insurer or required by law as a condition of payment of
- [Tennessee-Fraud Warning-All workers compensation forms - Sec. 56-_-112(b); Section 56-47-112(b) - Language is mandatory](https://insurancefraud.org/regulations/tennessee-fraud-warning-all-workers-compensation-forms-sec-56-_-112b-section-56-47-112b-language-is-mandatory/) - All workers compensation forms - Sec. 56-_-112(b) Section 56-47-112(b) - Language is mandatory (b)(1) All printed applications for insurance, and all printed claim forms provided and required by an insurer or required by law as a condition of payment of a claim, shall contain a statement, permanently affixed to the application or claim form, that
- [Tennessee-Mandatory Reporting-Section 56-47-110 as passed in the Tennessee Workers Compensation Act of 1996](https://insurancefraud.org/regulations/tennessee-mandatory-reporting-section-56-47-110-as-passed-in-the-tennessee-workers-compensation-act-of-1996/) - Workers compensation only. (b) Any insurer, insurance professional or other person that has reasonable belief that an act violating Section 56-47-103 or 56-47-104 will be, is being, or has been committed, shall furnish and disclose any information in its possession concerning such act to the appropriate law enforcement official or authority, Department of Commerce and
- [Tennessee-Mandatory Reporting-Section 56-53-109(b)](https://insurancefraud.org/regulations/tennessee-mandatory-reporting-section-56-53-109b/) - Section 56-53-109(b) Any insurer or insurance professional that has reasonable belief that an violating Section 56-53-102 or Section 56-53-103 will be, is being, or has been committed shall furnish and disclose any information in its possession concerning such act to the appropriate law enforcement official or authority, insurance department, state division of insurance fraud, or
- [Tennessee-SIU Requirement-Section 56-47-112](https://insurancefraud.org/regulations/tennessee-siu-requirement-section-56-47-112/) - For workers compensation only. Section 56-47-112 requires insurers to prepare, implement, maintain and submit anti-fraud plans to the Department of Commerce and Insurance. "Each insurer's antifraud plan shall outline specific procedures to: (A) prevent, detect and investigate all forms of insurance fraud, including fraud involving the insurer's employees or agents; fraud resulting from misrepresentations in
- [Texas-Fraud Plan-Texas Insurance Code 704.051; 704.001](https://insurancefraud.org/regulations/texas-fraud-plan-texas-insurance-code-704-051-704-001/) - § 704.051. Antifraud Plan Required for Certain Plan Issuers A plan issuer who collects direct written premium shall adopt an antifraud plan under this subchapter. § 704.001. Definition In this chapter, "plan issuer" means: (1) a health insurer, including a life, health, and accident insurer, a health and accident insurer, a health maintenance organization, and
- [Texas-Fraud Warning-Texas Insurance Code §704.002.](https://insurancefraud.org/regulations/texas-fraud-warning-texas-insurance-code-§704-002/) - State law requires us to include the following statement: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.
- [Texas-Mandatory Reporting-Texas Insurance Code Section 701.051](https://insurancefraud.org/regulations/texas-mandatory-reporting-texas-insurance-code-section-701-051/) - § 701.051. DUTY TO REPORT. (a) Not later than the 30th day after the date the person makes the determination or reasonably suspects that a fraudulent insurance act has been or is about to be committed in this state, the person: (1) shall report the information in writing to the insurance fraud unit of the
- [Utah-Fraud Plan-31A-31-112. Insurance Antifraud Plan.](https://insurancefraud.org/regulations/utah-fraud-plan-31a-31-112-insurance-antifraud-plan/) - NOTE: The state does not require insurers to file their plans with the department. Only Utah-domiciled insurers will be asked to provide these plans, which will only occur during a normal audit. Plans need not be submitted outside of the normal audit process. 31A-31-112. Insurance Antifraud Plan. (1) An insurer, as defined in Section 31A-31-102,
- [Utah-Fraud Warning-Section 35-1-109 - Language is permissive for first paragraph and mandatory for second paragraph](https://insurancefraud.org/regulations/utah-fraud-warning-section-35-1-109-language-is-permissive-for-first-paragraph-and-mandatory-for-second-paragraph/) - All workers compensation forms - Sec. 35-1-109 Section 35-1-109 - Language is permissive for first paragraph and mandatory for second paragraph “For your protection, Utah law requires the following to appear on this form: Any person who knowingly presents false or fraudulent underwriting information, files or causes to be filed a false or fraudulent claim
- [Utah-Fraud Warning-Statutes Section 28-35-39](https://insurancefraud.org/regulations/utah-fraud-warning-statutes-section-28-35-39/) - For benefit checks. Workers compensation insurance fraud is a crime punishable by Utah law.
- [Utah-Mandatory Reporting-Utah Code Section 31A-31-110](https://insurancefraud.org/regulations/utah-mandatory-reporting-utah-code-section-31a-31-110/) - Utah Code Section 31A-31-110 (1)(a) A person shall report a fraudulent insurance act to the department if: (i) the person has a good faith belief on the basis of a preponderance of the evidence that a fraudulent insurance act is being, will be, or has been committed by a person other than the person making
- [Vermont-Fraud Plan-Chapter 130 Section 4750](https://insurancefraud.org/regulations/vermont-fraud-plan-chapter-130-section-4750/) - CHAPTER 130. INSURANCE FRAUD § 4750. INSURER ANTI-FRAUD PLANS (a) Every insurer with direct written premiums shall prepare, implement, and maintain an insurance anti-fraud plan. Each insurer’s anti-fraud plan shall outline specific procedures, appropriate to the type of insurance the insurer writes in this state, to: (1) Prevent, detect, and investigate all forms of insurance
- [Virginia-Fraud Warning-Section 52-40(B) - of S. 421, Chapter 590, Laws 1998](https://insurancefraud.org/regulations/virginia-fraud-warning-section-52-40b-of-s-421-chapter-590-laws-1998/) - Section 52-40(B) - of S. 421, Chapter 590, Laws 1998 B. All applications for insurance and all claim forms provided and required by an insurer or required by law as a condition of payment of a claim shall contain a statement, permanently affixed to, or included as a part of the application or claim form,
- [Virginia-Mandatory Reporting-Section 52-40(A) - of S. 421, Chapter 590, Laws 1998](https://insurancefraud.org/regulations/virginia-mandatory-reporting-section-52-40a-of-s-421-chapter-590-laws-1998/) - Section 52-40(A) - of S. 421, Chapter 590, Laws 1998 A. If any insurer, any employee thereof, or any insurance professional has knowledge of, or has reason to believe that a violation of Section 18.2-178 will be, is being, or has been committed, that person shall furnish and disclose any information in his possession concerning
- [Washington-Annual Reporting-48.30A.060](https://insurancefraud.org/regulations/washington-annual-reporting-48-30a-060/) - By March 31st of each year, each insurer shall provide to the insurance commissioner a summary report on actions taken under its antifraud plan to prevent and combat insurance fraud. The report must also include, but not be limited to, measures taken to protect and ensure the integrity of electronic data processing-generated data and manually
- [Washington-Fraud Plan-Chapter 285, Laws of 1995 - Sections 8 - 11](https://insurancefraud.org/regulations/washington-fraud-plan-chapter-285-laws-of-1995-sections-8-11/) - Section 9 — Each insurer licensed to write direct insurance in this state shall institute and maintain an insurance antifraud plan. An insurer licensed on the effective date of this act shall file its antifraud plan with the insurance commissioner no later than December 31, 1995. An insurer licensed after the effective date of this
- [Washington-Fraud Warning-48.135.080](https://insurancefraud.org/regulations/washington-fraud-warning-48-135-080/) - No later than six months after July 1, 2006, or when the insurer has used all its existing paper application and claim forms which were in its possession on July 1, 2006, whichever is later, all applications for insurance, and all claim forms regardless of the form of transmission provided and required by an insurer
- [Washington-Mandatory Reporting-Section 48.135.050 Section 48.50.030 Section 48.50.040 (fire) Section 48.50.070 (immunity)](https://insurancefraud.org/regulations/washington-mandatory-reporting-section-48-135-050-section-48-50-030-section-48-50-040-fire-section-48-50-070-immunity/) - RCW 48.135.050 Furnishing and disclosing insurance fraud knowledge and information. (1) Any insurer or licensee of the commissioner that has reasonable belief that an act of insurance fraud which is or may be a crime under Washington law has been, is being, or is about to be committed shall furnish and disclose the knowledge and
- [West Virginia-Fraud Warning-Section 33-41-3](https://insurancefraud.org/regulations/west-virginia-fraud-warning-section-33-41-3/) - §33-41-3. Fraud warning authorized; statement required of nonadmitted insurers. (a) Claims forms and applications for insurance, regardless of the form of transmission, may contain the following warning or a substantially similar caveat: "Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in
- [Oklahoma-Fraud Warning-Section 3613.1](https://insurancefraud.org/regulations/oklahoma-fraud-warning-section-3613-1/) - Section 3613.1 - Language is permissive “WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.” The section also states that the absence of a warning is not
- [Oklahoma-Mandatory Reporting-Section 3(a) of House Bill 1502 - Title 36 Section 363](https://insurancefraud.org/regulations/oklahoma-mandatory-reporting-section-3a-of-house-bill-1502-title-36-section-363/) - (A) Any insurer who has reason to believe that a person or entity has engaged in or is engaging in an act or practice that violates any statute or administrative rule of this state related to insurance fraud shall immediately notify the Anti-Fraud Unit of the Insurance Department.
- [Oregon-Fraud Warning-Bulletin INS 2010-03 TO: All Insurers RE: Use of a Fraud or Misstatement Warning This Bulletin replaces INS 98-5](https://insurancefraud.org/regulations/oregon-fraud-warning-bulletin-ins-2010-03-to-all-insurers-re-use-of-a-fraud-or-misstatement-warning-this-bulletin-replaces-ins-98-5/) - Warning statements may be included on insurance applications, claim forms and claim payments. They may appear in policies and declaration pages only if the statement is part of the application for insurance. The Insurance Division reviews statements according to the following guidelines: For remedies other than denial of a claim (e.g. rescission or cancellation, depending
- [Oregon-Mandatory Reporting-Section 731.592](https://insurancefraud.org/regulations/oregon-mandatory-reporting-section-731-592/) - Section 731.592 (1) Notwithstanding ORS 746.665 (Limitations and conditions on disclosure of certain information), an insurer shall cooperate with any law enforcement agency or other state or federal agency that is investigating or prosecuting suspected criminal conduct involving insurance. The insurer shall provide any information requested by the agency unless the information is subject to
- [Pennsylvania-Annual Reporting-Section 1814 — “Report on antifraud activities](https://insurancefraud.org/regulations/pennsylvania-annual-reporting-section-1814-report-on-antifraud-activities/) - All insurer shall annually provide to the department a summary report on actions taken under the plan to prevent and combat insurance fraud, including, but not limited to, measures taken to protect and ensure the integrity of electronic data-processing-generated data and manually compiled data, statistical data on the amount of resources committed to combating fraud,
- [Pennsylvania-Fraud Plan-Title 75 Sections 1811-1816](https://insurancefraud.org/regulations/pennsylvania-fraud-plan-title-75-sections-1811-1816/) - Title 75 Sections 1811-1816 (Motor Vehicle Insurance Fraud) Section 1811 — Each insurer licensed to write motor vehicle insurance in this Commonwealth shall institute and maintain a motor vehicle insurance antifraud plan.... All insurers licensed ... shall file within six months of licensure. All changes to the antifraud plan shall be filed with the department
- [Pennsylvania-Fraud Warning-Section 117.4; 18 Pa. CSA 4117(k)(1)](https://insurancefraud.org/regulations/pennsylvania-fraud-warning-section-117-4-18-pa-csa-4117k1/) - Anti-arson applications - Section 117.4 All application and claim forms Section 68.402 Section 117.4 - anti-arson applications - Language is mandatory “I (We) certify that all information contained herein is true and correct to the best of my (our) knowledge and belief. I (We) acknowledge that this statement is signed under the pains and penalties
- [Pennsylvania-Mandatory Reporting-Title 75 Section 1817;Title 31 Sections 119.22-26; 31 Sec. 119.22; 31 Sec. 119.23; 31 Section 119.24; 31 Section 119.25; Title 31, Section 119.25](https://insurancefraud.org/regulations/pennsylvania-mandatory-reporting-title-75-section-1817title-31-sections-119-22-26-31-sec-119-22-31-sec-119-23-31-section-119-24-31-section-119-25-title-31-section-119-25/) - Title 75 Section 1817 — Reporting Requirements (Motor Vehicle Insurance Fraud) “Every insurer licensed to do business in this Commonwealth, and its employees, agents, brokers, motor vehicle physical damage appraisers and public adjusters, or public adjuster solicitors, who has a reasonable basis to believe insurance fraud has occurred shall be required to report the incidence
- [Rhode Island-Fraud Plan-27-54.1-5. Insurer antifraud initiatives.](https://insurancefraud.org/regulations/rhode-island-fraud-plan-27-54-1-5-insurer-antifraud-initiatives/) - 27-54.1-5. Insurer antifraud initiatives. -- (a) Insurers shall have antifraud initiatives reasonably calculated to detect, report, prosecute and prevent fraudulent insurance acts, antifraud initiatives may include: (1) Fraud investigators, who may be insurer employees or independent contractors; or (2) An antifraud plan. (b) A person engaged in the business of insurance having knowledge or a
- [Rhode Island-Fraud Warning-27-54.1-3. Fraud warning required](https://insurancefraud.org/regulations/rhode-island-fraud-warning-27-54-1-3-fraud-warning-required/) - 27-54.1-3. Fraud warning required. -- (a) Notwithstanding any similar requirements in title 28, every claim form and application for insurance, regardless of the form of transmission, shall contain the following statement or a substantially similar statement: "Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly
- [Rhode Island-Fraud Warning-Section 27-5-2.1 - Language is mandatory](https://insurancefraud.org/regulations/rhode-island-fraud-warning-section-27-5-2-1-language-is-mandatory/) - Anti-arson applications - Sec. 27-5-2.1 Section 27-5-2.1 - Language is mandatory Property insurers are required to use the ACORD Supplementary Property Application Form 190 as the mandatory anti-arson application.
- [Rhode Island-Fraud Warning-Statutes Section 28-35-39](https://insurancefraud.org/regulations/rhode-island-fraud-warning-statutes-section-28-35-39/) - For benefit checks. Statutes Section 28-35-39 I understand that endorsement whereon or deposit to my accounts constitutes my affirmation that I am receiving these benefits under the R.I. workers’ compensation act, that I have made no false claims or statements or concealed any material fact, and that doing so would make me liable for civil
- [Rhode Island-Mandatory Reporting-Chapter 42-16.1-14 of the General Laws entitled “Department of Labor and Training” Section 27-49-5.1](https://insurancefraud.org/regulations/rhode-island-mandatory-reporting-chapter-42-16-1-14-of-the-general-laws-entitled-department-of-labor-and-training-section-27-49-5-1/) - Workers compensation only. Disclosure of information to the fraud prevention unit -- Any insurer, or agent authorized by the insurer to act on its behalf, having reason to believe that an insurance transaction may be fraudulent, shall send to the fraud prevention unit a report of the transaction and any additional information requested by the
- [Rhode Island-Pre-insurance Inspection-Pre-Inspection Regulation LXXVII (77)](https://insurancefraud.org/regulations/rhode-island-pre-insurance-inspection-pre-inspection-regulation-lxxvii-77/) - Pre-Inspection Regulation LXXVII (77) Photograph required — Yes Grace Period (days) — 7 Exemptions/Waivers Existing Policyholder (years) — 4 Renewal Policy — Yes New Cars — Yes Vehicle Age — 6
- [South Carolina-Mandatory Reporting-Section 38-55-570 (A)](https://insurancefraud.org/regulations/south-carolina-mandatory-reporting-section-38-55-570-a/) - Section 38-55-570 (A) “Any person, insurer, or authorized agency having reason to believe that another has made a false statement or misrepresentation or has knowledge of a suspected false statement or misrepresentation shall, for purposes of reporting and investigation, notify the Insurance Fraud Division of the Office of the Attorney General of the knowledge or
- [South Dakota-Mandatory Reporting-Section 58-33-76 Section 58-33-77 Section 58-33-79](https://insurancefraud.org/regulations/south-dakota-mandatory-reporting-section-58-33-76-section-58-33-77-section-58-33-79/) - 58-33-76. Notification of suspected fraud. An insurer, or any person authorized to act on its behalf, which reasonably believes that a false or fraudulent claim, statement, or representation has occurred, may notify an authorized agency and provide it with all relevant information in its possession. 58-33-77. Accessibility of information relevant to suspected fraud--Types of information.
- [Tennessee-Annual Reporting-Chapter No. 356 – Enacted 2001 Legislative Session, Section 12 (a)](https://insurancefraud.org/regulations/tennessee-annual-reporting-chapter-no-356-enacted-2001-legislative-session-section-12-a/) - Chapter No. 356 – Enacted 2001 Legislative Session Section 12 (a) The commissioner may require each insurer to file a summary of the insurer’s anti-fraud activities and results. The anti-fraud plans and the summary of the insurer’s anti-fraud activities and results are not public records and are exempt from the public records act, and shall
- [Tennessee-Annual Reporting-Section 56-47-112(a)(5)](https://insurancefraud.org/regulations/tennessee-annual-reporting-section-56-47-112a5/) - For Workers Compensation Only. Section 56-47-112(a)(5) The commissioner may require each insurer to file a summary of the insurer's anti-fraud activities and results. The anti-fraud plans and the summary of the insurer's anti-fraud activities and results are not public records and are exempt from title 10, chapter 7, part 5, and shall be proprietary
- [Tennessee-Fraud Plan-56-53-111](https://insurancefraud.org/regulations/tennessee-fraud-plan-56-53-111/) - Chapter No. 356 – Enacted 2001 Legislative Session Section 12 (b) (1)(A) No later than six (6) months after the effective date of this act, all applications for insurance, and all claim forms regardless of the form of transmission provided and required by an insurer or required by law as a condition of payment of
- [Tennessee-Fraud Plan-Section 56-47-112](https://insurancefraud.org/regulations/tennessee-fraud-plan-section-56-47-112/) - For workers compensation only. Section 56-47-112 requires insurers to prepare, implement, maintain and submit anti-fraud plans to the Department of Commerce and Insurance. "Each insurer's antifraud plan shall outline specific procedures to: (A) prevent, detect and investigate all forms of insurance fraud, including fraud involving the insurer's employees or agents; fraud resulting from misrepresentations in
- [New Mexico-Mandatory Reporting-Section 59A-16C-6. Notice and cooperation required; tolling period.](https://insurancefraud.org/regulations/new-mexico-mandatory-reporting-section-59a-16c-6-notice-and-cooperation-required-tolling-period/) - 59A-16C-6. Notice and cooperation required; tolling period. A. Every insurer or licensed insurance professional that has a reasonable belief that an act of insurance fraud will be, is being or has been committed shall furnish and disclose knowledge and information about it to the superintendent and shall cooperate fully with any investigation conducted by the
- [New York-Annual Reporting-Section 409 (g)](https://insurancefraud.org/regulations/new-york-annual-reporting-section-409-g/) - “Every insurer required to file a fraud prevention plan shall report to the superintendent on an annual basis, no later than March fifteenth, describing the insurer’s experience, performance and cost effectiveness in implementing the plan, utilizing such forms as the superintendent may prescribe. Upon consideration of such reports, the superintendent may require amendments to the
- [New York-Fraud Plan-Section 86.4;](https://insurancefraud.org/regulations/new-york-fraud-plan-section-86-4/) - Regulation. Section 86.4 (a) All applications provided to applicants for commercial insurance and all claim forms for insurance, except personal automobile insurance, delivered to any person residing or located in this State on and after February 2, 1994 in connection with commercial insurance policies to be issued or issued for delivery in this State shall
- [New York-Fraud Plan-Section 86.6 - Fraud prevention plans and special investigation units & Title 11, Part 6 Electronic Filing](https://insurancefraud.org/regulations/new-york-fraud-plan-section-86-6-fraud-prevention-plans-and-special-investigation-units-title-11-part-6-electronic-filing/) - Regulation. Section 86.6 - Fraud prevention plans and special investigation units. (a) Every insurer writing private or commercial automobile insurance, worker’s compensation insurance, or individual, group or blanket accident and health insurance policies issued or issued for delivery in this state, which writes three thousand or more such policies in any given year, shall develop
- [New York-Fraud Warning-Section 403 - All applications and claims forms - Language is permissive; Section 404 - Automobile applications and claims forms - Language is permissive](https://insurancefraud.org/regulations/new-york-fraud-warning-section-403-all-applications-and-claims-forms-language-is-permissive-section-404-automobile-applications-and-claims-forms-language-is-permissive/) - Application forms - Section 403 All claim forms - Section 403 Section 403(d) - All applications and claims forms - Language is permissive “Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for
- [New York-Fraud Warning-Section 86.4 -](https://insurancefraud.org/regulations/new-york-fraud-warning-section-86-4/) - Regulation. Section 86.4 (a) All applications provided to applicants for commercial insurance and all claim forms for insurance, except personal automobile insurance, delivered to any person residing or located in this State on and after February 2, 1994 in connection with commercial insurance policies to be issued or issued for delivery in this State shall
- [New York-Fraud Warning-Workers Compensation Law Section 132 (as amended in A. 11331, 1996)](https://insurancefraud.org/regulations/new-york-fraud-warning-workers-compensation-law-section-132-as-amended-in-a-11331-1996/) - For benefit checks. By endorsement of this check, the payee, under penalty of fine and/or imprisonment, certifies entitlement to this payment for benefits or services, circumstances affecting such entitlement have not changed and no false statements or representations have been made in support of the claim for payment. False representations could result in civil and
- [New York-Mandatory Reporting-Section 86.5 - Reports of fraudulent acts](https://insurancefraud.org/regulations/new-york-mandatory-reporting-section-86-5-reports-of-fraudulent-acts/) - Regulation. Section 86.5 - Reports of fraudulent acts. Any person licensed pursuant to the provisions of the Insurance Law who determines that an insurance transaction or purported insurance transaction appears to be fraudulent or suspect shall submit a report thereon to the Insurance Frauds Bureau. Reports shall be submitted on the prescribed reporting form issued
- [New York-Mandatory Reporting-Section 86.5 - Reports of fraudulent acts](https://insurancefraud.org/regulations/new-york-mandatory-reporting-section-86-5-reports-of-fraudulent-acts-2/) - Regulation. Any person licensed pursuant to the provisions of the Insurance Law who determines that an insurance transaction or purported insurance transaction appears to be fraudulent or suspect shall submit a report thereon to the Insurance Frauds Bureau. Reports shall be submitted on the prescribed reporting form issued by the Insurance Frauds Bureau or upon
- [New York-Mandatory Reporting-State Insurance Code Section 405; State Insurance Code Section 409 (Fraud prevention plans and special investigations units)*](https://insurancefraud.org/regulations/new-york-mandatory-reporting-state-insurance-code-section-405-state-insurance-code-section-409-fraud-prevention-plans-and-special-investigations-units/) - State Insurance Code Section 405 (a) Any person licensed or registered pursuant to the provisions of this chapter, and any person engaged in the business of insurance or life settlement in this state who is exempted from compliance with the licensing requirements of this chapter, including the state insurance fund of this state, who has
- [New York-Mandatory Reporting-State Insurance Code Section 405; State Insurance Code Section 409 (Fraud prevention plans and special investigations units)*](https://insurancefraud.org/regulations/new-york-mandatory-reporting-state-insurance-code-section-405-state-insurance-code-section-409-fraud-prevention-plans-and-special-investigations-units-2/) - State Insurance Code Section 405 “Any person licensed ... who has reason to believe that an insurance transaction may be fraudulent, or has knowledge that a fraudulent insurance transaction is about to take place, or has taken place shall, within thirty days after determination by such person that the transaction appears to be fraudulent, send
- [New York-Pre-insurance Inspection-New York Insurance Code Section 3411; New York Rules & Regulations Section 67](https://insurancefraud.org/regulations/new-york-pre-insurance-inspection-new-york-insurance-code-section-3411-new-york-rules-regulations-section-67/) - Photograph required — Yes Grace Period (days) — 5 Exemptions/Waivers Existing Policyholder (years) — 4 Renewal Policy — No New Cars — No Vehicle Age — 7
- [New York-SIU Requirement-Section 86.6 - Fraud prevention plans and special investigation units](https://insurancefraud.org/regulations/new-york-siu-requirement-section-86-6-fraud-prevention-plans-and-special-investigation-units/) - (b) The plan shall include the following provisions: (1) Establishment of a full time Special Investigation Unit separate from the underwriting or claims functions of the insurer, which shall be responsible for investigation of cases of suspected fraudulent activity and for implementation of the insurer’s fraud prevention and reduction activities under the Fraud Prevention Plan.
- [New York-SIU Education-(c) Persons employed by the Special Investigations Units as investigators or by an independent provider of investigative services under contract with an insurer shall be qualified by education and/or experience which shall include a bachelor’s degree or either four years of claims investigation experience or five years of professional investigation experiences involving economic or insurance related matters. Notwithstanding these minimum requirements anyone employed as an investigator in a special investigation unit as of the effective date of this provision may continue in such employment provided the insurer identifies such person in writing to the superintendent giving the date such employment began and a description of the person’s qualifications, employment history and current job duties.](https://insurancefraud.org/regulations/new-york-siu-education-c-persons-employed-by-the-special-investigations-units-as-investigators-or-by-an-independent-provider-of-investigative-services-under-contract-with-an-insurer-shall-be-qualifi/) - (c) Persons employed by the Special Investigations Units as investigators or by an independent provider of investigative services under contract with an insurer shall be qualified by education and/or experience which shall include a bachelor’s degree or either four years of claims investigation experience or five years of professional investigation experiences involving economic or insurance
- [North Carolina-Mandatory Reporting-General Statutes Section 58-2-163](https://insurancefraud.org/regulations/north-carolina-mandatory-reporting-general-statutes-section-58-2-163/) - General Statutes Section 58-2-163 Whenever any insurance company, or employee or representative of such company, or any other person licensed or registered under ... this Chapter knows or has reasonable cause to believe that any other person has violated G.S. 58-2-161, 58-2-162, 58-2-180, 58-8-1, or 58-24-180(e), ... it is the duty of such person, upon
- [North Dakota-Mandatory Reporting-26.1-02.1-06. Mandatory reporting of fraudulent insurance acts.](https://insurancefraud.org/regulations/north-dakota-mandatory-reporting-26-1-02-1-06-mandatory-reporting-of-fraudulent-insurance-acts/) - 26.1-02.1-06. Mandatory reporting of fraudulent insurance acts. 1. A person engaged in the business of insurance having knowledge or a reasonable belief that a fraudulent insurance act is being, will be, or has been committed shall provide to the commissioner the information required by, and in a manner prescribed by, the commissioner. 2. Any other
- [Ohio-Fraud Plan-Section 3999.41](https://insurancefraud.org/regulations/ohio-fraud-plan-section-3999-41/) - (A) Except as provided in Division (D) of this section, every insurer, as defined in Division (A) of Section 3999.36 of the revised code, shall adopt an antifraud program and shall specify in a written plan the procedures it will follow when instances of insurance fraud or suspected insurance fraud are brought to its attention.
- [Ohio-Fraud Warning-Section 3999.21](https://insurancefraud.org/regulations/ohio-fraud-warning-section-3999-21/) - Section 3999.21 - Language is permissive, statement must be approved by Insurance Department “Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.” The section also states that
- [Ohio-Mandatory Reporting-Ohio Administrative Code Rule 3901-1-54 (Bulletin 93-3); 3999.42 Fraud; notification to department](https://insurancefraud.org/regulations/ohio-mandatory-reporting-ohio-administrative-code-rule-3901-1-54-bulletin-93-3-3999-42-fraud-notification-to-department/) - Ohio Administrative Code Rule 3901-1-54 (Bulletin 93-3) “If an insurer reasonably believes, based upon information obtained and documented within the claim file, that a claimant has fraudulently caused or contributed to the loss represented by a properly executed and documented proof of loss, such information shall be presented to the Fraud Division of the Department
- [Minnesota-Fraud Plan-General Insurance Powers Statutes Section 60A.954](https://insurancefraud.org/regulations/minnesota-fraud-plan-general-insurance-powers-statutes-section-60a-954/) - Section 60A.954 - Antifraud plan — Subdivision 1. Establishment. An insurer shall institute, implement, and maintain an antifraud plan. For the purpose of this section, the term insurer does not include reinsurers, self-insurers, and excess insurers. Within 30 days after instituting or modifying an antifraud plan, the insurer shall notify the commissioner in writing. The
- [Minnesota-Fraud Warning-Section 60A.955 - Language is permissive](https://insurancefraud.org/regulations/minnesota-fraud-warning-section-60a-955-language-is-permissive/) - All claim forms - Sec. 60A.955 Section 60A.955 - Language is permissive All insurance claim forms issued by an insurer for use in submitting a claim for payment or a claim for any other benefit pursuant to a policy shall clearly contain a warning substantially as follows: "A person who files a claim with intent
- [Minnesota-Mandatory Reporting-Minnesota Statutes Sec. 60A.951](https://insurancefraud.org/regulations/minnesota-mandatory-reporting-minnesota-statutes-sec-60a-951/) - Insurers shall notify an authorized person of a suspected fraudulent insurance act. An authorized person includes the county attorney, sheriff or chief of police, Bureau of Criminal Apprehension, the Commerce Commissioner, the Attorney General or a federal criminal investigative agency. Notice to one authorized person is deemed notice to all.
- [Missouri-Mandatory Reporting-Revised Statutes Section 375.992](https://insurancefraud.org/regulations/missouri-mandatory-reporting-revised-statutes-section-375-992/) - Any company which believes that a fraudulent claim is being made shall, within sixty days of the receipt of such notice, send to the department of insurance, on a form prescribed by the department, the information requested and such additional information relative to the claim and the parties claiming loss or damages because of the
- [Montana-Mandatory Reporting-33-2-2303 (1); 33-1-1205](https://insurancefraud.org/regulations/montana-mandatory-reporting-33-2-2303-1-33-1-1205/) - 33-2-2303 (1) intended for reporting of fraud committed by insurance producers or adjusters (1) An insurer, insurance producer, or other person who has reason to believe insurance fraud has occurred shall report the suspected fraud to the commissioner or to the insurance producer’s or other person’s insurer within 60 days of discovery of the occurrence.
- [Nebraska-Mandatory Reporting-Neb. Rev. Stat. Section 44-393 Section 44-3,136](https://insurancefraud.org/regulations/nebraska-mandatory-reporting-neb-rev-stat-section-44-393-section-44-3136/) - Every insurance company, agent, solicitor, or broker, and every person or party having knowledge of violation of any of the provisions of this chapter, is required to promptly report the facts and circumstances pertaining thereto to the Department of Insurance, which report and the name of the informant may be held confidential by the department,
- [Nevada-Mandatory Reporting-Nevada Revised Statutes Sec. 679B.159 (1)](https://insurancefraud.org/regulations/nevada-mandatory-reporting-nevada-revised-statutes-sec-679b-159-1/) - “Every insurer, agent, solicitor, broker, administrator or other person who has knowledge of a violation of any provision of this code shall promptly report the facts and circumstances pertaining to the violation to the commissioner.”
- [New Hampshire-Fraud Warning-Section 402:82 - Language is permissive](https://insurancefraud.org/regulations/new-hampshire-fraud-warning-section-40282-language-is-permissive/) - All claim forms - Sec. 402:82 All insurance claim forms shall contain a statement that clearly states in substance the following: “Any person who, with a purpose to injure, defraud or deceive any insurance company, files a statement of claim containing any false, incomplete or misleading information is subject to prosecution and punishment for insurance
- [New Hampshire-Mandatory Reporting-Section 417:28](https://insurancefraud.org/regulations/new-hampshire-mandatory-reporting-section-41728/) - Any company which believes that an insurance fraud has been committed shall, within 60 days of the forming such belief, send to the unit, on a form prescribed by the unit, the information requested and such additional information relative to the claim and other parties claiming loss or damage because of the claim as the
- [New Hampshire-SIU Requirement-Section 417:30](https://insurancefraud.org/regulations/new-hampshire-siu-requirement-section-41730/) - I. Except for insurance companies writing only credit, home warranty, travel, or title insurance, every insurance company licensed to write direct business in this state shall have antifraud initiatives reasonably calculated to detect, prosecute, and prevent fraudulent insurance acts, including: (a) Fraud investigations, who may be insurer employees or independent contractors; or (b) An antifraud
- [New Jersey-Annual Reporting-NJAC 11:16-6.8 Record retention](https://insurancefraud.org/regulations/new-jersey-annual-reporting-njac-1116-6-8-record-retention/) - (a) Insurers shall maintain up-to-date and accurate records on their fraud prevention and detection plan, which shall at minimum include those necessary to prepare the report required in (b) below. (b) Insurers shall submit to the Commissioner on or before March 31 of each year an annual re-port for the prior calendar year on MCEAFC
- [New Jersey-Fraud Plan-11:16-6.1 Purpose and scope; 11:16-6.2 Definitions; N.J.A.C. 11:4-16.7, 11:20-4.1 and 11:21-6.1; 17:30A-1 et seq.; 17:48D-1 et seq.;11:16-6.3 General requirements and filing format](https://insurancefraud.org/regulations/new-jersey-fraud-plan-1116-6-1-purpose-and-scope-1116-6-2-definitions-n-j-a-c-114-16-7-1120-4-1-and-1121-6-1-1730a-1-et-seq-1748d-1-et-seq-1116-6-3-general-requirements-and-filing-form/) - 17:33A-15. Filing of plan for prevention, detection of fraudulent health, auto insurance claims 1. a. Every insurer writing health insurance or private passenger automobile insurance in this State shall file with the commissioner a plan for the prevention and detection of fraudulent insurance applications and claims. The plan shall be deemed approved by the commissioner
- [New Jersey-Fraud Warning-17:33A-6; NJAC 11:16-1.2 17:33A-6](https://insurancefraud.org/regulations/new-jersey-fraud-warning-1733a-6-njac-1116-1-2-1733a-6/) - a. Insurance claims forms shall contain a statement in a form approved by the commissioner that clearly states in substance the following: “Any person who knowingly files a statement of claim containing any false or misleading information is subject to criminal and civil penalties.” b. (Deleted by P.L. 1987, c. 342) c. Insurance application forms
- [New Jersey-Mandatory Reporting-Section 17:33A-9](https://insurancefraud.org/regulations/new-jersey-mandatory-reporting-section-1733a-9/) - “Any person who believes that a violation of this act has been or is being made shall notify the division immediately after discovery of the alleged violation of this act and shall send to the division, on a form and in a manner prescribed by the commissioner, the information requested and such additional information relative
- [New Jersey-Pre-insurance Inspection-New Jersey Statutes 17:33B-33; NJAC 11:3-36.1 New Jersey Statutes 17:33B-33; NJAC 11:3-36.1](https://insurancefraud.org/regulations/new-jersey-pre-insurance-inspection-new-jersey-statutes-1733b-33-njac-113-36-1-new-jersey-statutes-1733b-33-njac-113-36-1/) - New Jersey Pre-insurance Inspection Photograph required — Yes Grace Period (days) — 7 Exemptions/Waivers Existing Policyholder (years) — 3 Renewal Policy — Yes New Cars — Yes Vehicle Age — 7
- [New Jersey-SIU Education-§ 11:16-6.5 Training program and manual for the prevention and detection of fraud](https://insurancefraud.org/regulations/new-jersey-siu-education-§-1116-6-5-training-program-and-manual-for-the-prevention-and-detection-of-fraud/) - § 11:16-6.5 Training program and manual for the prevention and detection of fraud (a) The requirements with respect to fraud prevention and detection training programs are set forth in this subsection. Except for automobile insurers that insure fewer than 2,500 New Jersey automobile policies and health insurers that insure fewer than 10,000 lives,
- [New Jersey-SIU Requirement-11:16-6.4 Special Investigations Unit (SIU)-duties, qualifications, and composition;11:16-6.5 Training program and manual for the prevention and detection of fraud;11:16-6.6 Fraud prevention and detection plan;11:16-6.7 Referrals to OIFP;11:16-6.8 Record retention;11:16-6.9 Approval and filing of fraud prevention and detection plans;11:16-6.10 Penalties;11:16-6.11 Transition;11:16-6.12 Confidential records and information](https://insurancefraud.org/regulations/new-jersey-siu-requirement-1116-6-4-special-investigations-unit-siu-duties-qualifications-and-composition1116-6-5-training-program-and-manual-for-the-prevention-and-detection-of-fraud1116-6-6/) - 11:16-6.4 Special Investigations Unit (SIU)-duties, qualifications, and composition ( a) Except for automobile insurers that insure fewer than 2,500 New Jersey automobile policies, and health insurers that insure fewer than 10,000 lives, the plan in accordance with N.J.A.C. 11:16-6.3 shall establish a full-time Special Investigations Unit ("SIU"). (b) The SIU shall be responsible for the
- [New Mexico-Fraud Plan-Section 10 - H 141, enacted 1998 session, effective July 1, 1998](https://insurancefraud.org/regulations/new-mexico-fraud-plan-section-10-h-141-enacted-1998-session-effective-july-1-1998/) - A. Within six months of the effective date of the Insurance Fraud Act and by July 1 of each succeeding year every insurer who in the previous calendar year reported ten million dollars ($10,000,000) or more in direct written premiums in New Mexico shall establish, prepare, implement and submit to the superintendent an anti-fraud plan
- [New Mexico-Fraud Warning-59A-16C-8](https://insurancefraud.org/regulations/new-mexico-fraud-warning-59a-16c-8/) - Within six months of the effective date of the Insurance Fraud Act all claim forms and applications for insurance shall contain a statement permanently affixed to the application or claim form which states substantially as follows: “Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly
- [Kentucky-SIU Education-806 KAR 47:030](https://insurancefraud.org/regulations/kentucky-siu-education-806-kar-47030/) - 806 KAR 47:030 — ... Section 2. All insurers shall implement the following in conjunction with their SIUs: (1) Systematic and effective methods to detect and investigate suspected fraudulent insurance claims; (2) Development and implementation of a corporate antifraud strategy to provide for the appropriate disposition of fraudulent insurance claims; (3) Provisions to educate and
- [Kentucky-SIU Requirement-KRS 304.47-080; 806 KAR 47:030](https://insurancefraud.org/regulations/kentucky-siu-requirement-krs-304-47-080-806-kar-47030/) - KRS 304.47-080 — (1) Every insurer admitted to do business in the Commonwealth shall maintain a unit to investigate possible fraudulent claims by insureds or by persons making claims for services or repairs against policies held by insureds. (2) Insurers may maintain the unit required by subsection (1) of this section, using its employees or
- [Louisiana-Annual Reporting-Sec. 22:572.1(F)](https://insurancefraud.org/regulations/louisiana-annual-reporting-sec-22572-1f/) - F. The anti-fraud plan and any summary report shall be filed with the commissioner on or before April first of each calendar year. Either on a calendar year basis or on whatever other interval he deems appropriate, the commissioner is authorized to require that each authorized insurer and each health maintenance organization file a summary
- [Louisiana-Fraud Plan-§572.1. Insurance anti-fraud plan](https://insurancefraud.org/regulations/louisiana-fraud-plan-§572-1-insurance-anti-fraud-plan/) - §572.1. Insurance anti-fraud plan Each authorized insurer and each health maintenance organization licensed to operate in this state shall prepare, implement, and maintain an insurance anti-fraud plan for the insurer's or health maintenance organization's operations in this state. The insurance anti-fraud plan utilized by each authorized insurer and each health maintenance organization in this state
- [Louisiana-Fraud Warning-LARS 40:1424](https://insurancefraud.org/regulations/louisiana-fraud-warning-lars-401424/) - B. All applications for insurance and all claim forms provided and required by an insurer or required by law as a condition of payment of a claim shall contain a statement, permanently affixed to or included as a part of the application or claim form, that clearly states in substance the following: “Any person who
- [Louisiana-Mandatory Reporting-LA R.S. 1208.2 Immunity  for Reporting](https://insurancefraud.org/regulations/louisiana-mandatory-reporting-la-r-s-1208-2-immunity-for-reporting/) - § 23:1208.2. Duty to report fraud; immunity from civil liability. A. Any person having knowledge of or who believes that an act is being or has been committed in violation of this Chapter shall report orally or in writing to the director the information that forms the basis of such knowledge or belief, as well
- [Louisiana-Mandatory Reporting-LA R.S. 22:1926](https://insurancefraud.org/regulations/louisiana-mandatory-reporting-la-r-s-221926/) - § 22:1926. Duties of companies and others. A. Any person, company, or other legal entity including but not limited to those engaged in the business of insurance, including producers and adjusters, that suspects that a fraudulent insurance act will be, is being, or has been committed shall, within sixty days of the receipt of such
- [Louisiana-Mandatory Reporting-Section 22:1926 Workers Compensation - 23:1208.2](https://insurancefraud.org/regulations/louisiana-mandatory-reporting-section-221926-workers-compensation-231208-2/) - §1926. Duties of companies and others A. Any person, company, or other legal entity including but not limited to those engaged in the business of insurance, including agents, brokers, and adjusters, which believes that a fraudulent claim is being made, shall within sixty days of the receipt of such notice, send to the section of
- [Maine-Annual Reporting-Sec. 2186 (4); Regulation: Chapter 920:](https://insurancefraud.org/regulations/maine-annual-reporting-sec-2186-4-regulation-chapter-920/) - 4. Reporting of fraudulent insurance acts. Fraudulent insurance acts must be reported in accordance with this subsection. A. An insurer shall, annually on or before March 1st or within any reasonable extension of time granted by the superintendent, file with the superintendent a report relating to fraudulent insurance acts that the insurer knew or reasonably
- [Maine-Fraud Plan-24-A MRSA Section 2186 (as enacted by Maine H 1545, Public Law 675, Laws 1998)](https://insurancefraud.org/regulations/maine-fraud-plan-24-a-mrsa-section-2186-as-enacted-by-maine-h-1545-public-law-675-laws-1998/) - 5. Insurer antifraud plans. Within 6 months of the effective date of this Act, every insurer writing direct insurance shall prepare and implement an antifraud plan. This subsection does not apply to any agency, producer or other person acting on behalf of an insurer. The superintendent may review an insurer’s antifraud plan to determine if
- [Maine-Fraud Warning-24-A MRSA Section 2186 (as enacted by Maine H 1545, Public Law 675, Laws 1998)](https://insurancefraud.org/regulations/maine-fraud-warning-24-a-mrsa-section-2186-as-enacted-by-maine-h-1545-public-law-675-laws-1998/) - 3. Fraud warning required. Fraud warnings are required in accordance with the following. A. All applications and claim forms for insurance used by insurers in this State, regardless of form of transmission, must contain the following statement or a substantially similar statement permanently affixed to the application or claim forms: “It is a crime to
- [Maine-SIU Requirement-24-A MRSA Section 2186 (as enacted by Maine H 1545, Public Law 675, Laws 1998)](https://insurancefraud.org/regulations/maine-siu-requirement-24-a-mrsa-section-2186-as-enacted-by-maine-h-1545-public-law-675-laws-1998/) - 5. Insurer antifraud plans. Within 6 months of the effective date of this Act, every insurer writing direct insurance shall prepare and implement an antifraud plan. This subsection does not apply to any agency, producer or other person acting on behalf of an insurer. The superintendent may review an insurer’s antifraud plan to determine if
- [Maryland-Annual Reporting-.06 - Reporting of Fraud Related Data](https://insurancefraud.org/regulations/maryland-annual-reporting-06-reporting-of-fraud-related-data/) - (A) Records and Report (1) An insurer shall maintain appropriate records for the Commissioner to determine the effectiveness of its antifraud plan. (2) A report shall be developed and provided to the Administration on an annual basis regarding the plan’s effectiveness and the effectiveness of the investigative and prosecutorial efforts. (3) The report shall be
- [Maryland-Fraud Plan-09.31.17.04 - Procedures and Requirements; 09.31.17.0.5 - Plan Components](https://insurancefraud.org/regulations/maryland-fraud-plan-09-31-17-04-procedures-and-requirements-09-31-17-0-5-plan-components/) - Regulation — 09.31.17 .04 - Procedures and Requirements A. Antifraud Plan (1) An insurer authorized to write insurance business in this State shall institute, implement, and maintain an insurance antifraud plan. B. Contents of Antifraud Plan An antifraud plan shall: (1) Contain provisions for educating and training an insurer’s employees in the detection of insurance
- [Maryland-Fraud Warning-Section 27-805](https://insurancefraud.org/regulations/maryland-fraud-warning-section-27-805/) - (A) In this section, “claim form” means any document supplied by an insurer to a claimant that a claimant is required to complete and submit in support of a claim for benefits. (B)(1) Except as provided in Subsection (C) of this section, all applications for insurance and all claim forms, regardless of the form of
- [Maryland-Mandatory Reporting-Section 27-802](https://insurancefraud.org/regulations/maryland-mandatory-reporting-section-27-802/) - §27–802. (a) (1) An authorized insurer, its employees, fund producers, insurance producers, a viatical settlement provider, or a viatical settlement broker who in good faith has cause to believe that insurance fraud has been or is being committed shall report the suspected insurance fraud in writing to the Commissioner, the Fraud Division, or the appropriate
- [Maryland-SIU Education-09.31.17.04 - Procedures and Requirements; 09.31.17.0.5 - Plan Components](https://insurancefraud.org/regulations/maryland-siu-education-09-31-17-04-procedures-and-requirements-09-31-17-0-5-plan-components/) - 0.5 - Plan Components A. Education/Training. (1) An antifraud plan shall contain procedures for the provision of education or training, or both, to the insurer’s employees regarding the detection of insurance fraud. (2) Training in the recognition and referral of suspicious claims shall be: (a) required of new and existing claim personnel, underwriters, auditors, agents,
- [Massachusetts-Mandatory Reporting-Chapter 76 Section 88 Chapter 26 Section 8B](https://insurancefraud.org/regulations/massachusetts-mandatory-reporting-chapter-76-section-88-chapter-26-section-8b/) - “Any insurer ... having reason to believe that an insurance transaction may be fraudulent, or having knowledge that a fraudulent insurance transaction is about to take place, or has taken place, shall within thirty days after determination that the transaction may be fraudulent, send to said insurance fraud bureau, on a form prescribed by the
- [Massachusetts-Pre-insurance Inspection-Massachusetts General Laws Chapter 175 Section 113S; Code of Regulations 94:01](https://insurancefraud.org/regulations/massachusetts-pre-insurance-inspection-massachusetts-general-laws-chapter-175-section-113s-code-of-regulations-9401/) - Photograph required — Yes Grace Period (days) — 7 Exemptions/Waivers Existing Policyholder (years) — 3 Renewal Policy — Yes New Cars — Yes Vehicle Age — 10
- [Michigan-Mandatory Reporting-500.4507 Release of information; purpose.](https://insurancefraud.org/regulations/michigan-mandatory-reporting-500-4507-release-of-information-purpose/) - Sec. 4507. (1) Upon written request by an authorized agency to an insurer, the insurer or an agent authorized by the insurer to act on its behalf may release to the authorized agency, at the authorized agency's expense, any or all information that is considered important relating to any suspected insurance fraud. An authorized agency
- [Florida-Fraud Plan-Section 626.9891 and reg. 69D-2](https://insurancefraud.org/regulations/florida-fraud-plan-section-626-9891-and-reg-69d-2/) - § 626.9891. Insurer anti-fraud investigative units; reporting requirements; penalties for noncompliance. (1) As used in this section, the term: (a) “Anti-fraud investigative unit” means the designated anti-fraud unit or division, or contractor authorized under subparagraph (2)(a)2. (b) “Designated anti-fraud unit or division” includes a distinct unit or division or a unit or division made up
- [Florida-Fraud Warning-Sec. 817.234(1b);Sec. 440.37(2)(a);Sec. 440.185(4)ction 817.234(1)(b);Section 440.37(2)(a);Section 440.185(4)](https://insurancefraud.org/regulations/florida-fraud-warning-sec-817-2341bsec-440-372asec-440-1854ction-817-2341bsection-440-372asection-440-1854/) - All Claim Forms - Sec. 817.234(1b) All Workers Compensation Claim Forms Sec. 440.37(2)(a) Underwriting - Workers Compensation Informational Brochures - Sec. 440.185(4) Section 817.234(1)(b) - Language is permissive, but must be approved by the Department of Insurance “Any person who knowingly and with intent to injure, defraud or deceive any insurance company files a statement
- [Florida-Mandatory Reporting-Florida Insurance Code Section 626.989 (6) Workers Comp - Section440.105(1)](https://insurancefraud.org/regulations/florida-mandatory-reporting-florida-insurance-code-section-626-989-6-workers-comp-section440-1051/) - “... any insurer, agent, or other person licensed under the code, or an employee thereof, having knowledge or who believes that a fraudulent insurance act or any other act or practice which, upon conviction, constitutes a felony or a misdemeanor under the code ... is being or has been committed shall send to the Division
- [Florida-Pre-insurance Inspection-Florida Insurance Code Section 627.744; Administrative Code Section 4-167.004](https://insurancefraud.org/regulations/florida-pre-insurance-inspection-florida-insurance-code-section-627-744-administrative-code-section-4-167-004/) - Photograph required — No Grace Period (days) — 7 Exemptions/Waivers Existing Policyholder (years) — 3 Renewal Policy — Yes New Cars — Yes Vehicle Age — 10
- [Florida-SIU Education-Sec. 626.9891](https://insurancefraud.org/regulations/florida-siu-education-sec-626-9891/) - (3) Each insurers anti-fraud plans shall include: (a) A description of the insurer's procedures for detecting and investigating possible fraudulent insurance acts; (b) A description of the insurer's procedures for the mandatory reporting of possible fraudulent insurance acts to the Division of Insurance Fraud of the department; (c) A description of the insurer's plan for
- [Florida-SIU Requirement-Section 626.9891; Rule Sections 69D - 2.001-2.005](https://insurancefraud.org/regulations/florida-siu-requirement-section-626-9891-rule-sections-69d-2-001-2-005/) - § 626.9891. Insurer anti-fraud investigative units; reporting requirements; penalties for noncompliance. (1) As used in this section, the term: (a) “Anti-fraud investigative unit” means the designated anti-fraud unit or division, or contractor authorized under subparagraph (2)(a)2. (b) “Designated anti-fraud unit or division” includes a distinct unit or division or a unit or division made up
- [Georgia-Mandatory Reporting-Section 33-1-16 (f)](https://insurancefraud.org/regulations/georgia-mandatory-reporting-section-33-1-16-f/) - “... any insurer, agent, or other person licensed under this title, or an employee thereof, having knowledge or who believes that a fraudulent insurance act is being or has been committed shall send to the Commissioner a report or information pertinent to such knowledge or belief and such additional information relative thereto as the Commissioner
- [Hawaii-Fraud Warning-?](https://insurancefraud.org/regulations/hawaii-fraud-warning/) - For your protection, Hawaii law requires you to be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment, or both.
- [Hawaii-Mandatory Reporting-Section 431:2-409](https://insurancefraud.org/regulations/hawaii-mandatory-reporting-section-4312-409/) - (a) Within sixty days of an insurer or other licensee's employee or agent discovering credible information indicating a violation of section 431:2-403, or as soon thereafter as practicable, the insurer or licensee shall provide to the branch information, including documents and other evidence, regarding the alleged violation of section 431:2-403. The insurance fraud investigations branch
- [Idaho-Fraud Warning-Section 41-1331 - Language is permissive](https://insurancefraud.org/regulations/idaho-fraud-warning-section-41-1331-language-is-permissive/) - “Any person who knowingly, and with intent to defraud or deceive any insurance company, files a statement containing any false, incomplete, or misleading information is guilty of a felony.” The section also states that lack of a warning does not constitute a defense against prosecution.
- [Idaho-Mandatory Reporting-Section 41-290 Idaho Code: Section 41-292 Idaho Code](https://insurancefraud.org/regulations/idaho-mandatory-reporting-section-41-290-idaho-code-section-41-292-idaho-code/) - Section 41-290 Idaho Code “Any insurer which has facts to support a belief that a fraudulent claim is being or has been made shall, within sixty (60) days of the receipt of such notice, send to the director of insurance, on a form prescribed by the director, the information requested and such additional information relative
- [Illinois-Mandatory Reporting-S 215 ILCS § 5/155.24](https://insurancefraud.org/regulations/illinois-mandatory-reporting-s-215-ilcs-§-5-155-24/) - NOTE: Auto only Insurance Code; Provisions Applicable to All Companies; Motor Vehicle Theft and Motor Insurance Fraud Reporting and Immunity Law (c) When an insurer knows or reasonably believes to know the identity of a person whom it has reason to believe committed a criminal or fraudulent act relating to a motor vehicle theft or
- [Indiana-Fraud Warning-Section 27-2-16-3(a); Section 27-2-16-3(b)](https://insurancefraud.org/regulations/indiana-fraud-warning-section-27-2-16-3a-section-27-2-16-3b/) - All preprinted claims forms - Sec. 27-2-16-3(a) Section 27-2-16-3(a) - Language is permissive “Any person who knowingly, and with intent to defraud an insurer, files a statement of claim containing false, incomplete or misleading information commits a felony.” Section 27-2-16-3(b) - the absence of a warning statement is not a defense against prosecution for insurance
- [Indiana-Mandatory Reporting-27-2-14-2 Fraudulent claims; notification by insurer](https://insurancefraud.org/regulations/indiana-mandatory-reporting-27-2-14-2-fraudulent-claims-notification-by-insurer/) - Sec. 2. If an insurer has reason to believe that a vehicle theft claim made by an insured is fraudulent, the insurer shall: (1) notify, in writing, an authorized agency of the suspected fraudulent claim; and (2) provide the agency with all material developed from the insurer's inquiry into the claim.
- [Iowa-Mandatory Reporting-Sec. 507E.6](https://insurancefraud.org/regulations/iowa-mandatory-reporting-sec-507e-6/) - "An insurer which believes that a claim or application for insurance coverage is being made which is a violation of section 507E.3 shall provide, within sixty days of the receipt of such claim or application, written notification to the bureau of the claim or application on a form prescribed by the bureau, including any additional
- [Kansas-Fraud Plan-KSA 40-2,118(d)](https://insurancefraud.org/regulations/kansas-fraud-plan-ksa-40-2118d/) - (d)(1) Each insurer shall have antifraud initiatives reasonably calculated to detect fraudulent insurance acts. Antifraud initiatives may include: fraud investigators, who may be insurer employees or independent contractors; or an antifraud plan submitted to the commissioner no later than July 1, 2007. Each insurer that submits an antifraud plan shall notify the commissioner of any
- [Kansas-Mandatory Reporting-KSA 40-2,118 (b) and (c)](https://insurancefraud.org/regulations/kansas-mandatory-reporting-ksa-40-2118-b-and-c/) - (b) An insurer that has knowledge or a good faith belief that a fraudulent insurance act is being or has been committed shall provide to the commissioner, on a form prescribed by the commissioner, any and all information and such additional information relating to such fraudulent insurance act as the commissioner may require. (c) Any
- [Kentucky-Fraud Plan-806 KAR 47:010. Fraud prevention.](https://insurancefraud.org/regulations/kentucky-fraud-plan-806-kar-47010-fraud-prevention/) - This administrative regulation establishes insurer requirements and a comprehensive process for reporting and investigating fraudulent insurance acts. Section 1. Definitions. "Division" is defined by KRS 304.47-010(6). "Special investigative unit" or "SIU" means a unit to investigate fraudulent insurance acts as required by KRS 304.47-080. Section 2. Scope. This administrative regulation shall apply to all insurers
- [Kentucky-Fraud Warning-KRS 304.47-030(1); KRS 304.47-030(2) - Language is permissive](https://insurancefraud.org/regulations/kentucky-fraud-warning-krs-304-47-0301-krs-304-47-0302-language-is-permissive/) - KRS 304.47-030(1) - Language is permissive “Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.” KRS 304.47-030(2)
- [Kentucky-Mandatory Reporting-Section 304.47-050 (2); 806 KAR47:020](https://insurancefraud.org/regulations/kentucky-mandatory-reporting-section-304-47-050-2-806-kar47020/) - Section 304.47-050 (2) “The following individuals having knowledge or believing that a fraudulent insurance act or any other act or practice which may constitute a felony or misdemeanor under this subtitle is being or has been committed shall send to the division a report or information pertinent to the knowledge or belief and additional relevant
- [California-SIU Requirement-Section 2698.40 Definitions, Section 2698.42, Section 2698.43 SIU Contracted Responsibilities, Section 2698.43, Section 2698.44 Section 2698.45 Section 2698.46  Section 2698.47  Section 2698.48  Section 2698.49 SIU Training Section 2698.50 SIU Annual Report Section 2698.51 Examinations Section 2698.52 Penalties](https://insurancefraud.org/regulations/california-siu-requirement-section-2698-40-definitions-section-2698-42-section-2698-43-siu-contracted-responsibilities-section-2698-43-section-2698-44-section-2698-45-section-2698-46-section-2698/) - Section 2698.40 Definitions As used in this article, the following definitions shall apply: (a) “Authorized governmental agency (agencies)” shall have the same meaning as used in the Insurance Frauds Prevention Act (IFPA). (b) "Claims handler" means every employee and agent of an insurer whose principal responsibilities include the investigation, adjustment, settlement and resolution of claims.
- [California-SIU Requirement-State Insurance Code Section 1875.20; California Code of Regulations Subchapter 9 Insurance Fraud Section 2698.30 et. seq.](https://insurancefraud.org/regulations/california-siu-requirement-state-insurance-code-section-1875-20-california-code-of-regulations-subchapter-9-insurance-fraud-section-2698-30-et-seq/) - State Insurance Code Section 1875.20 (Fraud unit required); Administrative Code - Title 10 Section 2698.42 (Purpose and objectives of insurer special investigative unit) Section 1875.20 — Every insurer admitted to do business in this state shall maintain a unit or division to investigate possible fraudulent claims by insureds or by persons making claims for services
- [Colorado-Annual Reporting-Section 10-1-127 of the Colorado Revised Statutes as amended by HB 96-1149 Subsection 6 (c)](https://insurancefraud.org/regulations/colorado-annual-reporting-section-10-1-127-of-the-colorado-revised-statutes-as-amended-by-hb-96-1149-subsection-6-c/) - Every licensed insurance company doing business in this state shall include as part of its annual report as required in Section 10-3-109 a summary of its anti-fraud efforts as described in paragraph (a) of Subsection (6). [Deadline for submission is March 1.]
- [Colorado-Fraud Plan-Section 10-1-128](https://insurancefraud.org/regulations/colorado-fraud-plan-section-10-1-128/) - (5)(a) Every licensed insurance company doing business in Colorado shall prepare, implement, and maintain an insurance anti-fraud plan; except that this subsection (5) shall not apply to entities whose principal business is the assumption of reinsurance, reinsurance agreements, or reinsurance claims transactions. Insurance companies approved by the commissioner under article 5 of this title may
- [Colorado-Fraud Warning-Section 10-1-128 (6A)](https://insurancefraud.org/regulations/colorado-fraud-warning-section-10-1-128-6a/) - “It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading
- [Colorado-Mandatory Reporting-Colorado Revised Statutes 10-4-1003 (as amended by Section 4 of HB 96-1149, enacted April 11, 1996)](https://insurancefraud.org/regulations/colorado-mandatory-reporting-colorado-revised-statutes-10-4-1003-as-amended-by-section-4-of-hb-96-1149-enacted-april-11-1996/) - “Any insurer or person that has reason to believe that ... any insurance claim may be fraudulent may furnish and disclose any relevant information in its possession concerning such loss or claim to any authorized agency, as defined in Section 10-4-1002 (1), for the purpose of detecting, prosecuting, or preventing fraudulent insurance claims.”
- [Colorado-SIU Education-Section 10-1-128](https://insurancefraud.org/regulations/colorado-siu-education-section-10-1-128/) - 5)(a) Every licensed insurance company doing business in Colorado shall prepare, implement, and maintain an insurance anti-fraud plan; except that this subsection (5) shall not apply to entities whose principal business is the assumption of reinsurance, reinsurance agreements, or reinsurance claims transactions. Insurance companies approved by the commissioner under article 5 of this title may
- [Connecticut-Annual Reporting-Sec. 38a-356. (Formerly Sec. 38-175v).](https://insurancefraud.org/regulations/connecticut-annual-reporting-sec-38a-356-formerly-sec-38-175v/) - (c) On or before March thirty-first of each year, each insurance company shall provide the Insurance Commissioner annual reports detailing all information received or investigations conducted by such company during the past year concerning insurance fraud in any claim under a motor vehicle insurance policy. Such reports shall be filed in a manner prescribed by
- [Connecticut-Mandatory Reporting-Sec 53-445](https://insurancefraud.org/regulations/connecticut-mandatory-reporting-sec-53-445/) - Sec. 53-445. Knowledge of health insurance fraud, report to Insurance Commissioner. Independent investigation conducted. Subject to civil liability, when. (a) Any person, including an insurer, as defined in subsection (c) of section 53-441, who has knowledge of or has reason to believe that health insurance fraud, as defined in section 53-442, has occurred, shall provide
- [Delaware-Fraud Warning-11 Delaware Code Section 913(b) - Language is permissive](https://insurancefraud.org/regulations/delaware-fraud-warning-11-delaware-code-section-913b-language-is-permissive/) - “Any person who knowingly, and with intent to injure, defraud or deceive any insurer, files a statement of claim containing any false, incomplete or misleading information is guilty of a felony.” The section further states that absences of a warning is not a defense against prosecution.
- [Delaware-Fraud Warning-Title 19 Section 2344](https://insurancefraud.org/regulations/delaware-fraud-warning-title-19-section-2344/) - For benefit checks. Your acceptance of this check for total or partial disability is a representation by you that you are legally entitled to such payment and a false representation is punishable under federal and state laws.
- [Delaware-Mandatory Reporting-Delaware Insurance Code Section 2408](https://insurancefraud.org/regulations/delaware-mandatory-reporting-delaware-insurance-code-section-2408/) - “Any insurer which has a reasonable belief that an act of insurance fraud is being, or has been, committed shall send to the Bureau, on a form prescribed by the Bureau, any and all information and such additional information relating to such act as the Bureau may require.”
- [District of Columbia-Annual Reporting-DC Code Sec. 22-3225.01 et seq.](https://insurancefraud.org/regulations/district-of-columbia-annual-reporting-dc-code-sec-22-3225-01-et-seq/) - The DC Insurance Anti-fraud Law and New Amendments may be found on Department’s website at www.disr.dc.gov, as a link under “Information/DC Insurance Anti-fraud Law.” A. Re: Submission of a CY Annual Anti-fraud Statistical Activity Reporting Form - NEW – Amendment, DC Code § 22-3225.12: (1) Current Filing Requirements: The new amendment requires insurers to report
- [District of Columbia-Fraud Plan-Section 22-3225.9 (Section 125I of Enrolled D.C. Act 12-595); Section 125I. Insurance fraud prevention and detection.](https://insurancefraud.org/regulations/district-of-columbia-fraud-plan-section-22-3225-9-section-125i-of-enrolled-d-c-act-12-595-section-125i-insurance-fraud-prevention-and-detection/) - Section 22-3225.9 (Section 125I of Enrolled D.C. Act 12-595) Section 125I. Insurance fraud prevention and detection. (a) Within 6 months of the effective date of this act [October 27, 1999], every insurer licensed in the District shall submit to the Department of Insurance and Securities Regulation, an insurance fraud prevention and detection plan (“plan”). The
- [District of Columbia-Fraud Warning-Section 22-3225.09 (Section 125I (d) of Enrolled D.C. Act 12-595)](https://insurancefraud.org/regulations/district-of-columbia-fraud-warning-section-22-3225-09-section-125i-d-of-enrolled-d-c-act-12-595/) - No later than 6 months after the effective date of this act [October 27, 1999], all insurance applications forms and claim forms shall contain a conspicuous warning in language the same or substantially similar to the following: “WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of
- [District of Columbia-Mandatory Reporting-Section 22-3825.8 (Section 125h (a) of Enrolled D.C. Act 12-595); Bulletin 99-FR-001-5/1 Attachment 3](https://insurancefraud.org/regulations/district-of-columbia-mandatory-reporting-section-22-3825-8-section-125h-a-of-enrolled-d-c-act-12-595-bulletin-99-fr-001-5-1-attachment-3/) - Section 22-3225.8 (Section 125h (a) of Enrolled D.C. Act 12-595) (a) Based upon a reasonable belief, an insurer, insurance professional, and any other pertinent person shall report to the Metropolitan Police Department or the Department of Insurance and Securities Regulation, actions that may constitute the commission of insurance fraud, and assist in the investigation of
- [District of Columbia-SIU Education-Bulletin 99-FR-001-5/1 Attachment 3](https://insurancefraud.org/regulations/district-of-columbia-siu-education-bulletin-99-fr-001-5-1-attachment-3/) - Bulletin 99-FR-001-5/1 Attachment 3 Recommendations for the Development and Application of the D.C. Insurance Fraud Prevention and Detection Plan I. Anti-fraud Plan Components: A. Prevention, Detection, and Investigation: D.C. Code 22-3825.9(a)(1) The anti-fraud plan should contain specific procedures for the prevention, detection and investigation of all areas of insurance fraud. Such procedures should be prepared,
- [District of Columbia-SIU Requirement-Bulletin 99-FR-001-5/1 Attachment 3](https://insurancefraud.org/regulations/district-of-columbia-siu-requirement-bulletin-99-fr-001-5-1-attachment-3/) - Recommendations for the Development and Application of the D.C. Insurance Fraud Prevention and Detection Plan C. Employment of fraud investigators: D.C. Code 22-3825.9 (a)(3) The anti-fraud plan should contain specific procedures for determining who should conduct or oversee such investigations. You should analyze your options to maintain an in-house staff of investigators or contract with
- [Florida-Annual Reporting-workers comp - Sec 626.9891(6)](https://insurancefraud.org/regulations/florida-annual-reporting-workers-comp-sec-626-98916/) - (6) In addition to providing information required under subsections (2), (4), and (5), each insurer writing workers’ compensation insurance shall also report the following information to the department, on or before March 1, 2019, and annually thereafter: (a) The estimated dollar amount of losses attributable to workers’ compensation fraud delineated by the type of fraud,
- [Alabama-Fraud Warning-§ 27-12A-20.  Fraud warning.](https://insurancefraud.org/regulations/alabama-fraud-warning-§-27-12a-20-fraud-warning/) - § 27-12A-20. Fraud warning. (a) A fraud warning shall be included on at least one of the following: Claim release forms, applications, reinstatements for insurance, participation agreements, declaration pages, and claim documents, regardless of the method or form of transmission and shall contain the following statement or a substantially similar statement: "Any person who knowingly
- [Alaska-Fraud Warning-Section 21.36.380](https://insurancefraud.org/regulations/alaska-fraud-warning-section-21-36-380/) - A claim form must contain a statement that states in substance the following: "A person who knowingly and with intent to injure, defraud, or deceive an insurance company files a claim containing false, incomplete, or misleading information may be prosecuted under state law." A lack of the statement on a claim form does not constitute
- [Alaska-Mandatory Reporting-Sec. 21.36.390](https://insurancefraud.org/regulations/alaska-mandatory-reporting-sec-21-36-390/) - (a) An insurer that has reason to believe that a fraudulent claim has been made against it shall send the director a report disclosing information that the director may require. (b) An insurer, employee, or agent of an insurer or another person acting without malice is not subject to civil liability for the filing of
- [Arizona-Fraud Warning-Revised Statutes Section 20-466.03](https://insurancefraud.org/regulations/arizona-fraud-warning-revised-statutes-section-20-466-03/) - The claims forms provided by an insurer to an insured or any other person for filing a notice or making a claim in connection with a policy or contract issued by the insurer shall include in substance the following statement in at least twelve point type: "For your protection Arizona law requires the following statement
- [Arizona-Mandatory Reporting-Arizona Revised Statutes Section 20-466 (A-K)](https://insurancefraud.org/regulations/arizona-mandatory-reporting-arizona-revised-statutes-section-20-466-a-k/) - Fraud unit; peace officer status; powers; information sharing duty of insurers A. A fraud unit is established in the department of insurance. B. The fraud unit shall work in conjunction with the department of public safety. C. The director may investigate any act or practice of fraud prohibited by section 20-466.01 and any other act
- [Arkansas-Fraud Plan-Sec. 6 Antifraud initiative requirements; Sec. 7. Fraud Investigators and independent contractors](https://insurancefraud.org/regulations/arkansas-fraud-plan-sec-6-antifraud-initiative-requirements-sec-7-fraud-investigators-and-independent-contractors/) - Sec. 6 Antifraud initiative requirements The antifraud initiative requirements of Arkansas Code Annotated Sec. 23-66-510(a) may be satisfied by an insurer by means of: (1) Fraud investigators, who may be insurer employees or independent contractors and who are in full compliance with Section (7) of this rule; or (2) An antifraud plan submitted to, and
- [Arkansas-Fraud Plan-Section 23-66-510](https://insurancefraud.org/regulations/arkansas-fraud-plan-section-23-66-510/) - (a) Insurers shall have antifraud initiatives reasonably calculated to detect, prosecute and prevent fraudulent insurance acts. Antifraud initiatives may include, but not limited to: (1) Fraud investigators, who may insurer employees or independent contractors; or (2) An antifraud plan submitted to the commissioner. Antifraud plans submitted to the commissioner shall be privileged and confidential and
- [Arkansas-Fraud Warning-Insurance Department Directive 1-95](https://insurancefraud.org/regulations/arkansas-fraud-warning-insurance-department-directive-1-95/) - For benefit checks. This check is for workers’ compensation related benefits. You must advise both the employer and (name of insurance company) of any other income received or earned, including from self-employment, while receiving these benefits. Failure to do so may result in civil and/or criminal liability.
- [Arkansas-Fraud Warning-Section 11-9-106(a)(1), (b) - Language is mandatory](https://insurancefraud.org/regulations/arkansas-fraud-warning-section-11-9-106a1-b-language-is-mandatory/) - “Any person or entity who willfully and knowingly makes any material false statement or representation for the purpose of obtaining any benefit or payment, or for the purpose of defeating or wrongfully decreasing any claim for benefit or payment or obtaining or avoiding workers compensation coverage or avoiding payment of the proper insurance premium, or
- [Arkansas-Fraud Warning-Section 23-66-503](https://insurancefraud.org/regulations/arkansas-fraud-warning-section-23-66-503/) - (a) Claim forms, proofs of loss, or any similar documents, however designated, seeking payment or benefit pursuant to an insurance policy, and applications for insurance, regardless of the form of transmission, shall contain the following statement or a substantially similar statement: Any person who knowingly presents a false or fraudulent claim for payment for a
- [Arkansas-Mandatory Reporting-Arkansas Code Sec. 11-9-106(d)(6)](https://insurancefraud.org/regulations/arkansas-mandatory-reporting-arkansas-code-sec-11-9-106d6/) - For workers compensation only. (a) Every carrier or employer who has “reason to suspect that a violation of ... has occurred shall be required to report all pertinent matters relating thereto to the Workers Compensation Fraud Investigation Unit.” (b) “No such carrier shall be liable to any employer or employee for any such report, and
- [Arkansas-Mandatory Reporting-Section 23-66-505; Reporting of Fraudulent Insurance Acts — Regulation 67;Sec. 6 Method of reporting suspected fraudulent insurance acts](https://insurancefraud.org/regulations/arkansas-mandatory-reporting-section-23-66-505-reporting-of-fraudulent-insurance-acts-regulation-67sec-6-method-of-reporting-suspected-fraudulent-insurance-acts/) - Section 23-66-505 (a) A person engaged in the business of insurance having knowledge or a reasonable belief that a fraudulent insurance act is being, will be, or has been committed shall provide to the commissioner the information required by, and in a manner prescribed by, the commissioner. (b) Any person engaged in the business of
- [Arkansas-SIU Education-Sec. 6 Antifraud initiative requirements; Sec. 7. Fraud Investigators and independent contractors](https://insurancefraud.org/regulations/arkansas-siu-education-sec-6-antifraud-initiative-requirements-sec-7-fraud-investigators-and-independent-contractors/) - Sec. 7. Fraud Investigators and independent contractors A. Fraud investigators who are employees of an insurer: (1) shall be qualified by education, experience or training in the detection, investigation and proper reporting of suspected fraudulent insurance acts, and may be employees whose principal responsibilities are the processing and disposition of claims, if they meet the
- [Arkansas-SIU Requirement-Sec. 6 Antifraud initiative requirements; Sec. 7. Fraud Investigators and independent contractors](https://insurancefraud.org/regulations/arkansas-siu-requirement-sec-6-antifraud-initiative-requirements-sec-7-fraud-investigators-and-independent-contractors/) - Sec. 6 Antifraud initiative requirements The antifraud initiative requirements of Arkansas Code Annotated Sec. 23-66-510(a) may be satisfied by an insurer by means of: (1) Fraud investigators, who may be insurer employees or independent contractors and who are in full compliance with Section (7) of this rule; or (2) An antifraud plan submitted to, and
- [California-Fraud Plan-California Code of Regulations: Section 2698.40 SIU Annual Report](https://insurancefraud.org/regulations/california-fraud-plan-california-code-of-regulations-section-2698-40-siu-annual-report/) - California Code of Regulations: Section 2698.40 SIU Annual Report 10 CCR § 2698.40 SIU Annual Report. (a) Each insurer shall file a report as prescribed herein, at the time its initial Certificate of Authority is issued, and annually thereafter. The annual report shall be due no later than 90 days after the date of mailing
- [California-Fraud Warning-All Claim Forms - Sec. 1871.2-.3;All Claim Forms regarding theft of insured vehicles - Sec. 1871.2-3;All Workers Compensation claim forms - Sec. 5401.7](https://insurancefraud.org/regulations/california-fraud-warning-all-claim-forms-sec-1871-2-3all-claim-forms-regarding-theft-of-insured-vehicles-sec-1871-2-3all-workers-compensation-claim-forms-sec-5401-7/) - Insurance Code - Sec. 1871.2 - Language is mandatory “For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.” Insurance Code
- [California-Mandatory Reporting-Cal Ins Code §1872.4 and  §1877.3 Workers Compensation](https://insurancefraud.org/regulations/california-mandatory-reporting-cal-ins-code-§1872-4-and-§1877-3-workers-compensation/) - ARTICLE 2. Bureau of Fraudulent Claims § 1872.4. (a) Any company licensed to write insurance in this state that reasonably believes or knows that a fraudulent claim is being made shall, within 60 days after determination by the insurer that the claim appears to be a fraudulent claim, send to the Fraud Division, on a
- [California-Mandatory Reporting-California Insurance Code Sect. 1872.4 Workers Commp - Section 1877.3](https://insurancefraud.org/regulations/california-mandatory-reporting-california-insurance-code-sect-1872-4-workers-commp-section-1877-3/) - “Any company licensed to write insurance in this state that believes that a fraudulent claim is being made shall, within 60 days after determination by the insurer that the claim appears to be a fraudulent claim, send to the Bureau of Fraudulent Claims, on a form prescribed by the Department, the information requested by the
- [California-Pre-insurance Inspection-California Insurance Code Section 400](https://insurancefraud.org/regulations/california-pre-insurance-inspection-california-insurance-code-section-400/) - [repealed effective 1/1/99] Photograph required — Yes Grace Period (days) — 7 Exemptions/Waivers: Existing Policyholder (years) — 3 Renewal Policy — Yes New Cars — Yes Vehicle Age — 7

## Statutes

- [Georgia-Fraud Bureau-Ga. Code Ann., ¤ 33-1-17](https://insurancefraud.org/statutes/georgia-fraud-bureau-ga-code-ann-¤-33-1-17/) - (a) The General Assembly finds that the proper and expeditious investigation and prosecution of fraudulent insurance acts are beneficial to the public interest. The General Assembly further finds that proper investigation of fraudulent insurance acts, followed by vigorous prosecution of insurance fraud, will bring about lower insurance rates for the citizens of this state. (b)
- [Arkansas - Anti-Runner Provisions - AR Code § 5-37-506](https://insurancefraud.org/statutes/arkansas-anti-runner-provisions-ar-code-§-5-37-506/) - 2018 Arkansas CodeTitle 5 - Criminal OffensesSubtitle 4 - Offenses Against PropertyChapter 37 - Forgery and Fraudulent PracticesSubchapter 5 - Business and Commercial Offenses Generally§ 5-37-506. Prohibited activity by a procurer or provider Universal Citation: AR Code § 5-37-506 (2018) (a) A person commits the offense of prohibited activity by a procurer or provider if: (1)
- [California – Staged Accidents - CA PENAL s 550](https://insurancefraud.org/statutes/california-ca-penal-s-550/) - § 550. False or fraudulent claims or statements; prohibited acts (a) It is unlawful to do any of the following, or to aid, abet, solicit, or conspire with any person to do any of the following: (3) Knowingly cause or participate in a vehicular collision, or any other vehicular accident, for the purpose of presenting
- [New York - Staged Accidents - CLS Penal § 176.75](https://insurancefraud.org/statutes/new-york-staged-accidents-cls-penal-§-176-75/) - § 176.75. Staging a motor vehicle accident in the second degree. A person is guilty of staging a motor vehicle accident in the second degree when, with intent to commit and in furtherance of a fraudulent insurance act, he or she operates a motor vehicle and intentionally causes a collision involving a motor vehicle. Staging a motor vehicle accident in the second degree is a class
- [New York - Staged Accidents - CLS Penal § 176.80](https://insurancefraud.org/statutes/new-york-staged-accidents-cls-penal-§-176-80/) - § 176.80. Staging a motor vehicle accident in the first degree. A person is guilty of staging a motor vehicle accident in the first degree when he or she commits the offense of staging a motor vehicle accident in the second degree and thereby causes serious physical injury or death to another person, other than a participant in such offense. Staging a motor vehicle accident in the first degree is
- [Louisiana – Staged Accidents - LA R.S. 14:68.4.2 ](https://insurancefraud.org/statutes/louisiana-staged-accidents-la-r-s-1468-4-2/) - § 68.4.2. Aggravated staging of a motor vehicle collision A. Aggravated staging of a motor vehicle collision is the staging of a motor vehicle collision, as defined in R.S. 14:68.4.1, which causes death or serious bodily injury to another person. B. Whoever commits the crime of aggravated staging of a motor vehicle collision shall be
- [Louisiana – Staged Accidents - LA R.S. 14:68.4.1 ](https://insurancefraud.org/statutes/louisiana-staged-accidents-la-r-s-1468-4-1-and-la-r-s-1468-4-2/) - § 68.4.1. Staging of a motor vehicle collision A. Staging of a motor vehicle collision is any of the following with an intent to defraud: (1) Causing a motor vehicle collision for the purpose of obtaining anything of value. (2) Providing information in connection with a motor vehicle collision, knowing that the collision was intentionally
- [Georgia – Staged Accidents - GA ST s 33-1.91](https://insurancefraud.org/statutes/georgia-staged-accidents-ga-st-s-33-1-91/) - § 33-1-9.1. Staging a collision; fraudulent claims (a) A person shall be guilty of the crime of staging a collision when, with intent to commit insurance fraud as defined in Code Section 33-1-9, such person does any of the following: (1) Intentionally causes or attempts to cause a motor vehicle collision; or (2) Engages in a
- [Colorado – Staged Accidents - CO ST s 18-5-221   ](https://insurancefraud.org/statutes/colorado-staged-accidents-co-st-s-18-5-221/) - § 18-5-211. Insurance Fraud -definitions (1)A person commits insurance fraud if the person does any of the following: (c) With an intent to defraud causes or participates, or purports to be involved, in a vehicular collision, or any other vehicular accident, for the purpose of presenting any false or fraudulent insurance claim; (4) Insurance fraud committed in
- [Mississippi - Immunity - MS Code § 11–69–1 (2018)](https://insurancefraud.org/statutes/mississippi-immunity/) - (1) Except as otherwise provided in subsection (2) of this section, there shall be no civil liability imposed on and no cause of action shall arise against a person or entity for furnishing information concerning suspected or completed insurance fraud to any law enforcement, investigatory, prosecutorial or regulatory agent or agency, insurer, or statutory residual
- [Hawaii (state claims only)](https://insurancefraud.org/statutes/hawaii-false-claims-act-yes/) - Click here for full statutory text.
- [Georgia (Medicaid only)](https://insurancefraud.org/statutes/georgia-false-claims-act-yes/) - Click here for full statutory text.
- [Colorado (medical only)](https://insurancefraud.org/statutes/colorado-false-claims-act-yes/) - Click here for full statutory text.
- [Washington (Medicaid only)](https://insurancefraud.org/statutes/washington-false-claims-act-yes/) - Click here for full statutory text.
- [Virginia - False Claims Act](https://insurancefraud.org/statutes/virginia-false-claims-act-yes/) - Click here for full statutory text.
- [Vermont (state claims solely)](https://insurancefraud.org/statutes/vermont-false-claims-act-yes/) - Click here for full statutory text.
- [Texas (Medicaid only)](https://insurancefraud.org/statutes/texas-false-claims-act-yes/) - Click here for full statutory text.
- [Rhode Island (state claims solely)](https://insurancefraud.org/statutes/rhode-island-false-claims-act-yes/) - Click here for full statutory text.
- [North Carolina (state claims solely)](https://insurancefraud.org/statutes/north-carolina-false-claims-act-yes/) - Click here for full statutory text.
- [New Mexico (Medicaid only)](https://insurancefraud.org/statutes/new-mexico-false-claims-act-yes/) - Click here for full statutory text.
- [New Jersey (state claims solely)](https://insurancefraud.org/statutes/new-jersey-false-claims-act-yes/) - Click here for full statutory text.
- [New Hampshire (state claims solely)](https://insurancefraud.org/statutes/new-hampshire-false-claims-act-yes/) - Click here for full statutory text.
- [Nevada (state claims solely)](https://insurancefraud.org/statutes/nevada-false-claims-act-yes/) - Click here for full statutory text.
- [Montana - False Claims Act](https://insurancefraud.org/statutes/montana-false-claims-act-yes/) - Click here for full statutory text.
- [Minnesota (state claims solely)](https://insurancefraud.org/statutes/minnesota-false-claims-act-yes/) - Click here for full statutory text.
- [Michigan (Medicaid solely)](https://insurancefraud.org/statutes/michigan-false-claims-act-yes/) - Click here for full statutory text.
- [Massachusetts - False Claims Act](https://insurancefraud.org/statutes/massachusetts-false-claims-act-yes/) - Click here for full statutory text.
- [Maryland (state healthcare only)](https://insurancefraud.org/statutes/maryland-false-claims-act-yes/) - Click here for full statutory text.
- [Louisiana - False Claims Act](https://insurancefraud.org/statutes/louisiana-false-claims-act-yes/) - Click here for full statutory text.
- [Iowa - False Claims Act](https://insurancefraud.org/statutes/iowa-false-claims-act-yes/) - Click here for full statutory text.
- [Indiana - False Claims Act](https://insurancefraud.org/statutes/indiana-false-claims-act-yes/) - Click here for full statutory text.
- [Illinois - False Claims Act](https://insurancefraud.org/statutes/illinois-false-claims-act-yes/) - Click here for full statutory text.
- [Florida - False Claims Act](https://insurancefraud.org/statutes/florida-false-claims-act-yes/) - Click here for full statutory text.
- [District of Columbia - False Claims Act](https://insurancefraud.org/statutes/district-of-columbia-false-claims-act-yes/) - Click here for full statutory text.
- [California - False Claims Act](https://insurancefraud.org/statutes/california-false-claims-act-yes/) - Click here for full statutory text.
- [Delaware - False Claims Act](https://insurancefraud.org/statutes/delaware-false-claims-act-yes/) - Click here for full statutory text.
- [New York - False Claims Act-Art. 13, §§187-194](https://insurancefraud.org/statutes/new-york-false-claims-act/) - § 187. SHORT TITLE This article shall be known and may be cited as the "New York false claims act". § 188. DEFINITIONS As used in this article, the following terms shall mean: 1. "Claim" (a) means any request or demand, whether under a contract or otherwise, for money or property that: (i) is presented
- [New York - Claims Fraud](https://insurancefraud.org/statutes/new-york-claims-fraud/) - A fraudulent insurance act is committed by any person who, knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, self insurer, or purported insurer, or purported self insurer, or any agent thereof: 1. Any written statement as
- [Alabama-False Claims Act-n/a](https://insurancefraud.org/statutes/alabama-false-claims-act-n-a/) - Alabama has no State False Claims Act. Though legislation has been proposed. See: https://www.maynardcooper.com/blog/alabama-false-claims-act-legislation-%E2%80%93-cause-concern-businesses-alabama
- [Wyoming-Claims Fraud-W.S.1977 ¤ 26-13-201](https://insurancefraud.org/statutes/wyoming-claims-fraud-w-s-1977-¤-26-13-201/) - (a) No person shall knowingly or willfully: (i) Make any false or fraudulent statement or representation in or with reference to any application for insurance or for the purpose of obtaining any money or benefit; (ii) Present or cause to be presented a false or fraudulent claim or any proof in support of a claim
- [Wyoming-Failing to Remit Premium-W.S.1977 ¤ 26-13-121](https://insurancefraud.org/statutes/wyoming-failing-to-remit-premium-w-s-1977-¤-26-13-121/) - (a) No person shall willfully collect any sum as premium or charge for insurance: (i) If the insurance is not then provided or is not in due course to be provided, subject to the insurer's acceptance of the risk, by an insurance policy issued by the insurer as authorized by this code [title 26]; (ii)
- [Wyoming-Immunity-W.S.1977 ¤ 26-15-109](https://insurancefraud.org/statutes/wyoming-immunity-w-s-1977-¤-26-15-109/) - (a) No cause of action shall arise nor shall any liability be imposed against the commissioner, the commissioner's authorized representatives or any examiner appointed by the commissioner for any statements made or conduct performed in good faith while carrying out an examination or related activity under the provisions of this chapter. (b) No cause of
- [Wyoming-Insurance Fraud - Definition-W.S.1977 ¤ 26-13-201](https://insurancefraud.org/statutes/wyoming-insurance-fraud-definition-w-s-1977-¤-26-13-201/) - (a) No person shall knowingly or willfully: (i) Make any false or fraudulent statement or representation in or with reference to any application for insurance or for the purpose of obtaining any money or benefit; (ii) Present or cause to be presented a false or fraudulent claim or any proof in support of a claim
- [Wyoming-Placing Bogus Coverage-W.S.1977 ¤ 26-13-124](https://insurancefraud.org/statutes/wyoming-placing-bogus-coverage-w-s-1977-¤-26-13-124/) - (a) A person is considered to be engaging in an unfair method of competition and unfair and deceptive act or practice in the business of insurance if that person commits or performs with such frequency as to indicate a general business practice any of the following unfair claims settlement practices: (i) Misrepresenting pertinent facts or
- [Wyoming-Practitioner Penalites-n/a](https://insurancefraud.org/statutes/wyoming-practitioner-penalites-n-a/) - No statute found
- [Wyoming-Premium Fraud-W.S.1977 ¤ 26-13-121](https://insurancefraud.org/statutes/wyoming-premium-fraud-w-s-1977-¤-26-13-121/) - (a) No person shall willfully collect any sum as premium or charge for insurance: (i) If the insurance is not then provided or is not in due course to be provided, subject to the insurer's acceptance of the risk, by an insurance policy issued by the insurer as authorized by this code [title 26]; (ii)
- [Wyoming-Range of Criminal Penalties-W.S.1977 ¤ 26-1-107](https://insurancefraud.org/statutes/wyoming-range-of-criminal-penalties-w-s-1977-¤-26-1-107/) - (a) Each violation of this code [title 26] for which a greater penalty is not provided by another provision of this code or by other applicable laws of this state, in addition to any applicable prescribed denial, suspension or revocation of certificate of authority or license, is a misdemeanor punishable upon conviction by a fine
- [Wyoming-Range of Civil Penalties-W.S.1977 ¤ 26-1-107](https://insurancefraud.org/statutes/wyoming-range-of-civil-penalties-w-s-1977-¤-26-1-107/) - (a) Each violation of this code [title 26] for which a greater penalty is not provided by another provision of this code or by other applicable laws of this state, in addition to any applicable prescribed denial, suspension or revocation of certificate of authority or license, is a misdemeanor punishable upon conviction by a fine
- [Wyoming-Rating of an Insurance Policy-W.S.1977 ¤ 26-14-105](https://insurancefraud.org/statutes/wyoming-rating-of-an-insurance-policy-w-s-1977-¤-26-14-105/) - (a) Rates shall not be excessive, inadequate or unfairly discriminatory. (b) Risks may be classified in any way except that no risk may be classified in whole or in part on the basis of race, color, creed or national origin. In determining whether rates in a noncompetitive market are excessive, inadequate or unfairly discriminatory, consideration
- [Wyoming-Underwriting Fraud-W.S.1977 ¤ 26-13-124](https://insurancefraud.org/statutes/wyoming-underwriting-fraud-w-s-1977-¤-26-13-124/) - (a) A person is considered to be engaging in an unfair method of competition and unfair and deceptive act or practice in the business of insurance if that person commits or performs with such frequency as to indicate a general business practice any of the following unfair claims settlement practices: (i) Misrepresenting pertinent facts or
- [Wyoming-Unauthorized Entities-W.S.1977 ¤ 26-12-102](https://insurancefraud.org/statutes/wyoming-unauthorized-entities-w-s-1977-¤-26-12-102/) - (a) No person in this state shall: (i) Act as agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact insurance in this state, in the: (A) Solicitation, negotiation, procurement or carrying out of insurance or annuity contracts or the renewal thereof; (B) Forwarding of applications for
- [Wisconsin-Claims Fraud-W.S.A. 895.486](https://insurancefraud.org/statutes/wisconsin-claims-fraud-w-s-a-895-486/) - (1) In this section, "insurance fraud" means the presentation of any statement, document or claim, or the preparation of a statement, document or claim with the knowledge that the statement, document or claim will be presented, that the person knew or should have known contained materially false, incomplete or misleading information concerning any of the
- [Wisconsin-Immunity-W.S.A. 895.486](https://insurancefraud.org/statutes/wisconsin-immunity-w-s-a-895-486/) - (2) Any person who, absent malice, files a report with or furnishes information concerning suspected, anticipated, or completed insurance fraud is immune from civil liability for his or her acts or omissions in filing the report or furnishing the information to any of the following or to their agents, employees or designees: (a) The office
- [Wisconsin-Insurance Fraud - Definition-W.S.A. 895.486](https://insurancefraud.org/statutes/wisconsin-insurance-fraud-definition-w-s-a-895-486/) - (1) In this section, "insurance fraud" means the presentation of any statement, document or claim, or the preparation of a statement, document or claim with the knowledge that the statement, document or claim will be presented, that the person knew or should have known contained materially false, incomplete or misleading information concerning any of the
- [Wisconsin-Premium Fraud-W.S.A. 895.486](https://insurancefraud.org/statutes/wisconsin-premium-fraud-w-s-a-895-486/) - (1) In this section, "insurance fraud" means the presentation of any statement, document or claim, or the preparation of a statement, document or claim with the knowledge that the statement, document or claim will be presented, that the person knew or should have known contained materially false, incomplete or misleading information concerning any of the
- [Wisconsin-Rating of an Insurance Policy-W.S.A. 625.11](https://insurancefraud.org/statutes/wisconsin-rating-of-an-insurance-policy-w-s-a-625-11/) - (1) General. Rates shall not be excessive, inadequate or unfairly discriminatory, nor shall an insurer charge any rate which if continued will have or tend to have the effect of destroying competition or creating a monopoly. (2) Excessiveness. (a) Competitive market. Rates are presumed not to be excessive if a reasonable degree of price competition
- [West Virginia-Claims Fraud-](https://insurancefraud.org/statutes/west-virginia-claims-fraud/) - (a) Any person who knowingly and willfully and with intent to defraud submits a materially false statement in support of a claim for insurance benefits or payment pursuant to a policy of insurance or who conspires to do so is guilty of a crime and is subject to the penalties set forth in the provisions
- [West Virginia-Fraud Bureau-W. Va. Code, ¤ 33-41-8](https://insurancefraud.org/statutes/west-virginia-fraud-bureau-w-va-code-¤-33-41-8/) - (a) There is established the West Virginia Insurance Fraud Unit within the office of the Insurance Commissioner of West Virginia. The commissioner may employ full-time supervisory, legal and investigative personnel for the unit who shall be qualified by training and experience in the areas of detection, investigation or prosecution of fraud within and against the
- [West Virginia-Immunity-W. Va. Code, ¤ 33-41-6](https://insurancefraud.org/statutes/west-virginia-immunity-w-va-code-¤-33-41-6/) - (a) There shall be no civil liability imposed on and no cause of action shall arise from a person's furnishing information concerning suspected or anticipated fraud relating to the business of insurance, if the information is provided to or received from: (1) The commissioner or the commissioner's employees, agents or representatives; (2) Federal, state, or
- [West Virginia-Insurance Fraud - Definition-n/a](https://insurancefraud.org/statutes/west-virginia-insurance-fraud-definition-n-a/) - No comprehensive statute found.
- [West Virginia-Mandatory Restitution-W. Va. Code, ¤ 33-41-12](https://insurancefraud.org/statutes/west-virginia-mandatory-restitution-w-va-code-¤-33-41-12/) - A person or entity engaged in the business of insurance or a person or entity making a claim against an insurer who violates any provision of this article may be subject to the following: (1) Where applicable, suspension or revocation of license or certificate of authority or a civil penalty of up to ten thousand
- [West Virginia-Practitioner Penalites-W. Va. Code, ¤ 33-41-12](https://insurancefraud.org/statutes/west-virginia-practitioner-penalites-w-va-code-¤-33-41-12/) - A person or entity engaged in the business of insurance or a person or entity making a claim against an insurer who violates any provision of this article may be subject to the following: (1) Where applicable, suspension or revocation of license or certificate of authority or a civil penalty of up to ten thousand
- [West Virginia-Range of Criminal Penalties-W. Va. Code, ¤ 33-41-11](https://insurancefraud.org/statutes/west-virginia-range-of-criminal-penalties-w-va-code-¤-33-41-11/) - (a) Any person who knowingly and willfully and with intent to defraud submits a materially false statement in support of a claim for insurance benefits or payment pursuant to a policy of insurance or who conspires to do so is guilty of a crime and is subject to the penalties set forth in the provisions
- [West Virginia-Range of Civil Penalties-W. Va. Code, ¤ 33-41-12](https://insurancefraud.org/statutes/west-virginia-range-of-civil-penalties-w-va-code-¤-33-41-12/) - A person or entity engaged in the business of insurance or a person or entity making a claim against an insurer who violates any provision of this article may be subject to the following: (1) Where applicable, suspension or revocation of license or certificate of authority or a civil penalty of up to ten thousand
- [West Virginia-Rating of an Insurance Policy-W. Va. Code, ¤ 33-20-3 (Proposed Legislation)](https://insurancefraud.org/statutes/west-virginia-rating-of-an-insurance-policy-w-va-code-¤-33-20-3-proposed-legislation/) - All rates shall be made in accordance with the following provisions: (a) Due consideration shall be given to past and prospective loss experience within and outside this state, to catastrophe hazards, if any, to a reasonable margin for underwriting profit and contingencies, to dividends, savings or unabsorbed premium deposits allowed or returned by insurers to
- [West Virginia-Underwriting Fraud-n/a](https://insurancefraud.org/statutes/west-virginia-underwriting-fraud-n-a/) - No statue found.
- [West Virginia-Unauthorized Entities-W. Va. Code, ¤ 33-44-4](https://insurancefraud.org/statutes/west-virginia-unauthorized-entities-w-va-code-¤-33-44-4/) - (a) It is unlawful for any person to engage in any act which constitutes the transaction of insurance under the provisions of this article unless authorized by a license in force pursuant to the laws of this state, or unless exempted by the insurance laws of this state. Any person or insurer engaged in any
- [Washington-Claims Fraud-West's RCWA 48.30.230](https://insurancefraud.org/statutes/washington-claims-fraud-wests-rcwa-48-30-230/) - (1) It is unlawful for any person, knowing it to be such, to: (a) Present, or cause to be presented, a false or fraudulent claim, or any proof in support of such a claim, for the payment of a loss under a contract of insurance; or (b) Prepare, make, or subscribe any false or fraudulent
- [Washington-Fraud Bureau-West's RCWA 48.135.020](https://insurancefraud.org/statutes/washington-fraud-bureau-wests-rcwa-48-135-020/) - (1) There is established an insurance fraud program within the office of the insurance commissioner. The commissioner may employ supervisory, legal, and investigative personnel for the program, who must be qualified by training and experience in the areas of detection, investigation, or prosecution of fraud in which the insurance industry is a victim. The chief
- [Washington-Immunity-West's RCWA 48.01.190; ¤ 48.50.070](https://insurancefraud.org/statutes/washington-immunity-wests-rcwa-48-01-190-¤-48-50-070/) - (1) Any person who files reports, or furnishes other information, required under Title 48 RCW, required by the commissioner under authority granted by Title 48 RCW, useful to the commissioner in the administration of Title 48 RCW, or furnished to the National Association of Insurance Commissioners at the request of the commissioner or pursuant to
- [Washington-Licensing Board Notification-n/a](https://insurancefraud.org/statutes/washington-licensing-board-notification-n-a/) - No statute found
- [Washington-Mandatory Restitution-West's RCWA 48.135.070](https://insurancefraud.org/statutes/washington-mandatory-restitution-wests-rcwa-48-135-070/) - In a criminal prosecution for any crime under Washington law in which the insurance company is a victim, the insurance company is entitled to be considered as a victim in any restitution ordered by the court under RCW 9.94A.753, as part of the criminal penalty imposed against the defendant convicted for such a violation.
- [Washington-Placing Bogus Coverage-West's RCWA 48.30.090](https://insurancefraud.org/statutes/washington-placing-bogus-coverage-wests-rcwa-48-30-090/) - No person shall make, issue or circulate, or cause to be made, issued or circulated any misrepresentation of the terms of any policy or the benefits or advantages promised thereby, or the dividends or share of surplus to be received thereon, or use any name or title of any policy or class of policies misrepresenting
- [Washington-Practitioner Penalites-West's RCWA 48.30A.040](https://insurancefraud.org/statutes/washington-practitioner-penalites-wests-rcwa-48-30a-040/) - A violation of this chapter is cause for discipline and constitutes unprofessional conduct that could result in any regulatory penalty provided by law, including refusal, revocation, or suspension of a business or professional license, or right or admission to practice. Conduct that constitutes a violation of this chapter is unprofessional conduct in violation of RCW
- [Washington-Range of Criminal Penalties-West's RCWA 48.01.080](https://insurancefraud.org/statutes/washington-range-of-criminal-penalties-wests-rcwa-48-01-080/) - Except as otherwise provided in this code, any person violating any provision of this code is guilty of a gross misdemeanor and will, upon conviction, be fined not less than ten dollars nor more than one thousand dollars, or imprisoned for not more than three hundred sixty-four days, or both, in addition to any other
- [Washington-Range of Civil Penalties-West's RCWA 48.01.080](https://insurancefraud.org/statutes/washington-range-of-civil-penalties-wests-rcwa-48-01-080/) - Except as otherwise provided in this code, any person violating any provision of this code is guilty of a gross misdemeanor and will, upon conviction, be fined not less than ten dollars nor more than one thousand dollars, or imprisoned for not more than three hundred sixty-four days, or both, in addition to any other
- [Washington-Rating of an Insurance Policy-West's RCWA 48.19.020](https://insurancefraud.org/statutes/washington-rating-of-an-insurance-policy-wests-rcwa-48-19-020/) - Premium rates for insurance shall not be excessive, inadequate, or unfairly discriminatory
- [Washington-Underwriting Fraud-West's RCWA 48.30.180](https://insurancefraud.org/statutes/washington-underwriting-fraud-wests-rcwa-48-30-180/) - No person shall by misrepresentations or by misleading comparisons, induce or tend to induce any insured to lapse, terminate, forfeit, surrender, retain, or convert any insurance policy.
- [Washington-Unauthorized Entities-West's RCWA 48.15.020](https://insurancefraud.org/statutes/washington-unauthorized-entities-wests-rcwa-48-15-020/) - (1) An insurer that is not authorized by the commissioner may not solicit insurance business in this state or transact insurance business in this state, except as provided in this chapter. (2)(a) A person may not, in this state, represent an unauthorized insurer except as provided in this chapter. This subsection does not apply to
- [Virginia-Aiding & Abetting-n/a](https://insurancefraud.org/statutes/virginia-aiding-abetting-n-a/) - No statute found
- [Virginia-Anti-Runner Provisions-n/a](https://insurancefraud.org/statutes/virginia-anti-runner-provisions-n-a/) - No statute found
- [Virginia-Attempted Fraud-n/a](https://insurancefraud.org/statutes/virginia-attempted-fraud-n-a/) - No statute found
- [Virginia-Claims Fraud-n/a](https://insurancefraud.org/statutes/virginia-claims-fraud-n-a/) - No statute found
- [Virginia-Failing to Remit Premium-VA Code Ann. ¤ 38.2-1363](https://insurancefraud.org/statutes/virginia-failing-to-remit-premium-va-code-ann-¤-38-2-1363/) - B. The Commission may, in addition to or in lieu of a penalty imposed under ¤ 38.2-218, place on probation, suspend, revoke or refuse to issue or renew any person's license as a managing general agent for any one or more of the following causes: 4. Improperly withholding, misappropriating, or converting any moneys or properties
- [Virginia-Fraud Bureau-VA Code Ann. ¤ 52-37 (Proposed Legislation).](https://insurancefraud.org/statutes/virginia-fraud-bureau-va-code-ann-¤-52-37-proposed-legislation/) - A. There shall be established within the Department of State Police, Bureau of Criminal Investigation, the Insurance Fraud Investigation Unit. The purposes of this unit shall be to: 1. Initiate independent inquiries and conduct independent investigations when the Department has reason to believe that insurance fraud may have been or is currently being committed, and
- [Virginia-Immunity-VA Code Ann. ¤ 52-41](https://insurancefraud.org/statutes/virginia-immunity-va-code-ann-¤-52-41/) - A. Any insurer providing information to an authorized representative of the Department pursuant to ¤ 52-38 or pursuant to subdivision B 5 of ¤ 38.2-613 shall have the right to request relevant information and receive, within thirty days, the information requested. B. No cause of action in the nature of defamation, invasion of privacy, or
- [Virginia-Insurance Fraud - Definition-VA Code Ann. ¤ 18.2-178](https://insurancefraud.org/statutes/virginia-insurance-fraud-definition-va-code-ann-¤-18-2-178/) - A. If any person obtain, by any false pretense or token, from any person, with intent to defraud, money, a gift certificate or other property that may be the subject of larceny, he shall be deemed guilty of larceny thereof; or if he obtain, by any false pretense or token, with such intent, the signature
- [Virginia-Licensing Board Notification-n/a](https://insurancefraud.org/statutes/virginia-licensing-board-notification-n-a/) - No statute found
- [Virginia-Mandatory Restitution-VA Code Ann. ¤ 38.2-218](https://insurancefraud.org/statutes/virginia-mandatory-restitution-va-code-ann-¤-38-2-218/) - D. 1. The Commission may require a person to make restitution in the amount of the direct actual financial loss: a. For charging a rate in excess of that provided by statute or by the rates filed with the Commission by the insurer; b. For charging a premium that is determined by the Commission to
- [Virginia-Practitioner Penalites-VA Code Ann. ¤ 38.2-219](https://insurancefraud.org/statutes/virginia-practitioner-penalites-va-code-ann-¤-38-2-219/) - A. Whenever the Commission has reason to believe that any person has committed a violation of this title or of any rule, regulation, or order issued by the Commission under this title, it shall issue and serve an order upon that person by certified or registered mail or in any other manner permitted by law.
- [Virginia-Range of Civil Penalties-VA Code Ann. ¤ 38.2-218](https://insurancefraud.org/statutes/virginia-range-of-civil-penalties-va-code-ann-¤-38-2-218/) - A. Any person who knowingly or willfully violates any provision of this title or any regulation issued pursuant to this title shall be punished for each violation by a penalty of not more than $5,000. B. Any person who violates without knowledge or intent any provision of this title or any rule, regulation, or order
- [Virginia-Rating of an Insurance Policy-VA Code Ann. ¤ 38.2-1904](https://insurancefraud.org/statutes/virginia-rating-of-an-insurance-policy-va-code-ann-¤-38-2-1904/) - A. Rates for the classes of insurance to which this chapter applies shall not be excessive, inadequate, or unfairly discriminatory. All rates and all changes and amendments to rates to which this chapter applies for use in this Commonwealth shall consider loss experience and other factors within Virginia if relevant and actuarially sound, provided that
- [Vermont-Claims Fraud-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-claims-fraud-13-v-s-a-¤-2031-proposed-legislation/) - (b) Fraudulent insurance act. No person shall, with intent to defraud: (1) present or cause to be presented a claim for payment or benefit, pursuant to any insurance policy, that contains false representations as to any material fact or which conceals a material fact;
- [Vermont-Immunity-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-immunity-13-v-s-a-¤-2031-proposed-legislation/) - (f) Immunity. No insurer or insurance professional acting in good faith and furnishing or disclosing information to the appropriate law enforcement official shall be subject to civil liability for libel, slander, or any other cause of action arising from the furnishing or disclosing of such information, except if the information is furnished solely to obtain
- [Vermont-Insurance Fraud - Definition-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-insurance-fraud-definition-13-v-s-a-¤-2031-proposed-legislation/) - (a) Definitions. As used in this section: (1) "Conceal" means to take affirmative action intended to prevent others from discovering information. Mere failure to disclose information does not constitute concealment. (2) "Insurance policy" has the same meaning as in 8 V.S.A. ¤ 4722(3) and includes a workers' compensation policy issued pursuant to chapter 9 of
- [Vermont-Licensing Board Notification-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-licensing-board-notification-13-v-s-a-¤-2031-proposed-legislation/) - (b) Fraudulent insurance act. No person shall, with intent to defraud: (1) present or cause to be presented a claim for payment or benefit, pursuant to any insurance policy, that contains false representations as to any material fact or which conceals a material fact; or (2) present or cause to be presented any information which
- [Vermont-Practitioner Penalites-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-practitioner-penalites-13-v-s-a-¤-2031-proposed-legislation/) - (b) Fraudulent insurance act. No person shall, with intent to defraud: (1) present or cause to be presented a claim for payment or benefit, pursuant to any insurance policy, that contains false representations as to any material fact or which conceals a material fact; or (2) present or cause to be presented any information which
- [Vermont-Range of Criminal Penalties-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-range-of-criminal-penalties-13-v-s-a-¤-2031-proposed-legislation/) - (c) Penalties. A person who violates subsection (b) of this section shall: (1) if the benefit wrongfully obtained or the loss suffered by any person as a result of the violation has a value of less than $900.00, be imprisoned for not more than six months or fined not more than $5,000.00, or both; or
- [Vermont-Range of Civil Penalties-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-range-of-civil-penalties-13-v-s-a-¤-2031-proposed-legislation/) - (c) Penalties. A person who violates subsection (b) of this section shall: (1) if the benefit wrongfully obtained or the loss suffered by any person as a result of the violation has a value of less than $900.00, be imprisoned for not more than six months or fined not more than $5,000.00, or both; or
- [Vermont-Rating of an Insurance Policy-8 V.S.A. ¤ 4685](https://insurancefraud.org/statutes/vermont-rating-of-an-insurance-policy-8-v-s-a-¤-4685/) - (a) General. Rates shall not be excessive, inadequate, or unfairly discriminatory. (b) Excessiveness. (1) Competitive market. A rate in a competitive market is not excessive. (2) Noncompetitive market. Rates in a noncompetitive market are excessive if they are producing or are likely to produce unreasonably high profits for the insurance provided or if expenses are
- [Vermont-Underwriting Fraud-13 V.S.A. ¤ 2031 (Proposed Legislation)](https://insurancefraud.org/statutes/vermont-underwriting-fraud-13-v-s-a-¤-2031-proposed-legislation/) - (b) Fraudulent insurance act. No person shall, with intent to defraud: (1) present or cause to be presented a claim for payment or benefit, pursuant to any insurance policy, that contains false representations as to any material fact or which conceals a material fact; or (2) present or cause to be presented any information which
- [Vermont-Unauthorized Entities-8 V.S.A. ¤ 3368a](https://insurancefraud.org/statutes/vermont-unauthorized-entities-8-v-s-a-¤-3368a/) - (a) No person shall transact insurance business in this State unless the Commissioner has issued a license or certificate of authority to such person as required by section 3361 or 3368 of this title, or by chapters 123, 125, and 139 of this title. The provisions of this section shall not apply to an insurer
- [Utah-Aiding & Abetting-U.C.A. 1953 ¤ 31A-31-103](https://insurancefraud.org/statutes/utah-aiding-abetting-u-c-a-1953-¤-31a-31-103/) - (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: (a) knowingly presents or causes to be presented to an insurer any oral or written statement or representation knowing that the statement or representation contains false, incomplete, or misleading information concerning any fact material to an application for
- [Utah-Anti-Runner Provisions-U.C.A. 1953 ¤ 31A-31-102; U.C.A. 1953 ¤ 31A-31-103](https://insurancefraud.org/statutes/utah-anti-runner-provisions-u-c-a-1953-¤-31a-31-102-u-c-a-1953-¤-31a-31-103/) - (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: (g) knowingly employs, uses, or acts as a runner for the purpose of committing a fraudulent insurance act. (6)(a) "Runner" means a person who procures clients at the direction of, or in cooperation with a person who intends
- [Utah-Claims Fraud-U.C.A. 1953 ¤ 31A-31-103](https://insurancefraud.org/statutes/utah-claims-fraud-u-c-a-1953-¤-31a-31-103/) - (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: (a) knowingly presents or causes to be presented to an insurer any oral or written statement or representation knowing that the statement or representation contains false, incomplete, or misleading information concerning any fact material to an application for
- [Utah-Failing to Remit Premium-U.C.A. 1953 ¤ 31A-23a-411.1](https://insurancefraud.org/statutes/utah-failing-to-remit-premium-u-c-a-1953-¤-31a-23a-411-1/) - A person commits insurance fraud as described in Subsection 31A-31-103(1)(f) if that person knowingly fails to forward to the insurer a premium: (1) received from one of the following in partial or total payment of the premium due from: (a) an applicant; (b) a policyholder; or (c) a certificate holder; or (2) collected from or
- [Utah-Fraud Bureau-U.C.A. 1953 ¤ 31A-2-104](https://insurancefraud.org/statutes/utah-fraud-bureau-u-c-a-1953-¤-31a-2-104/) - (1) The department shall employ a chief examiner and such other professional, technical, and clerical employees as necessary to carry out the duties of the department. (2) An insurance fraud investigator employed pursuant to Subsection (1) may as approved by the commissioner: (a) be designated a law enforcement officer, as defined in Section 53-13-103; and
- [Utah-Immunity-U.C.A. 1953 ¤ 31A-31-105](https://insurancefraud.org/statutes/utah-immunity-u-c-a-1953-¤-31a-31-105/) - (1)(a) A person, insurer, or authorized agency is immune from civil action, civil penalty, or damages when in good faith that person, insurer, or authorized agency: (i) cooperates with an agency described in Subsection (1)(b); (ii) furnishes evidence to an agency described in Subsection (1)(b); (iii) provides information regarding a suspected fraudulent insurance act to
- [Utah-Insurance Fraud - Definition-U.C.A. 1953 ¤ 31A-31-103; U.C.A. 1953 ¤ 76-6-521](https://insurancefraud.org/statutes/utah-insurance-fraud-definition-u-c-a-1953-¤-31a-31-103-u-c-a-1953-¤-76-6-521/) - (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: (a) knowingly presents or causes to be presented to an insurer any oral or written statement or representation knowing that the statement or representation contains false, incomplete, or misleading information concerning any fact material to an application for
- [Utah-Licensing Board Notification-U.C.A. 1953 ¤ 31A-31-110](https://insurancefraud.org/statutes/utah-licensing-board-notification-u-c-a-1953-¤-31a-31-110/) - (1)(a) A person shall report a fraudulent insurance act to the department if: (i) the person has a good faith belief on the basis of a preponderance of the evidence that a fraudulent insurance act is being, will be, or has been committed by a person other than the person making the report; and (ii)
- [Utah-Looting & diverting-U.C.A. 1953 ¤ 31A-31-103](https://insurancefraud.org/statutes/utah-looting-diverting-u-c-a-1953-¤-31a-31-103/) - (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: (c) knowingly accepts a benefit from the proceeds derived from a fraudulent insurance act; or (d) assists, abets, solicits, or conspires with another to commit a fraudulent insurance act.
- [Utah-Mandatory Restitution-U.C.A. 1953 ¤ 31A-31-109](https://insurancefraud.org/statutes/utah-mandatory-restitution-u-c-a-1953-¤-31a-31-109/) - (1) In addition to other penalties provided by law, a person who violates this chapter: (a) is subject to the following civil penalties: (i) the person shall make full restitution; and (ii) the person shall pay the costs of enforcement of this chapter for the case in which the person is found to have violated
- [Utah-Placing Bogus Coverage-U.C.A. 1953 ¤ 31A-31-103](https://insurancefraud.org/statutes/utah-placing-bogus-coverage-u-c-a-1953-¤-31a-31-103/) - (3) An insurer commits a fraudulent insurance act if that insurer with intent to deceive or defraud: (a) knowingly withholds information or provides false or misleading information with respect to an application, coverage, benefits, or claims under a policy or certificate; (b) assists, abets, solicits, or conspires with another to commit a fraudulent insurance act;
- [Utah-Practitioner Penalites-U.C.A. 1953 ¤ 31A-31-106](https://insurancefraud.org/statutes/utah-practitioner-penalites-u-c-a-1953-¤-31a-31-106/) - (1) If, after giving notice and a hearing conducted pursuant to Title 63G, Chapter 4, Administrative Procedures Act, the commissioner finds by a preponderance of the evidence that a person licensed under Title 31A, Insurance Code, has committed a fraudulent insurance act, the commissioner may suspend or revoke the license issued under Title 31A, Insurance
- [Utah-Premium Fraud-U.C.A. 1953 ¤ 31A-23a-411.1](https://insurancefraud.org/statutes/utah-premium-fraud-u-c-a-1953-¤-31a-23a-411-1/) - A person commits insurance fraud as described in Subsection 31A-31-103(1)(f) if that person knowingly fails to forward to the insurer a premium: (1) received from one of the following in partial or total payment of the premium due from: (a) an applicant; (b) a policyholder; or (c) a certificate holder; or (2) collected from or
- [Utah-Range of Criminal Penalties-U.C.A. 1953 ¤ 76-6-521](https://insurancefraud.org/statutes/utah-range-of-criminal-penalties-u-c-a-1953-¤-76-6-521/) - (2)(a) A violation of Subsection (1)(a) is a class B misdemeanor. (b) A violation of Subsections (1)(b) through (1)(g) is punishable as in the manner prescribed by Section 76-10-1801 for communication fraud for property of like value. (3) A corporation or association is guilty of the offense of insurance fraud under the same conditions as
- [Utah-Range of Civil Penalties-U.C.A. 1953 ¤ 31A-31-109](https://insurancefraud.org/statutes/utah-range-of-civil-penalties-u-c-a-1953-¤-31a-31-109/) - (1) In addition to other penalties provided by law, a person who violates this chapter: (a) is subject to the following civil penalties: (i) the person shall make full restitution; and (ii) the person shall pay the costs of enforcement of this chapter for the case in which the person is found to have violated
- [Utah-Rating of an Insurance Policy-U.C.A. 1953 ¤ 31A-19a-201](https://insurancefraud.org/statutes/utah-rating-of-an-insurance-policy-u-c-a-1953-¤-31a-19a-201/) - (1) Rates may not be excessive, inadequate, or unfairly discriminatory. (2)(a) Rates are not excessive if a reasonable degree of price competition exists at the consumer level with respect to the class of business to which they apply. In determining whether a reasonable degree of price competition exists, the commissioner shall consider: (i) relevant tests
- [Utah-Underwriting Fraud-U.C.A. 1953 ¤ 31A-31-103](https://insurancefraud.org/statutes/utah-underwriting-fraud-u-c-a-1953-¤-31a-31-103/) - (2) A service provider commits a fraudulent insurance act if that service provider with intent to deceive or defraud: (a) knowingly submits or causes to be submitted a bill or request for payment: (i) containing charges or costs for an item or service that are substantially in excess of customary charges or costs for the
- [Utah-Unauthorized Entities-U.C.A. 1953 ¤ 31A-15-102](https://insurancefraud.org/statutes/utah-unauthorized-entities-u-c-a-1953-¤-31a-15-102/) - (1) No person may do any act enumerated under Subsection (2) who knows or should know that the act may assist in the illegal placement of insurance with an unauthorized insurer or the subsequent servicing of an insurance policy illegally placed with an unauthorized insurer. (2) An act performed by mail is performed both at
- [Texas-Attempted Fraud-V.T.C.A., Insurance Code ¤ 701.001](https://insurancefraud.org/statutes/texas-attempted-fraud-v-t-c-a-insurance-code-¤-701-001/) - (2) "Fraudulent insurance act" means an act that is a violation of a penal law and is: (A) committed or attempted while engaging in the business of insurance; (B) committed or attempted as part of or in support of an insurance transaction; or (C) part of an attempt to defraud an insurer.
- [Texas-Claims Fraud-V.T.C.A., Penal Code ¤ 35.02](https://insurancefraud.org/statutes/texas-claims-fraud-v-t-c-a-penal-code-¤-35-02/) - (a) A person commits an offense if, with intent to defraud or deceive an insurer, the person, in support of a claim for payment under an insurance policy: (1) prepares or causes to be prepared a statement that: (A) the person knows contains false or misleading material information; and (B) is presented to an insurer;
- [Texas-Fraud Bureau-V.T.C.A., Insurance Code ¤ 701.101](https://insurancefraud.org/statutes/texas-fraud-bureau-v-t-c-a-insurance-code-¤-701-101/) - (a) The purpose of the department's insurance fraud unit is to enforce laws relating to fraudulent insurance acts. (b) The insurance fraud unit may receive, review, and investigate in a timely manner insurer antifraud reports submitted under Chapter 704. (c) The insurance fraud unit shall report annually to the commissioner in writing regarding: (1) the
- [Texas-Immunity-V.T.C.A., Insurance Code ¤ 701.052](https://insurancefraud.org/statutes/texas-immunity-v-t-c-a-insurance-code-¤-701-052/) - (a) A person is not liable in a civil action, including an action for libel or slander, and a civil action may not be brought against the person, for furnishing information relating to a suspected, anticipated, or completed fraudulent insurance act if the information is provided to: (1) an authorized governmental agency or the department;
- [Texas-Insurance Fraud - Definition-V.T.C.A., Penal Code ¤ 35.02](https://insurancefraud.org/statutes/texas-insurance-fraud-definition-v-t-c-a-penal-code-¤-35-02/) - (a) A person commits an offense if, with intent to defraud or deceive an insurer, the person, in support of a claim for payment under an insurance policy: (1) prepares or causes to be prepared a statement that: (A) the person knows contains false or misleading material information; and (B) is presented to an insurer;
- [Texas-Licensing Board Notification-V.T.C.A., Insurance Code ¤ 701.051](https://insurancefraud.org/statutes/texas-licensing-board-notification-v-t-c-a-insurance-code-¤-701-051/) - (a) Not later than the 30th day after the date the person makes the determination or reasonably suspects that a fraudulent insurance act has been or is about to be committed in this state, the person: (1) shall report the information in writing to the insurance fraud unit of the department, in the format prescribed
- [Texas-Mandatory Restitution-V.A.T.S. Insurance Code, ¤ 101.102](https://insurancefraud.org/statutes/texas-mandatory-restitution-v-a-t-s-insurance-code-¤-101-102/) - (e) The court shall order a defendant convicted of an offense under this section to pay restitution, including court costs and attorney's fees, to an affected insurer.
- [Texas-Placing Bogus Coverage-V.A.T.S. Insurance Code, ¤ 101.102](https://insurancefraud.org/statutes/texas-placing-bogus-coverage-v-a-t-s-insurance-code-¤-101-102/) - (a) A person, including an insurer, may not directly or indirectly do an act that constitutes the business of insurance under this chapter except as authorized by statute. (b) With respect to insurance of a subject that is resident, located, or to be performed in this state, this section does not prohibit an act performed
- [Texas-Practitioner Penalites-V.A.T.S. Insurance Code, ¤ 84.022](https://insurancefraud.org/statutes/texas-practitioner-penalites-v-a-t-s-insurance-code-¤-84-022/) - (a) The penalty for a violation may not exceed $25,000, unless a greater or lesser penalty is specified by this code or another insurance law of this state. (b) The amount of the penalty shall be based on: (1) the seriousness of the violation, including: (A) the nature, circumstances, extent, and gravity of the violation;
- [Texas-Range of Criminal Penalties-V.T.C.A., Penal Code ¤ 35.02](https://insurancefraud.org/statutes/texas-range-of-criminal-penalties-v-t-c-a-penal-code-¤-35-02/) - (c) An offense under Subsection (a) or (b) is: (1) a Class C misdemeanor if the value of the claim is less than $100; (2) a Class B misdemeanor if the value of the claim is $100 or more but less than $750; (3) a Class A misdemeanor if the value of the claim is
- [Texas-Underwriting Fraud-V.T.C.A., Penal Code ¤ 35.02](https://insurancefraud.org/statutes/texas-underwriting-fraud-v-t-c-a-penal-code-¤-35-02/) - (a) A person commits an offense if, with intent to defraud or deceive an insurer, the person, in support of a claim for payment under an insurance policy: (1) prepares or causes to be prepared a statement that: (A) the person knows contains false or misleading material information; and (B) is presented to an insurer;
- [Texas-Unauthorized Entities-V.A.T.S. Insurance Code, ¤ 101.102](https://insurancefraud.org/statutes/texas-unauthorized-entities-v-a-t-s-insurance-code-¤-101-102/) - (a) A person, including an insurer, may not directly or indirectly do an act that constitutes the business of insurance under this chapter except as authorized by statute. (b) With respect to insurance of a subject that is resident, located, or to be performed in this state, this section does not prohibit an act performed
- [Tennessee-Aiding & Abetting-T. C. A. ¤ 56-53-102](https://insurancefraud.org/statutes/tennessee-aiding-abetting-t-c-a-¤-56-53-102/) - (b) It shall be unlawful for any person to commit, or to attempt to commit, or aid, assist, abet or solicit another to commit, or to conspire to commit a fraudulent insurance act.
- [Tennessee-Claims Fraud-T. C. A. ¤ 56-53-102](https://insurancefraud.org/statutes/tennessee-claims-fraud-t-c-a-¤-56-53-102/) - (a) Any person who, knowingly and with intent to defraud, and for the purpose of depriving another of property or for pecuniary gain, commits, participates in or aids, abets, or conspires to commit or solicits another person to commit, or intentionally permits its employees or its agents to commit any of the following acts, has
- [Tennessee-Failing to Remit Premium-T. C. A. ¤ 56-6-910](https://insurancefraud.org/statutes/tennessee-failing-to-remit-premium-t-c-a-¤-56-6-910/) - (a) The commissioner may place on probation, cancel, terminate, suspend, revoke or refuse to issue or renew a public adjuster's license, or may levy a civil penalty, in accordance with this section, or any combination of actions, for any one (1) or more of the following causes: (4) Improperly withholding, misappropriating, or converting to the
- [Tennessee-Fraud Bureau-n/a](https://insurancefraud.org/statutes/tennessee-fraud-bureau-n-a/) - No statute found
- [Tennessee-Immunity-T. C. A. ¤ 56-53-110](https://insurancefraud.org/statutes/tennessee-immunity-t-c-a-¤-56-53-110/) - In the absence of actual malice, no person furnishing, disclosing or requesting information pursuant to ¤ 56-53-109 shall be subject to civil liability for libel, slander, or any other cause of action arising from the furnishing, disclosing or requesting of the information. No person providing information pursuant to ¤ 56-53-109(a) shall be subject to civil
- [Tennessee-Insurance Fraud - Definition-T. C. A. ¤ 56-53-103; T. C. A. ¤ 56-53-102](https://insurancefraud.org/statutes/tennessee-insurance-fraud-definition-t-c-a-¤-56-53-103-t-c-a-¤-56-53-102/) - (a) Any person who commits, participates in, or aids, abets, or conspires to commit, or solicits another person to commit, or permits its employees or its agents to commit any of the following acts with an intent to induce reliance, has committed an unlawful insurance act: (1) Presents, causes to be presented, or prepares with
- [Tennessee-Licensing Board Notification-T. C. A. ¤ 56-53-109](https://insurancefraud.org/statutes/tennessee-licensing-board-notification-t-c-a-¤-56-53-109/) - (a) When any law enforcement official or authority, any insurance department, state division of insurance fraud, or state or federal regulatory or licensing authority requests information from an insurer or insurance professional for the purpose of detecting, prosecuting or preventing insurance fraud, the insurer or insurance professional shall take all reasonable actions to provide the
- [Tennessee-Looting & diverting-T. C. A. ¤ 56-53-102](https://insurancefraud.org/statutes/tennessee-looting-diverting-t-c-a-¤-56-53-102/) - (a) Any person who, knowingly and with intent to defraud, and for the purpose of depriving another of property or for pecuniary gain, commits, participates in or aids, abets, or conspires to commit or solicits another person to commit, or intentionally permits its employees or its agents to commit any of the following acts, has
- [Tennessee-Mandatory Restitution-T. C. A. ¤ 56-53-105](https://insurancefraud.org/statutes/tennessee-mandatory-restitution-t-c-a-¤-56-53-105/) - (a) A person convicted of a violation of ¤ 56-53-102 shall be ordered to make monetary restitution for any financial loss or damages sustained by any other person as a result of the violation. Financial loss or damage shall include, but is not necessarily limited to, loss of earnings, out-of-pocket and other expenses, paid deductible
- [Tennessee-Placing Bogus Coverage-T. C. A. ¤ 56-53-103](https://insurancefraud.org/statutes/tennessee-placing-bogus-coverage-t-c-a-¤-56-53-103/) - (a) Any person who commits, participates in, or aids, abets, or conspires to commit, or solicits another person to commit, or permits its employees or its agents to commit any of the following acts with an intent to induce reliance, has committed an unlawful insurance act: (3) Solicits or accepts new or renewal insurance risks
- [Tennessee-Practitioner Penalites-T. C. A. ¤ 56-53-106](https://insurancefraud.org/statutes/tennessee-practitioner-penalites-t-c-a-¤-56-53-106/) - (a)(1) Any practitioner determined by the court to have violated ¤ 56-53-102 shall be deemed to have committed an act involving moral turpitude that is inimical to the public well being. The court or prosecutor shall notify the appropriate licensing authority in this state of the judgment for appropriate disciplinary action, including revocation of the
- [Tennessee-Premium Fraud-T. C. A. ¤ 56-53-103; T. C. A. ¤ 56-53-102](https://insurancefraud.org/statutes/tennessee-premium-fraud-t-c-a-¤-56-53-103-t-c-a-¤-56-53-102/) - (a) Any person who, knowingly and with intent to defraud, and for the purpose of depriving another of property or for pecuniary gain, commits, participates in or aids, abets, or conspires to commit or solicits another person to commit, or intentionally permits its employees or its agents to commit any of the following acts, has
- [Tennessee-Range of Criminal Penalties-T. C. A. ¤ 39-14-133](https://insurancefraud.org/statutes/tennessee-range-of-criminal-penalties-t-c-a-¤-39-14-133/) - Any person who intentionally presents or causes to be presented a false or fraudulent claim, or any proof in support of such claim, for the payment of a loss, or other benefits, upon any contract of insurance coverage, or automobile comprehensive or collision insurance, or certificate of such insurance or prepares, makes or subscribes to
- [Tennessee-Range of Civil Penalties-T. C. A. ¤ 56-53-107](https://insurancefraud.org/statutes/tennessee-range-of-civil-penalties-t-c-a-¤-56-53-107/) - (a)(1) Any person injured in the person's business or property by reason of a violation of ¤ 56-53-103 may recover for the injury from the person or persons violating ¤ 56-53-103, in any appropriate court having jurisdiction, the following: (A) Return of any profit, benefit, compensation or payment received by the person violating ¤ 56-53-103
- [Tennessee-Rating of an Insurance Policy-T. C. A. ¤ 56-5-103](https://insurancefraud.org/statutes/tennessee-rating-of-an-insurance-policy-t-c-a-¤-56-5-103/) - (a) GENERAL. Rates: (1) Shall not be excessive, inadequate or unfairly discriminatory; or (2) In the case of an advisory prospective loss costs filing, shall reasonably reflect projected losses and loss adjustment expenses. (b) EXCESSIVENESS. A rate is excessive if it is likely to produce a profit that is unreasonably high for the insurance provided
- [Tennessee-Underwriting Fraud-T. C. A. ¤ 56-6-910](https://insurancefraud.org/statutes/tennessee-underwriting-fraud-t-c-a-¤-56-6-910/) - (a) The commissioner may place on probation, cancel, terminate, suspend, revoke or refuse to issue or renew a public adjuster's license, or may levy a civil penalty, in accordance with this section, or any combination of actions, for any one (1) or more of the following causes: (1) Providing materially incorrect, misleading, incomplete, or untrue
- [Tennessee-Unauthorized Entities-T. C. A. ¤ 56-2-107](https://insurancefraud.org/statutes/tennessee-unauthorized-entities-t-c-a-¤-56-2-107/) - Any of the following acts in this state, effected by mail or otherwise by an unauthorized insurer, are included among those deemed to constitute transacting insurance business in this state: (1) The issuance or delivery of contracts of insurance to residents of this state; (2) The solicitation of applications for contracts of insurance; (3) The
- [South Dakota-Aiding & Abetting-SDCL ¤ 58-4A-2](https://insurancefraud.org/statutes/south-dakota-aiding-abetting-sdcl-¤-58-4a-2/) - (7) Assists, abets, solicits, or conspires with another to prepare or make any statement that is intended to be presented to or by an insurer or person in connection with or in support of any claim for payment or other benefit, or denial, pursuant to an insurance policy knowing that the statement contains any false,
- [South Dakota-Claims Fraud-SDCL ¤ 58-4A-2](https://insurancefraud.org/statutes/south-dakota-claims-fraud-sdcl-¤-58-4a-2/) - For purposes of this chapter, a person commits a fraudulent insurance act if the person: (2) Is engaged in the business of insurance, whether authorized or unauthorized, receives money for the purpose of purchasing insurance and converts the money to the person's own benefit or for a purpose not intended or authorized by an insured
- [South Dakota-Fraud Bureau-SDCL ¤ 58-4A-3](https://insurancefraud.org/statutes/south-dakota-fraud-bureau-sdcl-¤-58-4a-3/) - The insurance fraud prevention unit through its investigator or attorney may do the following: (1) The investigator or attorney may initiate and conduct independent investigations if the unit has cause to believe that a fraudulent insurance act has been or may be committed; (2) The investigator or attorney may review reports or complaints of alleged
- [South Dakota-Immunity-SDCL ¤ 58-4A-13](https://insurancefraud.org/statutes/south-dakota-immunity-sdcl-¤-58-4a-13/) - Any person acting in good faith is immune from civil liability for filing a report with or for furnishing any information relating to suspected, anticipated, or completed fraudulent insurance acts to: (1) The Department of Labor and Regulation and the director of insurance; (2) Any governmental agency established to detect and prevent fraud; (3) Law
- [South Dakota-Insurance Fraud - Definition-SDCL ¤ 58-4A-2](https://insurancefraud.org/statutes/south-dakota-insurance-fraud-definition-sdcl-¤-58-4a-2/) - For purposes of this chapter, a person commits a fraudulent insurance act if the person: (1) Knowingly and with intent to defraud or deceive issues or possesses fake or counterfeit insurance policies, certificates of insurance, insurance identification cards, or insurance binders; (2) Is engaged in the business of insurance, whether authorized or unauthorized, receives money
- [South Dakota-Looting & diverting-SDCL ¤ 58-4A-2](https://insurancefraud.org/statutes/south-dakota-looting-diverting-sdcl-¤-58-4a-2/) - For purposes of this chapter, a person commits a fraudulent insurance act if the person: (2) Is engaged in the business of insurance, whether authorized or unauthorized, receives money for the purpose of purchasing insurance and converts the money to the person's own benefit or for a purpose not intended or authorized by an insured
- [South Dakota-Placing Bogus Coverage-SDCL ¤ 58-4A-2](https://insurancefraud.org/statutes/south-dakota-placing-bogus-coverage-sdcl-¤-58-4a-2/) - For purposes of this chapter, a person commits a fraudulent insurance act if the person: (1) Knowingly and with intent to defraud or deceive issues or possesses fake or counterfeit insurance policies, certificates of insurance, insurance identification cards, or insurance binders;
- [South Dakota-Practitioner Penalites-SDCL ¤ 58-30-167](https://insurancefraud.org/statutes/south-dakota-practitioner-penalites-sdcl-¤-58-30-167/) - The director may suspend for not more than twelve months, or may revoke or refuse to continue, any license issued under this chapter, or any license of a surplus lines broker after a hearing. Notice of such hearing and of the charges against the licensee shall be given to the licensee and to the insurers
- [South Dakota-Range of Criminal Penalties-SDCL ¤ 58-4A-5](https://insurancefraud.org/statutes/south-dakota-range-of-criminal-penalties-sdcl-¤-58-4a-5/) - Any violation of this section for an amount of four hundred dollars or less is a Class 2 misdemeanor. Any violation of this section for an amount in excess of four hundred dollars and less than one thousand dollars is a Class 1 misdemeanor. Any violation of this section for an amount of one thousand
- [South Dakota-Range of Civil Penalties-SDCL ¤ 58-4A-7](https://insurancefraud.org/statutes/south-dakota-range-of-civil-penalties-sdcl-¤-58-4a-7/) - If the insurance fraud prevention unit or its designees initiate civil action against any person and that person is found by a court of competent jurisdiction to have committed a fraudulent insurance act as set forth in ¤ 58-4A-2, that person is subject to a civil penalty not to exceed five thousand dollars for the
- [South Dakota-Rating of an Insurance Policy-SDCL ¤ 58-24-5](https://insurancefraud.org/statutes/south-dakota-rating-of-an-insurance-policy-sdcl-¤-58-24-5/) - Rates shall not be excessive, inadequate, or unfairly discriminatory.
- [South Dakota-Underwriting Fraud-SDCL ¤ 58-4A-2](https://insurancefraud.org/statutes/south-dakota-underwriting-fraud-sdcl-¤-58-4a-2/) - For purposes of this chapter, a person commits a fraudulent insurance act if the person: (3) Willfully embezzles, abstracts, steals, misappropriates, or converts money, funds, premiums, credits, or other property of an insurer or person engaged in the business of insurance or of an insured or prospective insured; (4) Knowingly and with intent to defraud
- [South Dakota-Unauthorized Entities-SDCL ¤ 58-8-1](https://insurancefraud.org/statutes/south-dakota-unauthorized-entities-sdcl-¤-58-8-1/) - No person may in this state, directly or indirectly, act as insurance producer for, or otherwise represent any insurer not then authorized to transact insurance business in this state, in the solicitation, negotiation, or effectuation of insurance or of annuity contracts, inspection of risks, fixing of rates, investigation or adjustment of losses, collection of premiums,
- [South Carolina-Aiding & Abetting-Code 1976 ¤ 38-55-540 (Proposed Legislation)](https://insurancefraud.org/statutes/south-carolina-aiding-abetting-code-1976-¤-38-55-540-proposed-legislation/) - (A) A person who knowingly makes a false statement or misrepresentation, and any other person knowingly, with an intent to injure, defraud, or deceive, or who assists, abets, solicits, or conspires with a person to make a false statement or misrepresentation, is guilty of a: (1) misdemeanor, for a first offense violation, if the amount
- [South Carolina-Anti-Runner Provisions-Code 1976 ¤ 38-55-170](https://insurancefraud.org/statutes/south-carolina-anti-runner-provisions-code-1976-¤-38-55-170/) - A person who knowingly causes to be presented a false claim for payment to an insurer transacting business in this State, to a health maintenance organization transacting business in this State, or to any person, including the State of South Carolina, providing benefits for health care in this State, whether these benefits are administered directly
- [South Carolina-Claims Fraud-Code 1976 ¤ 38-55-170](https://insurancefraud.org/statutes/south-carolina-claims-fraud-code-1976-¤-38-55-170/) - A person who knowingly causes to be presented a false claim for payment to an insurer transacting business in this State, to a health maintenance organization transacting business in this State, or to any person, including the State of South Carolina, providing benefits for health care in this State, whether these benefits are administered directly
- [South Carolina-Failing to Remit Premium-Code 1976 ¤ 38-43-130](https://insurancefraud.org/statutes/south-carolina-failing-to-remit-premium-code-1976-¤-38-43-130/) - (A) The director or his designee may place on probation, revoke, or suspend a producer's license after ten days' notice or refuse to issue or reissue a license when it appears that a producer has been convicted of a crime involving moral turpitude, has violated this title or any regulation promulgated by the department, or
- [South Carolina-Fraud Bureau-Code 1976 ¤ 38-55-560 (Proposed Legislation)](https://insurancefraud.org/statutes/south-carolina-fraud-bureau-code-1976-¤-38-55-560-proposed-legislation/) - (A) There is established in the Office of the Attorney General a division to be known as the Insurance Fraud Division, which must prosecute violations of Sections 38-55-170 and 38-55-540 and related criminal insurance activity. Upon receipt of any claims or allegations of violations of Section 38-55-170 and 38-55-540 and related criminal insurance activity, the
- [South Carolina-Immunity-Code 1976 ¤ 38-55-580](https://insurancefraud.org/statutes/south-carolina-immunity-code-1976-¤-38-55-580/) - (A) A person, insurer, or authorized agency, when acting without malice or in good faith, is immune from any liability arising out of filing reports, cooperating with investigations by any authorized agency, or furnishing other information, whether written or oral, and whether in response to a request by an authorized agency or upon their own
- [South Carolina-Mandatory Restitution-Code 1976 ¤ 38-55-540 (Proposed Legislation)](https://insurancefraud.org/statutes/south-carolina-mandatory-restitution-code-1976-¤-38-55-540-proposed-legislation/) - (B) In addition to the criminal penalties set forth in subsection (A), a person convicted pursuant to the provisions of this section must be ordered by the court to make full restitution to a victim for any economic advantage or benefit which has been obtained by the person as a result of that violation, and
- [South Carolina-Placing Bogus Coverage-SECTION 38-55-130.   SECTION 38-55-150.](https://insurancefraud.org/statutes/south-carolina-placing-bogus-coverage-section-38-55-130-section-38-55-150/) - Doing business after charter has been canceled or surrendered is unlawful. It is unlawful for an insurer or for any person acting for or on its behalf knowingly to solicit, deliver any policy, or collect any premiums of insurance for the insurer from any person within this State when the insurer has surrendered its charter
- [South Carolina-Premium Fraud-Code 1976 ¤ 38-55-150](https://insurancefraud.org/statutes/south-carolina-premium-fraud-code-1976-¤-38-55-150/) - It is unlawful for a director or officer of an insurer to wilfully receive a premium or assessment on behalf of the insurer, knowing at the time of receipt of the premium or assessment that the insurer is insolvent according to the laws of its home state, and to fail to notify the person paying
- [South Carolina-Range of Criminal Penalties-Code 1976 ¤ 38-55-540 (Proposed Legislation)](https://insurancefraud.org/statutes/south-carolina-range-of-criminal-penalties-code-1976-¤-38-55-540-proposed-legislation/) - (A) A person who knowingly makes a false statement or misrepresentation, and any other person knowingly, with an intent to injure, defraud, or deceive, or who assists, abets, solicits, or conspires with a person to make a false statement or misrepresentation, is guilty of a: (1) misdemeanor, for a first offense violation, if the amount
- [South Carolina-Range of Civil Penalties-Code 1976 ¤ 38-55-550](https://insurancefraud.org/statutes/south-carolina-range-of-civil-penalties-code-1976-¤-38-55-550/) - (A) In addition to any criminal liability, any person who is found by a court of competent jurisdiction to have violated any provision of this article, including Section 38-55-170, is subject to a civil penalty for each violation as follows: (1) for a first offense, a fine not to exceed five thousand dollars; (2) for
- [South Carolina-Rating of an Insurance Policy-Code 1976 ¤ 38-73-430](https://insurancefraud.org/statutes/south-carolina-rating-of-an-insurance-policy-code-1976-¤-38-73-430/) - Rates must be made in accordance with the following provisions: (1) Due consideration must be given to past and prospective loss experience within and outside this State, to catastrophe hazards, if any, to a reasonable margin for underwriting profit and contingencies, to dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their
- [South Carolina-Underwriting Fraud-Code 1976 ¤ 38-55-530](https://insurancefraud.org/statutes/south-carolina-underwriting-fraud-code-1976-¤-38-55-530/) - (D) "False statement or misrepresentation" means a statement or representation made by a person that is false, material, made with the person's knowledge of the falsity of the statement and made with the intent of obtaining or causing another to obtain or attempting to obtain or causing another to obtain an undeserved economic advantage or
- [South Carolina-Unauthorized Entities-Code 1976 ¤ 38-25-110](https://insurancefraud.org/statutes/south-carolina-unauthorized-entities-code-1976-¤-38-25-110/) - It is unlawful for an insurer to transact insurance business in this State without a certificate of authority from the director or his designee. Any of the acts listed in items (1) through (8) in this State effected by mail or otherwise by or on behalf of an unauthorized insurer is considered to constitute the
- [Rhode Island-Aiding & Abetting-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-aiding-abetting-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Anti-Runner Provisions-n/a](https://insurancefraud.org/statutes/rhode-island-anti-runner-provisions-n-a/) - No statute found
- [Rhode Island-Attempted Fraud-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-attempted-fraud-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Claims Fraud-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-claims-fraud-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Failing to Remit Premium-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-failing-to-remit-premium-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Fraud Bureau-Gen.Laws 1956, ¤ 31-50-1](https://insurancefraud.org/statutes/rhode-island-fraud-bureau-gen-laws-1956-¤-31-50-1/) - (a) There is established an office of automobile theft and insurance fraud. (b) The scope and purpose of the office of automobile theft and insurance fraud shall be to investigate and prosecute crimes involving the theft or other unauthorized use of motor vehicles and to investigate and prosecute all forms of automobile insurance-related fraud. (c)
- [Rhode Island-Immunity-Gen.Laws 1957, 27-49-5; 27-49-5.1](https://insurancefraud.org/statutes/rhode-island-immunity-gen-laws-1957-27-49-5-27-49-5-1/) - No insurer, or agent authorized by an insurer to act on its behalf, authorized governmental agency or their respective employees shall be subject to any civil or criminal liability in a cause of action of any kind for releasing or receiving any factually accurate information pursuant to ÌÙ 27- 49-3 or ÌÙ 27-49-4. Nothing herein
- [Rhode Island-Insurance Fraud - Definition-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-insurance-fraud-definition-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Looting & diverting-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-looting-diverting-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Practitioner Penalites-Gen.Laws 1956, ¤ 27-54.1-6](https://insurancefraud.org/statutes/rhode-island-practitioner-penalites-gen-laws-1956-¤-27-54-1-6/) - A person who violates this chapter is subject to suspension or revocation of license or certificate of authority or administrative penalties per Rhode Island general laws ¤ 42-14-16 or both. Suspension or revocation of license or certificate of authority and imposition of administrative penalties shall be pursuant to an order of the commissioner issued under
- [Rhode Island-Premium Fraud-Gen.Laws 1956, ¤ 27-54.1-1](https://insurancefraud.org/statutes/rhode-island-premium-fraud-gen-laws-1956-¤-27-54-1-1/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (i) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer,
- [Rhode Island-Range of Criminal Penalties-Gen.Laws 1956, ¤ 27-54-1](https://insurancefraud.org/statutes/rhode-island-range-of-criminal-penalties-gen-laws-1956-¤-27-54-1/) - (a) Any person who knowingly and with intent to deceive the director of business regulation (referred to in this section as "director") about the financial condition of an insurance company, makes any false statement, representation or report to the director concerning an insurance company; or who knowingly and with intent to deceive the director about
- [Rhode Island-Range of Civil Penalties-Gen.Laws 1956, ¤ 27-54-2](https://insurancefraud.org/statutes/rhode-island-range-of-civil-penalties-gen-laws-1956-¤-27-54-2/) - In addition to the criminal penalties set forth in ¤ 27-54-1, the attorney general or the director or his or her designee may bring a civil action against any person who engages in conduct constituting an offense under this chapter and, upon proof of that conduct by a preponderance of the evidence, the person shall
- [Rhode Island-Rating of an Insurance Policy-Gen.Laws 1956, ¤ 27-6-4](https://insurancefraud.org/statutes/rhode-island-rating-of-an-insurance-policy-gen-laws-1956-¤-27-6-4/) - Rates shall be made in accordance with the following provisions: (1) Manual, minimum, or class rates, rating schedules, or rating plans shall be made and adopted, except in the case of specific inland marine rates, on risks specially rated; (2) Rates shall not be excessive, inadequate, or unfairly discriminatory; and (3) Due consideration shall be
- [Rhode Island-Underwriting Fraud-n/a](https://insurancefraud.org/statutes/rhode-island-underwriting-fraud-n-a/) - (3) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following: (E) Payments made in accordance with the terms of an insurance policy or reinsurance contract; (F) A document filed with the commissioner
- [Rhode Island-Unauthorized Entities-Gen.Laws 1956, ¤ 27-16-1.2](https://insurancefraud.org/statutes/rhode-island-unauthorized-entities-gen-laws-1956-¤-27-16-1-2/) - (a) It shall be unlawful for any insurer to transact insurance business in this state as set forth in subsection (b) of this section without a certificate of compliance from the commissioner; provided, that this section shall not apply to: (1) The lawful transaction of surplus lines insurance; (2) The lawful transaction of reinsurance by
- [Pennsylvania-Aiding & Abetting-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-aiding-abetting-18-pa-c-s-a-¤-4117/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (3) Knowingly and with the intent to defraud any insurer or self-insured, assists, abets, solicits or conspires with another to prepare or make any statement that is intended to be presented to any insurer or self-insured in connection with, or
- [Pennsylvania-Anti-Runner Provisions-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-anti-runner-provisions-18-pa-c-s-a-¤-4117/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (5) Knowingly benefits, directly or indirectly, from the proceeds derived from a violation of this section due to the assistance, conspiracy or urging of any person. (6) Is the owner, administrator or employee of any health care facility and knowingly
- [Pennsylvania-Claims Fraud-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-claims-fraud-18-pa-c-s-a-¤-4117/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (2) Knowingly and with the intent to defraud any insurer or self-insured, presents or causes to be presented to any insurer or self-insured any statement forming a part of, or in support of, a claim that contains any false, incomplete
- [Pennsylvania-Failing to Remit Premium-n/a](https://insurancefraud.org/statutes/pennsylvania-failing-to-remit-premium-n-a/) - No statute found..
- [Pennsylvania-Fraud Bureau-40 P.S. ¤ 325.21](https://insurancefraud.org/statutes/pennsylvania-fraud-bureau-40-p-s-¤-325-21/) - (a) Establishment.--There is hereby established a body corporate and politic to be known as the Insurance Fraud Prevention Authority. The purposes, powers and duties of the authority shall be vested in and exercised by a board of directors. (b) Composition.--The board of the authority shall consist of seven members composed and appointed in accordance with
- [Pennsylvania-Immunity-18 Pa.C.S.A. ¤ 4117; 40 P.S. ¤ 325.47](https://insurancefraud.org/statutes/pennsylvania-immunity-18-pa-c-s-a-¤-4117-40-p-s-¤-325-47/) - (f) Immunity. "Ó An insurer, and any agent, servant or employee thereof acting in the course and scope of his employment, shall be immune from civil or criminal liability arising from the supply or release of written or oral information to any entity duly authorized to receive such information by Federal or State law, or
- [Pennsylvania-Insurance Fraud - Definition-](https://insurancefraud.org/statutes/pennsylvania-insurance-fraud-definition/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (1) Knowingly and with the intent to defraud a State or local government agency files, presents or causes to be filed with or presented to the government agency a document that contains false, incomplete or misleading information concerning any fact
- [Pennsylvania-Licensing Board Notification-75 Pa.C.S.A. ¤ 1817](https://insurancefraud.org/statutes/pennsylvania-licensing-board-notification-75-pa-c-s-a-¤-1817/) - Every insurer licensed to do business in this Commonwealth, and its employees, agents, brokers, motor vehicle physical damage appraisers and public adjusters, or public adjuster solicitors, who has a reasonable basis to believe insurance fraud has occurred shall be required to report the incidence of suspected insurance fraud to Federal, State or local criminal law
- [Pennsylvania-Looting & diverting-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-looting-diverting-18-pa-c-s-a-¤-4117/) - (5) Knowingly benefits, directly or indirectly, from the proceeds derived from a violation of this section due to the assistance, conspiracy or urging of any person. (6) Is the owner, administrator or employee of any health care facility and knowingly allows the use of such facility by any person in furtherance of a scheme or
- [Pennsylvania-Mandatory Restitution-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-mandatory-restitution-18-pa-c-s-a-¤-4117/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (e) Restitution.--The court may, in addition to any other sentence authorized by law, sentence a person convicted of violating this section to make restitution.
- [Pennsylvania-Range of Criminal Penalties-¤ 4117. Insurance fraud](https://insurancefraud.org/statutes/pennsylvania-range-of-criminal-penalties-¤-4117-insurance-fraud/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (1) Knowingly and with the intent to defraud a State or local government agency files, presents or causes to be filed with or presented to the government agency a document that contains false, incomplete or misleading information concerning any fact
- [Pennsylvania-Range of Civil Penalties-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-range-of-civil-penalties-18-pa-c-s-a-¤-4117/) - (j) Violations, penalties, etc.-- (1) If a person is found by court of competent jurisdiction, pursuant to a claim initiated by a prosecuting authority, to have violated any provision of this section, the person shall be subject to civil penalties of not more than $5,000 for the first violation, $10,000 for the second violation and
- [Pennsylvania-Unauthorized Entities-18 Pa.C.S.A. ¤ 4117](https://insurancefraud.org/statutes/pennsylvania-unauthorized-entities-18-pa-c-s-a-¤-4117/) - (a) Offense defined.--A person commits an offense if the person does any of the following: (4) Engages in unlicensed agent, broker or unauthorized insurer activity as defined by the act of May 17, 1921 (P.L.789, No.285), known as The Insurance Department Act of one thousand nine hundred and twenty-one, knowingly and with the intent to
- [Oregon-Immunity-O.R.S. ¤ 731.594; 731.737](https://insurancefraud.org/statutes/oregon-immunity-o-r-s-¤-731-594-731-737/) - Unless it is shown that the person, including an insurer, acted with actual malice, a person who discloses or provides information under ORS 731.592 has immunity from any civil liability that might otherwise be incurred or imposed with respect to the disclosure or provision of the information. A person has the same immunity with respect
- [Oregon-Licensing Board Notification-O.R.S. ¤ 731.592](https://insurancefraud.org/statutes/oregon-licensing-board-notification-o-r-s-¤-731-592/) - (1) Notwithstanding ORS 746.665, an insurer shall cooperate with any law enforcement agency or other state or federal agency that is investigating or prosecuting suspected criminal conduct involving insurance. The insurer shall provide any information requested by the agency unless the information is subject to a legal privilege that would prohibit disclosure. (2) If an
- [Oregon-Mandatory Restitution-O.R.S. ¤ 744.991](https://insurancefraud.org/statutes/oregon-mandatory-restitution-o-r-s-¤-744-991/) - (1) Violation of ORS 744.369, in addition to any applicable prescribed denial, suspension or revocation of any license or civil forfeiture, shall be punishable upon conviction as for the crime of theft under ORS 164.015 to 164.135 or the crime of forgery or related offenses under ORS 165.002 to 165.070. (2) A person convicted of
- [Oregon-Practitioner Penalites-O.R.S. ¤ 731.988](https://insurancefraud.org/statutes/oregon-practitioner-penalites-o-r-s-¤-731-988/) - (1) A person that violates any provision of the Insurance Code, any lawful rule or final order of the Director of the Department of Consumer and Business Services or any judgment that a court makes in response to the director's application, shall forfeit and pay to the General Fund of the State Treasury a civil
- [Oregon-Range of Criminal Penalties-O.R.S. ¤ 731.992](https://insurancefraud.org/statutes/oregon-range-of-criminal-penalties-o-r-s-¤-731-992/) - (1) A violation of ORS 731.260 is a Class A misdemeanor. (2) A violation of a provision of ORS 732.517 to 732.596 is a Class C felony. (3) An officer, director or employee of an insurance holding company system who willfully and knowingly makes, causes to be made, or subscribes to, a false statement, report
- [Oregon-Range of Civil Penalties-O.R.S. ¤ 731.988](https://insurancefraud.org/statutes/oregon-range-of-civil-penalties-o-r-s-¤-731-988/) - (1) A person that violates any provision of the Insurance Code, any lawful rule or final order of the Director of the Department of Consumer and Business Services or any judgment that a court makes in response to the director's application, shall forfeit and pay to the General Fund of the State Treasury a civil
- [Oregon-Rating of an Insurance Policy-O.R.S. ¤ 737.310](https://insurancefraud.org/statutes/oregon-rating-of-an-insurance-policy-o-r-s-¤-737-310/) - The following standards shall apply to the making and use of rates: (1) Rates shall not be excessive, inadequate or unfairly discriminatory. (2) As to all classes of insurance, other than workers' compensation and title insurance: (a) No rate shall be held to be excessive unless: (A) Such rate is unreasonably high for the insurance
- [Oregon-Unauthorized Entities-O.R.S. ¤ 731.362](https://insurancefraud.org/statutes/oregon-unauthorized-entities-o-r-s-¤-731-362/) - (1) A foreign or alien insurer may be authorized to transact insurance in this state when it has complied with the following requirements: (a) It shall file with the Director of the Department of Consumer and Business Services a certified copy of its charter, articles of incorporation or deed of settlement and a statement of
- [Oklahoma-Claims Fraud-21 Okl.St.Ann. ¤ 1662](https://insurancefraud.org/statutes/oklahoma-claims-fraud-21-okl-st-ann-¤-1662/) - Any person who presents or causes to be presented any false or fraudulent claim, or any proof in support of any such claim, upon any contract of insurance, for the payment of any loss, or who prepares, makes or subscribes any account, certificate, survey affidavit, proof of loss, or other book, paper or writing, with
- [Oklahoma-Fraud Bureau-74 Okl.St.Ann. ¤ 18n-1](https://insurancefraud.org/statutes/oklahoma-fraud-bureau-74-okl-st-ann-¤-18n-1/) - A. There is hereby created within the Office of the Attorney General an Insurance Fraud Unit. B. The Insurance Fraud Unit, upon inquiry or complaint or upon referral from the Insurance Department, shall determine the extent, if any, to which a violation has occurred of any statute or administrative rule of this state pertaining to
- [Oklahoma-Immunity-36 Okl.St.Ann. ¤ 363](https://insurancefraud.org/statutes/oklahoma-immunity-36-okl-st-ann-¤-363/) - A. Any insurer, employee or agent of any insurer who has reason to believe that a person or entity has engaged in or is engaging in an act or practice that violates any statute or administrative rule of this state related to insurance fraud shall immediately notify the Anti-Fraud Unit of the Insurance Department and,
- [Oklahoma-Practitioner Penalites-36 Okl.St.Ann. ¤ 6220](https://insurancefraud.org/statutes/oklahoma-practitioner-penalites-36-okl-st-ann-¤-6220/) - A. The Commissioner may censure, suspend, revoke, or refuse to issue or renew a license after hearing for any of the following causes: 1. Material misrepresentation or fraud in obtaining an adjuster's license; 2. Any cause for which original issuance of a license could have been refused; 3. Misappropriation, conversion to the personal use of
- [Oklahoma-Range of Criminal Penalties-21 Okl.St.Ann. ¤ 1662](https://insurancefraud.org/statutes/oklahoma-range-of-criminal-penalties-21-okl-st-ann-¤-1662/) - Any person who presents or causes to be presented any false or fraudulent claim, or any proof in support of any such claim, upon any contract of insurance, for the payment of any loss, or who prepares, makes or subscribes any account, certificate, survey affidavit, proof of loss, or other book, paper or writing, with
- [Oklahoma-Unauthorized Entities-36 Okl.St.Ann. ¤ 1101](https://insurancefraud.org/statutes/oklahoma-unauthorized-entities-36-okl-st-ann-¤-1101/) - A. No person in Oklahoma shall in any manner: 1. Represent or assist any nonadmitted insurer in the soliciting, procuring, placing, or maintenance of any nonadmitted insurance coverage upon or with relation to any subject of insurance resident, located, or to be performed in Oklahoma without being a surplus lines licensee or broker as defined
- [Ohio-Aiding & Abetting-R.C. ¤ 2913.47](https://insurancefraud.org/statutes/ohio-aiding-abetting-r-c-¤-2913-47/) - (B) No person, with purpose to defraud or knowing that the person is facilitating a fraud, shall do either of the following: (1) Present to, or cause to be presented to, an insurer any written or oral statement that is part of, or in support of, an application for insurance, a claim for payment pursuant
- [Ohio-Attempted Fraud-R.C. ¤ 2913.47](https://insurancefraud.org/statutes/ohio-attempted-fraud-r-c-¤-2913-47/) - (B) No person, with purpose to defraud or knowing that the person is facilitating a fraud, shall do either of the following: (1) Present to, or cause to be presented to, an insurer any written or oral statement that is part of, or in support of, an application for insurance, a claim for payment pursuant
- [Ohio-Claims Fraud-R.C. ¤ 2913.47](https://insurancefraud.org/statutes/ohio-claims-fraud-r-c-¤-2913-47/) - (B) No person, with purpose to defraud or knowing that the person is facilitating a fraud, shall do either of the following: (1) Present to, or cause to be presented to, an insurer any written or oral statement that is part of, or in support of, an application for insurance, a claim for payment pursuant
- [Ohio-Immunity-R.C. ¤ 3999.31](https://insurancefraud.org/statutes/ohio-immunity-r-c-¤-3999-31/) - (A) As used in this section: (1) "Fraudulent insurance act" means an act committed by a person who, knowingly and with intent to defraud, presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, purported insurer, broker, or any agent thereof, any written statement
- [Ohio-Insurance Fraud - Definition-R.C. ¤ 2913.47](https://insurancefraud.org/statutes/ohio-insurance-fraud-definition-r-c-¤-2913-47/) - (B) No person, with purpose to defraud or knowing that the person is facilitating a fraud, shall do either of the following: (1) Present to, or cause to be presented to, an insurer any written or oral statement that is part of, or in support of, an application for insurance, a claim for payment pursuant
- [Ohio-Licensing Board Notification-R.C. ¤ 3999.42](https://insurancefraud.org/statutes/ohio-licensing-board-notification-r-c-¤-3999-42/) - (A) If an insurer, as defined in division (A) of section 3999.36 of the Revised Code, has a reasonable belief that a person is perpetrating or facilitating an insurance fraud, as established by section 2913.47 of the Revised Code, or has done so, the insurer shall notify the department of insurance. (B) The notification required
- [Ohio-Mandatory Restitution-R.C. ¤ 3999.99](https://insurancefraud.org/statutes/ohio-mandatory-restitution-r-c-¤-3999-99/) - (I) If a person is found guilty under this section, the court may award restitution in accordance with section 2929.18 of the Revised Code.
- [Ohio-Range of Criminal Penalties-R.C. ¤ 3999.99](https://insurancefraud.org/statutes/ohio-range-of-criminal-penalties-r-c-¤-3999-99/) - (A) Whoever violates section 3999.02 of the Revised Code is guilty of a misdemeanor of the second degree. (B) Whoever violates section 3999.03, 3999.07, 3999.13, 3999.14, or 3999.15 of the Revised Code is guilty of a misdemeanor of the first degree. (C) Whoever violates section 3999.04, 3999.05, 3999.08, or 3999.09 of the Revised Code is
- [Ohio-Range of Civil Penalties-3999.99 Penalties](https://insurancefraud.org/statutes/ohio-range-of-civil-penalties-3999-99-penalties/) - (D) Whoever violates section 3999.10 or 3999.11 of the Revised Code shall be fined five hundred dollars for a first offense and shall be fined one thousand dollars for each subsequent offense. (E) Whoever violates section 3999.12 of the Revised Code shall be fined not less than ten nor more than one thousand dollars.
- [Ohio-Rating of an Insurance Policy-R.C. ¤ 3935.03](https://insurancefraud.org/statutes/ohio-rating-of-an-insurance-policy-r-c-¤-3935-03/) - Rates shall be made as follows: (A) Manual, minimum class rates, rating schedules, or rating plans shall be made and adopted, except in the case of specific inland marine rates on risks specially rated. (B) Rates shall not be excessive, inadequate, or unfairly discriminatory. (C) Consideration shall be given to: (1) Past and prospective loss
- [Ohio-Unauthorized Entities-R.C. ¤ 3905.33](https://insurancefraud.org/statutes/ohio-unauthorized-entities-r-c-¤-3905-33/) - (A) No person licensed under section 3905.30 of the Revised Code shall solicit, procure an application for, bind, issue, renew, or deliver a policy with any insurer that is not eligible to write insurance on an unauthorized basis in this state. Pursuant to the "Nonadmitted and Reinsurance Reform Act of 2010," 15 U.S.C. 8201 et
- [North Dakota-Aiding & Abetting-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-aiding-abetting-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Attempted Fraud-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-attempted-fraud-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Claims Fraud-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-claims-fraud-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Failing to Remit Premium-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-failing-to-remit-premium-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: d. Theft by deception or otherwise, or embezzlement, abstracting, purloining, or conversion of moneys, funds, premiums, credits, or other property of an insurer, reinsurer, or person engaged in the business of insurance.
- [North Dakota-Fraud Bureau-NDCC, 26.1-02.1-08](https://insurancefraud.org/statutes/north-dakota-fraud-bureau-ndcc-26-1-02-1-08/) - 1. The North Dakota insurance fraud unit is established within the insurance department. The commissioner may appoint the full-time supervisory and investigative personnel of the insurance fraud unit, who must be qualified by training and experience to perform the duties of their positions. The commissioner may also appoint clerical and other staff necessary for the
- [North Dakota-Immunity-NDCC, 26.1-02-24.2; 26.1-02.1-04](https://insurancefraud.org/statutes/north-dakota-immunity-ndcc-26-1-02-24-2-26-1-02-1-04/) - In the absence of fraud or bad faith, no person is subject to civil liability of any kind, including for libel and slander, by virtue of filing reports, without malice, or furnishing other information, without malice, required by the insurance laws of this state or required by the commissioner, and no civil cause of action
- [North Dakota-Insurance Fraud - Definition-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-insurance-fraud-definition-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Licensing Board Notification-NDCC, 26.1-02.1-06](https://insurancefraud.org/statutes/north-dakota-licensing-board-notification-ndcc-26-1-02-1-06/) - 1. A person engaged in the business of insurance having knowledge or a reasonable belief that a fraudulent insurance act is being, will be, or has been committed shall provide to the commissioner the information required by, and in a manner prescribed by, the commissioner. 2. Any other person having knowledge or a reasonable belief
- [North Dakota-Looting & diverting-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-looting-diverting-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Mandatory Restitution-NDCC, 26.1-02.1-05](https://insurancefraud.org/statutes/north-dakota-mandatory-restitution-ndcc-26-1-02-1-05/) - 3. In addition to any other punishment, a person who violates section 26. 1-02.1-02.1 must be ordered to make restitution to the insurer or to any other person for any financial loss sustained as a result of the violation of section 26.1-02.1-02.1. The court shall determine the extent and method of restitution.
- [North Dakota-Placing Bogus Coverage-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-placing-bogus-coverage-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Premium Fraud-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-premium-fraud-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Range of Criminal Penalties-NDCC, 26.1-02.1-05](https://insurancefraud.org/statutes/north-dakota-range-of-criminal-penalties-ndcc-26-1-02-1-05/) - 1. a. A violation of section 26.1-02.1-02.1 is: (1) A class A felony if the value of any property or services retained exceeds fifty thousand dollars; (2) A class B felony if the value of any property or services attempted to be obtained exceeds fifty thousand dollars; (3) A class B felony if the value
- [North Dakota-Rating of an Insurance Policy-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-rating-of-an-insurance-policy-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Underwriting Fraud-NDCC, 26.1-02.1-01](https://insurancefraud.org/statutes/north-dakota-underwriting-fraud-ndcc-26-1-02-1-01/) - 5. "Fraudulent insurance act" includes the following acts or omissions committed by a person knowingly and with intent to defraud: a. Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, insurance producer, or any agent thereof, false or misleading information as part
- [North Dakota-Unauthorized Entities-NDCC, 26.1-02-06](https://insurancefraud.org/statutes/north-dakota-unauthorized-entities-ndcc-26-1-02-06/) - Any of the following acts in this state effected by mail or otherwise by or on behalf of an unauthorized insurance company constitutes the transaction of an insurance business in this state: 1. Making or proposing to make, as an insurance company, an insurance contract. 2. Making or proposing to make, as guarantor or surety,
- [North Carolina-Aiding & Abetting-N.C.G.S.A. ¤ 58-2-161](https://insurancefraud.org/statutes/north-carolina-aiding-abetting-n-c-g-s-a-¤-58-2-161/) - (b) Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (2) Assists, abets, solicits, or conspires with another person to prepare or make any written or oral statement that is intended to be presented to an insurer or insurance claimant in connection with, in support of, or in
- [North Carolina-Claims Fraud-N.C.G.S.A. ¤ 58-2-161](https://insurancefraud.org/statutes/north-carolina-claims-fraud-n-c-g-s-a-¤-58-2-161/) - (b) Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (1) Presents or causes to be presented a written or oral statement, including computer-generated documents as part of, in support of, or in opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing
- [North Carolina-Failing to Remit Premium-N.C.G.S.A. ¤ 58-2-162](https://insurancefraud.org/statutes/north-carolina-failing-to-remit-premium-n-c-g-s-a-¤-58-2-162/) - If any insurance agent, broker, or administrator embezzles or fraudulently converts to his own use, or, with intent to use or embezzle, takes, secretes, or otherwise disposes of, or fraudulently withholds, appropriates, lends, invests, or otherwise uses or applies any money, negotiable instrument, or other consideration received by him in his performance as an agent,
- [North Carolina-Immunity-N.C.G.S.A. ¤ 58-2-160](https://insurancefraud.org/statutes/north-carolina-immunity-n-c-g-s-a-¤-58-2-160/) - (a) As used in this section, "Commissioner" includes an employee, agent, or designee of the Commissioner. A person, or an employee or agent of that person, acting without actual malice, is not subject to civil liability for libel, slander, or any other cause of action by virtue of furnishing to the Commissioner under the requirements
- [North Carolina-Insurance Fraud - Definition-N.C.G.S.A. ¤ 58-2-161](https://insurancefraud.org/statutes/north-carolina-insurance-fraud-definition-n-c-g-s-a-¤-58-2-161/) - (b) Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (1) Presents or causes to be presented a written or oral statement, including computer-generated documents as part of, in support of, or in opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing
- [North Carolina-Looting & diverting-N.C.G.S.A. ¤ 58-2-161](https://insurancefraud.org/statutes/north-carolina-looting-diverting-n-c-g-s-a-¤-58-2-161/) - (b) Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (1) Presents or causes to be presented a written or oral statement, including computer-generated documents as part of, in support of, or in opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing
- [North Carolina-Mandatory Restitution-N.C.G.S.A. ¤ 58-2-70](https://insurancefraud.org/statutes/north-carolina-mandatory-restitution-n-c-g-s-a-¤-58-2-70/) - (a) This section applies to any person who is subject to licensure or certification under this Chapter. (b) Whenever the Commissioner has reason to believe that any person has violated any of the provisions of this Chapter, and the violation subjects the license or certification of that person to suspension or revocation, the Commissioner may,
- [North Carolina-Placing Bogus Coverage-N.C.G.S.A. ¤ 58-2-161](https://insurancefraud.org/statutes/north-carolina-placing-bogus-coverage-n-c-g-s-a-¤-58-2-161/) - (b) Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (1) Presents or causes to be presented a written or oral statement, including computer-generated documents as part of, in support of, or in opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing
- [North Carolina-Practitioner Penalites-N.C.G.S.A. ¤ 58-41-55; N.C.G.S.A. ¤ 58-2-162](https://insurancefraud.org/statutes/north-carolina-practitioner-penalites-n-c-g-s-a-¤-58-41-55-n-c-g-s-a-¤-58-2-162/) - In addition to criminal penalties for acts declared unlawful by this Article, any violation of this Article subjects an insurer to revocation or suspension of its license, or monetary penalties or payment of restitution as provided in G.S. 58-2-70.; If any insurance agent, broker, or administrator embezzles or fraudulently converts to his own use, or,
- [North Carolina-Premium Fraud-n/a](https://insurancefraud.org/statutes/north-carolina-premium-fraud-n-a/) - No staute found.
- [North Carolina-Range of Civil Penalties-N.C.G.S.A. ¤ 58-2-70](https://insurancefraud.org/statutes/north-carolina-range-of-civil-penalties-n-c-g-s-a-¤-58-2-70/) - (a) This section applies to any person who is subject to licensure or certification under this Chapter. (b) Whenever the Commissioner has reason to believe that any person has violated any of the provisions of this Chapter, and the violation subjects the license or certification of that person to suspension or revocation, the Commissioner may,
- [North Carolina-Rating of an Insurance Policy-N.C.G.S.A. ¤ 58-40-25](https://insurancefraud.org/statutes/north-carolina-rating-of-an-insurance-policy-n-c-g-s-a-¤-58-40-25/) - In determining whether rates comply with the standards under G.S. 58-40-20, the following criteria shall be applied: (1) Due consideration shall be given to past and prospective loss and expense experience within this State, to catastrophe hazards, to a reasonable margin for underwriting profit and contingencies, to trends within this State, to dividends or savings
- [North Carolina-Underwriting Fraud-N.C.G.S.A. ¤ 58-2-161](https://insurancefraud.org/statutes/north-carolina-underwriting-fraud-n-c-g-s-a-¤-58-2-161/) - (b) Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (1) Presents or causes to be presented a written or oral statement, including computer-generated documents as part of, in support of, or in opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing
- [North Carolina-Unauthorized Entities-N.C.G.S.A. ¤ 58-14-15](https://insurancefraud.org/statutes/north-carolina-unauthorized-entities-n-c-g-s-a-¤-58-14-15/) - When any domestic insurer knowingly engages in the practice of soliciting, advertising or making contracts for insurance in states or jurisdictions in which it is not licensed, the Commissioner may issue an order requiring the company to cease and desist from engaging in such activities and, for the purposes of this section, the acts prohibited
- [New York-Fraud Bureau-McKinney's Executive Law ¤ 846-l (Proposed Law)](https://insurancefraud.org/statutes/new-york-fraud-bureau-mckinneys-executive-law-¤-846-l-proposed-law/) - 1. There is hereby created in the division of criminal justice services the New York motor vehicle theft and insurance fraud prevention board (hereinafter "board"), which shall consist of the following members: (a) The commissioner of criminal justice services (hereinafter "commissioner"), or his designee, who shall serve as the voting chairperson of the board; (b)
- [New York-Insurance Fraud - Definition-](https://insurancefraud.org/statutes/new-york-insurance-fraud-definition/) - A fraudulent insurance act is committed by any person who, knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, self insurer, or purported insurer, or purported self insurer, or any agent thereof: 1. any written statement as
- [New York-Placing Bogus Coverage-](https://insurancefraud.org/statutes/new-york-placing-bogus-coverage/) - A fraudulent insurance act is committed by any person who, knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, self insurer, or purported insurer, or purported self insurer, or any agent thereof: 1. any written statement as
- [New York-Range of Criminal Penalties-](https://insurancefraud.org/statutes/new-york-range-of-criminal-penalties/) - A person is guilty of insurance fraud in the fifth degree when he commits a fraudulent insurance act. Insurance fraud in the fifth degree is a class A misdemeanor. A person is guilty of insurance fraud in the fourth degree when he commits a fraudulent insurance act and thereby wrongfully takes, obtains or withholds, or
- [New York-Range of Civil Penalties-McKinney's Insurance Law ¤ 403](https://insurancefraud.org/statutes/new-york-range-of-civil-penalties-mckinneys-insurance-law-¤-403/) - (c) In addition to any criminal liability arising under the provisions of this section, the superintendent shall be empowered to levy a civil penalty not exceeding five thousand dollars and the amount of the claim for each violation upon any person, including those persons and their employees licensed pursuant to this chapter, who is found
- [New York-Rating of an Insurance Policy-](https://insurancefraud.org/statutes/new-york-rating-of-an-insurance-policy/) - Rates shall not be excessive, inadequate, unfairly discriminatory, destructive of competition or detrimental to the solvency of insurers. In determining whether rates comply with the foregoing standards, the superintendent shall include all income earned by such insurer and any insurer controlling or controlled by such insurer or under common control by or with such insurer
- [New York-Unauthorized Entities-](https://insurancefraud.org/statutes/new-york-unauthorized-entities/) - (a) In this article: (1) "Insurance contract" means any agreement or other transaction whereby one party, the "insurer", is obligated to confer benefit of pecuniary value upon another party, the "insured" or "beneficiary", dependent upon the happening of a fortuitous event in which the insured or beneficiary has, or is expected to have at the
- [New Mexico-Claims Fraud-N. M. S. A. 1978, ¤ 59A-16-23](https://insurancefraud.org/statutes/new-mexico-claims-fraud-n-m-s-a-1978-¤-59a-16-23/) - A. An agent, broker, solicitor, examining physician, applicant or other person shall not knowingly or willfully: (1) make a false or fraudulent statement or representation as to a material fact in or with reference to an application for insurance or other coverage; (2) for the purpose of obtaining money or benefit, present or cause to
- [New Mexico-Failing to Remit Premium-N. M. S. A. 1978, ¤ 59A-16-24](https://insurancefraud.org/statutes/new-mexico-failing-to-remit-premium-n-m-s-a-1978-¤-59a-16-24/) - A. No person shall wilfully collect any sum as premium or charge for insurance or other coverage, which insurance or coverage is not then provided or in due course to be provided (subject to acceptance of the risk by the insurer) by a policy issued by an insurer as authorized by the Insurance Code. B.
- [New Mexico-Immunity-N. M. S. A. 1978, ¤ 59A-16C-7](https://insurancefraud.org/statutes/new-mexico-immunity-n-m-s-a-1978-¤-59a-16c-7/) - A. The provisions of Section 59A-4-21 NMSA 1978 regarding immunity from civil liability for enforcement actions performed in good faith by the superintendent, his authorized representatives and examiners shall apply to the Insurance Fraud Act. B. Except when a person intentionally communicates false information he actually believes to be false, a person shall not be
- [New Mexico-Insurance Fraud - Definition-N. M. S. A. 1978, ¤ 59A-16-23](https://insurancefraud.org/statutes/new-mexico-insurance-fraud-definition-n-m-s-a-1978-¤-59a-16-23/) - A. An agent, broker, solicitor, examining physician, applicant or other person shall not knowingly or willfully: (1) make a false or fraudulent statement or representation as to a material fact in or with reference to an application for insurance or other coverage; (2) for the purpose of obtaining money or benefit, present or cause to
- [New Mexico-Placing Bogus Coverage-N. M. S. A. 1978, ¤ 59A-16-4](https://insurancefraud.org/statutes/new-mexico-placing-bogus-coverage-n-m-s-a-1978-¤-59a-16-4/) - No person shall make, publish, issue or circulate any estimate, illustration, circular, statement, sales presentation or comparison which: A. misrepresents the benefits, advantages, conditions or terms of any policy; B. misrepresents the premium overcharge commonly called dividends or share of the surplus to be received on any policy; C. makes any false or misleading statement
- [New Mexico-Practitioner Penalites-N. M. S. A. 1978, ¤ 59A-1-18](https://insurancefraud.org/statutes/new-mexico-practitioner-penalites-n-m-s-a-1978-¤-59a-1-18/) - A. Unless the same is defined as a felony under any other law of this state or punishment therefor classifies it otherwise, every violation of the Insurance Code is a petty misdemeanor punishable by a fine not to exceed five hundred dollars ($500). B. Where other monetary penalty is not expressly provided for, an administrative
- [New Mexico-Range of Civil Penalties-N. M. S. A. 1978, ¤ 59A-1-18](https://insurancefraud.org/statutes/new-mexico-range-of-civil-penalties-n-m-s-a-1978-¤-59a-1-18/) - A. Unless the same is defined as a felony under any other law of this state or punishment therefor classifies it otherwise, every violation of the Insurance Code is a petty misdemeanor punishable by a fine not to exceed five hundred dollars ($500). B. Where other monetary penalty is not expressly provided for, an administrative
- [New Mexico-Rating of an Insurance Policy-N. M. S. A. 1978, ¤ 59A-17-7](https://insurancefraud.org/statutes/new-mexico-rating-of-an-insurance-policy-n-m-s-a-1978-¤-59a-17-7/) - In determining whether rates comply with the rate standards, the following criteria shall be applied: A. due consideration shall be given to past and prospective loss and expense experience within and without this state, to catastrophic hazards and contingencies, to trends within and without this state, to loadings for leveling premium rates over time or
- [New Mexico-Underwriting Fraud-N. M. S. A. 1978, ¤ 59A-16-4](https://insurancefraud.org/statutes/new-mexico-underwriting-fraud-n-m-s-a-1978-¤-59a-16-4/) - No person shall make, publish, issue or circulate any estimate, illustration, circular, statement, sales presentation or comparison which: A. misrepresents the benefits, advantages, conditions or terms of any policy; B. misrepresents the premium overcharge commonly called dividends or share of the surplus to be received on any policy; C. makes any false or misleading statement
- [New Mexico-Unauthorized Entities-N. M. S. A. 1978, ¤ 59A-15-2](https://insurancefraud.org/statutes/new-mexico-unauthorized-entities-n-m-s-a-1978-¤-59a-15-2/) - A. No person shall in this state directly or indirectly act as agent for, or otherwise represent or aid on behalf of another, any unauthorized insurer in solicitation, negotiation, procurement or effectuation of insurance or renewals thereof, or forwarding of applications, or delivery of policies or contracts, or inspection of risks, or fixing of rates,
- [New Jersey-Aiding & Abetting-N.J.S.A. 17:33A-4 (Proposed Legislation)](https://insurancefraud.org/statutes/new-jersey-aiding-abetting-n-j-s-a-1733a-4-proposed-legislation/) - (6) Prepares, presents or causes to be presented to any insurer or other person, or demands or requires the issuance of, a certificate of insurance that contains any false or misleading information concerning the policy of insurance to which the certificate makes reference, or assists, abets, solicits or conspires with another to do any of
- [New Jersey-Anti-Runner Provisions-N.J.S.A. 17:33A-4 (Proposed Legislation)](https://insurancefraud.org/statutes/new-jersey-anti-runner-provisions-n-j-s-a-1733a-4-proposed-legislation/) - (6) Prepares, presents or causes to be presented to any insurer or other person, or demands or requires the issuance of, a certificate of insurance that contains any false or misleading information concerning the policy of insurance to which the certificate makes reference, or assists, abets, solicits or conspires with another to do any of
- [New Jersey-Claims Fraud-N.J.S.A. 17:33A-3](https://insurancefraud.org/statutes/new-jersey-claims-fraud-n-j-s-a-1733a-3/) - a. A person or a practitioner violates this act if he: (1) Presents or causes to be presented any written or oral statement as part of, or in support of or opposition to, a claim for payment or other benefit pursuant to an insurance policy or the "Unsatisfied Claim and Judgment Fund Law," P.L.1952, c.
- [New Jersey-Failing to Remit Premium-n/a](https://insurancefraud.org/statutes/new-jersey-failing-to-remit-premium-n-a/) - No staute found.
- [New Jersey-Fraud Bureau-N.J.S.A. 17:33A-16](https://insurancefraud.org/statutes/new-jersey-fraud-bureau-n-j-s-a-1733a-16/) - There is established in the Division of Criminal Justice in the Department of Law and Public Safety the Office of the Insurance Fraud Prosecutor. The Insurance Fraud Prosecutor shall be appointed by, and serve at the pleasure of, the Governor with the advice and consent of the Senate and be under the direction and supervision
- [New Jersey-Immunity-N.J.S.A. 17:33A-9 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-immunity-n-j-s-a-1733a-9-proposed-legislation/) - a. (1) Any person who believes that a violation of this act has been or is being made shall notify the bureau and the Office of the Insurance Fraud Prosecutor1 immediately after discovery of the alleged violation of this act and shall send to the bureau and office, on a form and in a manner
- [New Jersey-Insurance Fraud - Definition-](https://insurancefraud.org/statutes/new-jersey-insurance-fraud-definition/) - a. A person is guilty of the crime of insurance fraud if that person knowingly makes, or causes to be made, a false, fictitious, fraudulent, or misleading statement of material fact in, or omits a material fact from, or causes a material fact to be omitted from, any record, bill, claim or other document, in
- [New Jersey-Licensing Board Notification-N.J.S.A. 17:33A-9 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-licensing-board-notification-n-j-s-a-1733a-9-proposed-legislation/) - a. (1) Any person who believes that a violation of this act has been or is being made shall notify the bureau and the Office of the Insurance Fraud Prosecutor1 immediately after discovery of the alleged violation of this act and shall send to the bureau and office, on a form and in a manner
- [New Jersey-Mandatory Restitution-N.J.S.A. 17:33A-26](https://insurancefraud.org/statutes/new-jersey-mandatory-restitution-n-j-s-a-1733a-26/) - The Insurance Fraud Prosecutor shall consider the restitution of moneys to insurers and others who are defrauded as a major priority, in order that policyholders may benefit from the prosecution of those persons guilty of insurance fraud, and to that end, any assets of any person guilty of fraud shall be subject to seizure.
- [New Jersey-Placing Bogus Coverage-N.J.S.A. 17:29A-4 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-placing-bogus-coverage-n-j-s-a-1729a-4-proposed-legislation/) - (1) Presents or causes to be presented any written or oral statement as part of, or in support of or opposition to, a claim for payment or other benefit pursuant to an insurance policy or the "Unsatisfied Claim and Judgment Fund Law," P.L.1952, c. 174 (C.39:6-61 et seq.), knowing that the statement contains any false
- [New Jersey-Practitioner Penalites-N.J.S.A. 17:29A-4 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-practitioner-penalites-n-j-s-a-1729a-4-proposed-legislation/) - c. Insurance fraud constitutes a crime of the second degree if the person knowingly commits five or more acts of insurance fraud, including acts of health care claims fraud pursuant to section 2 of P.L.1997, c. 353 (C.2C:21-4.2) and if the aggregate value of property, services or other benefit wrongfully obtained or sought to be
- [New Jersey-Premium Fraud-N.J.S.A. 17:29A-4 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-premium-fraud-n-j-s-a-1729a-4-proposed-legislation/) - a. A person or a practitioner violates this act if he:(3) Conceals or knowingly fails to disclose the occurrence of an event which affects any person's initial or continued right or entitlement to (a) any insurance benefit or payment or (b) the amount of any benefit or payment to which the person is entitled;
- [New Jersey-Range of Criminal Penalties-N.J.S.A. 17:29A-4 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-range-of-criminal-penalties-n-j-s-a-1729a-4-proposed-legislation/) - c. Insurance fraud constitutes a crime of the second degree if the person knowingly commits five or more acts of insurance fraud, including acts of health care claims fraud pursuant to section 2 of P.L.1997, c. 353 (C.2C:21-4.2) and if the aggregate value of property, services or other benefit wrongfully obtained or sought to be
- [New Jersey-Range of Civil Penalties-N.J.S.A. 17:33A-5](https://insurancefraud.org/statutes/new-jersey-range-of-civil-penalties-n-j-s-a-1733a-5/) - a. Whenever the commissioner 1 determines that a person has violated any provision of P.L.1983, c. 320 (C.17:33A-1 et seq.), the commissioner may either: (1) bring a civil action in accordance with subsection b. of this section; or (2) levy a civil administrative penalty and order restitution in accordance with subsection c. of this section.
- [New Jersey-Rating of an Insurance Policy-N.J.S.A. 17:29A-4 (Proposed legislation)](https://insurancefraud.org/statutes/new-jersey-rating-of-an-insurance-policy-n-j-s-a-1729a-4-proposed-legislation/) - Every rating organization, and every insurer which makes its own rates, shall make rates that are not unreasonably high or inadequate for the safety and soundness of the insurer, and which do not unfairly discriminate between risks in this State involving essentially the same hazards and expense elements, and shall, in rate-making, and in making
- [New Jersey-Unauthorized Entities-N.J.S.A. 17:51-1](https://insurancefraud.org/statutes/new-jersey-unauthorized-entities-n-j-s-a-1751-1/) - (a) Any of the following acts in this State, by an insurer not authorized to transact business in this State: (1) the issuance or delivery of contracts of insurance to residents of this State or to corporations authorized to do business therein, (2) the solicitation of applications for such contracts, (3) the collection of premiums,
- [New Hampshire-Aiding & Abetting-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-aiding-abetting-n-h-rev-stat-¤-63820/) - III. A person is guilty as an accomplice to insurance fraud, if, with a purpose to injure, defraud or deceive any insurer, the person assists, abets, solicits or conspires with another to commit insurance fraud, as defined in paragraph II of this section.
- [New Hampshire-Anti-Runner Provisions-n/a](https://insurancefraud.org/statutes/new-hampshire-anti-runner-provisions-n-a/) - No statute found
- [New Hampshire-Claims Fraud-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-claims-fraud-n-h-rev-stat-¤-63820/) - I. A person is guilty of insurance fraud, if, such person knowingly and with intent to injure, defraud or deceive any insurer, conceals or causes to be concealed from any insurer a material statement, or presents or causes to be presented to any insurer, or prepares with knowledge or belief that it will be so
- [New Hampshire-Fraud Bureau-N.H. Rev. Stat. ¤ 417:23](https://insurancefraud.org/statutes/new-hampshire-fraud-bureau-n-h-rev-stat-¤-41723/) - There is established in the department of insurance the insurance fraud investigation unit. The unit shall assist the commissioner, or any law enforcement agency, in investigating insurance fraud or other insurance-related criminal activity and in developing and implementing programs to prevent insurance fraud and abuse. The unit shall have the power to subpoena witnesses and
- [New Hampshire-Immunity-N.H. Rev. Stat. ¤ 400-A:36-b](https://insurancefraud.org/statutes/new-hampshire-immunity-n-h-rev-stat-¤-400-a36-b/) - I. In the absence of actual malice, members of the National Association of Insurance Commissioners, their duly authorized committees, subcommittees, and task forces, their delegates, employees, and all others charged with the responsibility of collecting, reviewing, analyzing, and disseminating the information developed from the filing of the annual statement convention blanks shall be acting as
- [New Hampshire-Insurance Fraud - Definition-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-insurance-fraud-definition-n-h-rev-stat-¤-63820/) - I. In this section: (a) "Bidding" includes a bid made as any contractor, general contractor, or subcontractor. (b) "Financial interest" means any direct or indirect interest in the entity, whether as an owner, partner, officer, manager, employee, agent, consultant, advisor, or representative, but does not include an employee who does not participate in management of
- [New Hampshire-Licensing Board Notification-N.H. Rev. Stat. ¤ 417:28](https://insurancefraud.org/statutes/new-hampshire-licensing-board-notification-n-h-rev-stat-¤-41728/) - Any person or entity regulated under title XXXVII which has reason to believe that an insurance fraud or insurance-related criminal activity has been committed shall make a report to the unit within 60 days or within a shorter period under such circumstances as the commissioner may prescribe by rule. No waiver of any such regulated
- [New Hampshire-Mandatory Restitution-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-mandatory-restitution-n-h-rev-stat-¤-63820/) - VI. In addition to any other penalty authorized by law, any person convicted of violating subparagraphs II(a), (b), or (d) relative to a workers' compensation insurance policy shall, as a condition of his or her sentence, be prohibited from participating in any public works projects for a period of no less than one year and
- [New Hampshire-Placing Bogus Coverage-n/a](https://insurancefraud.org/statutes/new-hampshire-placing-bogus-coverage-n-a/) - No statute found
- [New Hampshire-Premium Fraud-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-premium-fraud-n-h-rev-stat-¤-63820/) - II. A person is guilty of insurance fraud, if, such person knowingly and with intent to injure, defraud or deceive any insurer, conceals or causes to be concealed from any insurer a material statement, or presents or causes to be presented to any insurer, or prepares with knowledge or belief that it will be so
- [New Hampshire-Range of Criminal Penalties-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-range-of-criminal-penalties-n-h-rev-stat-¤-63820/) - IV. (a) Insurance fraud is: (1) A class A felony if the value of the fraudulent portion of the claim for payment or other benefit pursuant to an insurance policy is more than $1,500. (2) A class B felony if the value of the fraudulent portion of the claim for payment or other benefit pursuant
- [New Hampshire-Range of Civil Penalties-N.H. Rev. Stat. ¤ 638:20](https://insurancefraud.org/statutes/new-hampshire-range-of-civil-penalties-n-h-rev-stat-¤-63820/) - IV. (a) Insurance fraud is: (1) A class A felony if the value of the fraudulent portion of the claim for payment or other benefit pursuant to an insurance policy is more than $1,500. (2) A class B felony if the value of the fraudulent portion of the claim for payment or other benefit pursuant
- [New Hampshire-Rating of an Insurance Policy-N.H. Rev. Stat. ¤ 412:15](https://insurancefraud.org/statutes/new-hampshire-rating-of-an-insurance-policy-n-h-rev-stat-¤-41215/) - Rates shall be made in accordance with the following provisions: I. Rates shall not be excessive, inadequate, or unfairly discriminatory. (a) A rate in a competitive market shall not be disapproved for being excessive. (b) A rate in a noncompetitive market is excessive if it is likely to produce a profit that is unreasonably high
- [New Hampshire-Unauthorized Entities-N.H. Rev. Stat. ¤ 406-B:2](https://insurancefraud.org/statutes/new-hampshire-unauthorized-entities-n-h-rev-stat-¤-406-b2/) - Any of the following acts in this state effected by mail or otherwise by or on behalf of an unlicensed insurer is deemed to constitute the transaction or doing of an insurance business in this state. The venue of an act committed by mail is at the point where the matter transmitted by mail is
- [Nevada-Aiding & Abetting-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-aiding-abetting-n-r-s-686a-2815/) - 1. "Insurance fraud" means knowingly and willfully: (c) Assisting, abetting, soliciting or conspiring with another person to present or cause to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who assists, abets, solicits or conspires knows that the statement conceals or omits facts,
- [Nevada-Anti-Runner Provisions-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-anti-runner-provisions-n-r-s-686a-2815/) - 1. "Insurance fraud" means knowingly and willfully: (g) Employing a person to procure clients, patients or other persons who obtain services or benefits under a policy of insurance for the purpose of engaging in any act or omission specified in this section, except that such insurance fraud does not include contact or communication by an
- [Nevada-Claims Fraud-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-claims-fraud-n-r-s-686a-2815/) - 1. "Insurance fraud" means knowingly and willfully: (b) Presenting or causing to be presented any statement as a part of, or in support of, a claim for payment or other benefits under a policy of insurance, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits
- [Nevada-Fraud Bureau-N.R.S. 228.412](https://insurancefraud.org/statutes/nevada-fraud-bureau-n-r-s-228-412/) - 2. The Attorney General shall establish within his or her office a Fraud Control Unit for Insurance. The Fraud Control Unit must consist of such persons as are necessary to carry out the duties set forth in this section, NRS 679B.600 to 679B.700, inclusive, and NRS 686A.281 to 686A.292, inclusive, including, without limitation, attorneys and
- [Nevada-Immunity-N.R.S."679B.670](https://insurancefraud.org/statutes/nevada-immunity-n-r-s-679b-670/) - Liability for disclosure of information on fraudulent claim or suspicious fire.""Any person, governmental entity, insurer, employee or representative of an insurer, official of an investigative or law enforcement agency, employee of the Division, the Commissioner, the Attorney General or a member of the Fraud Control Unit is not subject to a criminal penalty or subject
- [Nevada-Insurance Fraud - Definition-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-insurance-fraud-definition-n-r-s-686a-2815/) - 1. "Insurance fraud" means knowingly and willfully: (a) Presenting or causing to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits facts, or contains false or misleading information
- [Nevada-Looting & diverting-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-looting-diverting-n-r-s-686a-2815/) - 1. "Insurance fraud" means knowingly and willfully: (f) Accepting any proceeds or other benefits under a policy of insurance, if the person who accepts the proceeds or other benefits knows that the proceeds or other benefits are derived from any act or omission specified in this section. (g) Employing a person to procure clients, patients
- [Nevada-Mandatory Restitution-N.R.S. 686A.292](https://insurancefraud.org/statutes/nevada-mandatory-restitution-n-r-s-686a-292/) - 1. A court may, in addition to imposing the penalties set forth in NRS 193.130, order a person who is convicted of, or who pleads guilty, guilty but mentally ill or nolo contendere to, insurance fraud to pay: 3. An insurer or other organization, or any other person, subject to the jurisdiction of the Commissioner
- [Nevada-Placing Bogus Coverage-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-placing-bogus-coverage-n-r-s-686a-2815/) - 1. "Insurance fraud" means knowingly and willfully: (a) Presenting or causing to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits facts, or contains false or misleading information
- [Nevada-Practitioner Penalites-N.R.S. 686A.295](https://insurancefraud.org/statutes/nevada-practitioner-penalites-n-r-s-686a-295/) - If a person who is licensed or registered under the laws of the State of Nevada to engage in a business or profession is convicted of, or pleads guilty or guilty but mentally ill to, engaging in an act of insurance fraud, the Commissioner and the Attorney General shall forward to each agency by which
- [Nevada-Range of Criminal Penalties-N.R.S. 686A.291; N.R.S. 193.130](https://insurancefraud.org/statutes/nevada-range-of-criminal-penalties-n-r-s-686a-291-n-r-s-193-130/) - A person who commits insurance fraud is guilty of a category D felony and shall be punished as provided in NRS 193.130.***1. Except when a person is convicted of a category A felony, and except as otherwise provided by specific statute, a person convicted of a felony shall be sentenced to a minimum term and
- [Nevada-Range of Civil Penalties-N.R.S. 686A.292](https://insurancefraud.org/statutes/nevada-range-of-civil-penalties-n-r-s-686a-292/) - 1. A court may, in addition to imposing the penalties set forth in NRS 193.130, order a person who is convicted of, or who pleads guilty, guilty but mentally ill or nolo contendere to, insurance fraud to pay: (a) Court costs; and (b) The cost of the investigation and prosecution of the insurance fraud for
- [Nevada-Rating of an Insurance Policy-n/a](https://insurancefraud.org/statutes/nevada-rating-of-an-insurance-policy-n-a/) - No statute found
- [Nevada-Underwriting Fraud-N.R.S. 686A.2815](https://insurancefraud.org/statutes/nevada-underwriting-fraud-n-r-s-686a-2815/) - (e) As a practitioner, an insurer or any agent thereof, acting to assist, conspire with or urge another person to commit any act or omission specified in this section through deceit, misrepresentation or other fraudulent means. (f) Accepting any proceeds or other benefits under a policy of insurance, if the person who accepts the proceeds
- [Nevada-Unauthorized Entities-N.R.S. 685B.030](https://insurancefraud.org/statutes/nevada-unauthorized-entities-n-r-s-685b-030/) - 1. As used in this section unless otherwise indicated, "insurer" includes: (a) All corporations, associations, partnerships and natural persons engaged as principals in the business of insurance, including a fraternal benefit society, a nonprofit corporation offering dental, hospital and medical services, a health maintenance organization, a prepaid limited health service organization, an organization for dental
- [Nebraska-Aiding & Abetting-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-aiding-abetting-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she:(2) Assists, abets, solicits, or conspires with another to prepare or make any statement that is intended to be presented to or by an insurer or person in connection with or in support of any claim
- [Nebraska-Claims Fraud-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-claims-fraud-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she: (1) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, or any agent of an
- [Nebraska-Failing to Remit Premium-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-failing-to-remit-premium-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she: (6) Willfully embezzles, abstracts, purloins, misappropriates, or converts money, funds, premiums, credits, or other property of an insurer or person engaged in the business of insurance;
- [Nebraska-False Claims Act-n/a](https://insurancefraud.org/statutes/nebraska-false-claims-act-n-a/) - No statute found
- [Nebraska-Fraud Bureau-Neb.Rev.St. ¤ 44-6606](https://insurancefraud.org/statutes/nebraska-fraud-bureau-neb-rev-st-¤-44-6606/) - (1) In order to investigate activities involving insurance fraud, the director shall appoint a sufficient staff to be known as the Insurance Fraud Prevention Division. (2)(a) As specified by the director, division investigators who are certified law enforcement officers of the State of Nebraska shall be vested with the authority and power of a peace
- [Nebraska-Immunity-Neb.Rev.St. ¤ 44-6605](https://insurancefraud.org/statutes/nebraska-immunity-neb-rev-st-¤-44-6605/) - (1) Any person or entity, including the department, an insurer, or a person employed by or authorized by an insurer whose activities include the investigation of or reporting of suspected insurance fraud, acting without malice, fraudulent intent, or bad faith shall be immune from civil liability for furnishing any information relating to suspected fraudulent insurance
- [Nebraska-Insurance Fraud - Definition-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-insurance-fraud-definition-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she: (1) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, or any agent of an
- [Nebraska-Looting & diverting-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-looting-diverting-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she: (5) Receives money for the purpose of purchasing insurance and converts the money to the person's own benefit; (6) Willfully embezzles, abstracts, purloins, misappropriates, or converts money, funds, premiums, credits, or other property of an
- [Nebraska-Mandatory Restitution-n/a](https://insurancefraud.org/statutes/nebraska-mandatory-restitution-n-a/) - No statute found
- [Nebraska-Placing Bogus Coverage-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-placing-bogus-coverage-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she: (1) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, or any agent of an
- [Nebraska-Premium Fraud-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-premium-fraud-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she: (6) Willfully embezzles, abstracts, purloins, misappropriates, or converts money, funds, premiums, credits, or other property of an insurer or person engaged in the business of insurance;
- [Nebraska-Range of Criminal Penalties-Neb.Rev.St. ¤ 28-631](https://insurancefraud.org/statutes/nebraska-range-of-criminal-penalties-neb-rev-st-¤-28-631/) - (2)(a) A violation of subdivisions (1)(a) through (f) of this section is a Class III felony when the amount involved is five thousand dollars or more. (b) A violation of subdivisions (1)(a) through (f) of this section is a Class IV felony when the amount involved is one thousand five hundred dollars or more but
- [Nebraska-Range of Civil Penalties-Neb.Rev.St. ¤ 44-6607](https://insurancefraud.org/statutes/nebraska-range-of-civil-penalties-neb-rev-st-¤-44-6607/) - (1) A person or entity who is found by a court of competent jurisdiction, pursuant to an action initiated by the Director of Insurance, to have committed a fraudulent insurance act set forth in section 44-6604 is subject to a civil penalty not to exceed five thousand dollars for the first violation, ten thousand dollars
- [Nebraska-Rating of an Insurance Policy-Neb.Rev.St. ¤ 44-7510](https://insurancefraud.org/statutes/nebraska-rating-of-an-insurance-policy-neb-rev-st-¤-44-7510/) - (1) Rating systems shall not produce premiums that are excessive. A premium level is excessive if it is likely to produce a profit that is unreasonably high for the insurance provided or if expenses are unreasonably high in relation to services rendered. In the evaluation of a premium level, due consideration shall be given to
- [Nebraska-Underwriting Fraud-Neb.Rev.St. ¤ 44-6604](https://insurancefraud.org/statutes/nebraska-underwriting-fraud-neb-rev-st-¤-44-6604/) - For purposes of the Insurance Fraud Act, a person or entity commits a fraudulent insurance act if he or she:(4) Knowingly and willfully transacts any contract, agreement, or instrument which violates this section; (5) Receives money for the purpose of purchasing insurance and converts the money to the person's own benefit; (6) Willfully embezzles, abstracts,
- [Nebraska-Unauthorized Entities-Neb.Rev.St. ¤ 44-2002](https://insurancefraud.org/statutes/nebraska-unauthorized-entities-neb-rev-st-¤-44-2002/) - (1) It shall be unlawful for any insurer to transact insurance business in this state, as set forth in subsection (2) of this section, without a certificate of authority from the director. This section shall not apply to: (a) The lawful transaction of surplus lines insurance; (b) The lawful transaction of reinsurance by insurers; (c)
- [Montana-Aiding & Abetting-MCA 33-1-1202](https://insurancefraud.org/statutes/montana-aiding-abetting-mca-33-1-1202/) - (2) assists, abets, solicits, or conspires with another to prepare or make any written or oral statement containing false, incomplete, or misleading information concerning any fact that is intended to be presented to any insurer or purported insurer or in connection with, material to, or in support of any claim for payment or other benefit
- [Montana-Anti-Runner Provisions-n/a](https://insurancefraud.org/statutes/montana-anti-runner-provisions-n-a/)
- [Montana-Claims Fraud-MCA 33-1-1202](https://insurancefraud.org/statutes/montana-claims-fraud-mca-33-1-1202/) - A person commits the act of administrative or civil insurance fraud when the person: (1) for the purpose of obtaining any money or benefit, presents or causes to be presented to any insurer, purported insurer, producer, or administrator, as defined in 33-17-102, any written or oral statement, including computer-generated documents, containing false, incomplete, or misleading
- [Montana-Failing to Remit Premium-MCA 33-1-1202](https://insurancefraud.org/statutes/montana-failing-to-remit-premium-mca-33-1-1202/) - A person commits the act of administrative or civil insurance fraud when the person: (4) accepts premium money knowing that coverage will not be provided;
- [Montana-Fraud Bureau-MCA 33-1-1203](https://insurancefraud.org/statutes/montana-fraud-bureau-mca-33-1-1203/) - (1) The commissioner may: (a) initiate independent inquiries and conduct independent investigations when the commissioner has reason to believe that insurance fraud may be, has been, or is currently being committed; (b) respond to notice or complaints generated by federal, state, county, and local law enforcement officers, other entities with law enforcement responsibilities, or governmental
- [Montana-Immunity-MCA 33-1-1210](https://insurancefraud.org/statutes/montana-immunity-mca-33-1-1210/) - (1) In the absence of malice, an insurer, an officer, employee, or producer of the insurer, an independent adjuster, an administrator, a consultant, or any private person is not subject to civil liability for filing reports, providing information, or otherwise cooperating with an investigation or examination of insurance fraud conducted by the commissioner. (2) A
- [Montana-Insurance Fraud - Definition-MCA 33-1-1202; MCA 33-1-1504](https://insurancefraud.org/statutes/montana-insurance-fraud-definition-mca-33-1-1202-mca-33-1-1504/) - A person commits the act of administrative or civil insurance fraud when the person: (1) for the purpose of obtaining any money or benefit, presents or causes to be presented to any insurer, purported insurer, producer, or administrator, as defined in 33-17-102, any written or oral statement, including computer-generated documents, containing false, incomplete, or misleading
- [Montana-Licensing Board Notification-MCA 33-1-1205](https://insurancefraud.org/statutes/montana-licensing-board-notification-mca-33-1-1205/) - (1) Each insurer, independent adjuster, independent administrator, independent consultant, and independent producer shall cooperate fully with the commissioner with respect to the provisions of this part. (2) Except as provided in subsection (4), an insurer, an officer, or an employee of the insurer, an independent adjuster, an independent administrator, an independent consultant, or an independent
- [Montana-Mandatory Restitution-MCA 33-1-1211](https://insurancefraud.org/statutes/montana-mandatory-restitution-mca-33-1-1211/) - (1) If, after a hearing conducted under 33-1-701, the commissioner determines that a person has committed administrative or civil insurance fraud, the commissioner may: (a) impose any penalty provided for in 33-1-317; or (b) require the person to pay the costs of the proceeding. (2) In addition to any other penalties, the commissioner shall require
- [Montana-Practitioner Penalites-MCA 33-1-317](https://insurancefraud.org/statutes/montana-practitioner-penalites-mca-33-1-317/) - The commissioner may, after having conducted a hearing pursuant to 33-1-701, impose a fine not to exceed the sum of $25,000 upon a person found to have violated a provision of this code or regulation promulgated by the commissioner, except that the fine imposed upon insurance producers or adjusters may not exceed $5,000 per violation.
- [Montana-Premium Fraud-MCA 33-1-1202](https://insurancefraud.org/statutes/montana-premium-fraud-mca-33-1-1202/) - A person commits the act of administrative or civil insurance fraud when the person: (4) accepts premium money knowing that coverage will not be provided;
- [Montana-Range of Criminal Penalties-MCA 33-1-1504](https://insurancefraud.org/statutes/montana-range-of-criminal-penalties-mca-33-1-1504/) - (2)(a) A person convicted of criminal insurance fraud involving a benefit or benefits with a value not exceeding $1,500 shall be fined not more than $1,500 or be imprisoned in the county detention center for not more than 6 months, or both. (b) A person convicted of the offense of insurance fraud involving a benefit
- [Montana-Range of Civil Penalties-MCA 33-1-1211; MCA 33-1-317](https://insurancefraud.org/statutes/montana-range-of-civil-penalties-mca-33-1-1211-mca-33-1-317/) - (1) If, after a hearing conducted under 33-1-701, the commissioner determines that a person has committed administrative or civil insurance fraud, the commissioner may: (a) impose any penalty provided for in 33-1-317; or (b) require the person to pay the costs of the proceeding. (2) In addition to any other penalties, the commissioner shall require
- [Montana-Rating of an Insurance Policy-MCA 33-16-201](https://insurancefraud.org/statutes/montana-rating-of-an-insurance-policy-mca-33-16-201/) - The following standards apply to the making and use of rates pertaining to all classes of insurance to which the provisions of this chapter are applicable: (1)(a) Rates may not be excessive or inadequate, and they may not be unfairly discriminatory. (b) A rate may not be held to be excessive unless the rate is
- [Montana-Underwriting Fraud-MCA 33-1-1202](https://insurancefraud.org/statutes/montana-underwriting-fraud-mca-33-1-1202/) - A person commits the act of administrative or civil insurance fraud when the person: (4) accepts premium money knowing that coverage will not be provided; (5) as a health care provider, submits a false or altered bill or report of physical condition to an insurer; (6) offers or accepts a direct or indirect inducement to
- [Missouri-Claims Fraud-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-claims-fraud-v-a-m-s-375-991/) - 2. For the purposes of sections 375.991 to 375.994, a person commits a "fraudulent insurance act" if such person knowingly presents, causes to be presented, or prepares with knowledge or belief that it will be presented, to or by an insurer, purported insurer, broker, or any agent thereof, any oral or written statement including computer
- [Missouri-Immunity-V.A.M.S. 375.993](https://insurancefraud.org/statutes/missouri-immunity-v-a-m-s-375-993/) - 1. The department's papers, documents, reports, or evidence relative to the subject of an investigation under this section shall not be subject to public inspection for so long as the department deems reasonably necessary to complete the investigation and any subsequent legal action. Further, such papers, documents, reports, or evidence relative to the subject of
- [Missouri-Insurance Fraud - Definition-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-insurance-fraud-definition-v-a-m-s-375-991/) - 1. As used in sections 375.991 to 375.994, the term "statement" means any communication, notice statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of damages, bills for services, diagnosis, prescription, hospital or doctor records, x-rays, test results or other evidence of loss, injury or expense. 2. For the purposes of
- [Missouri-Mandatory Restitution-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-mandatory-restitution-v-a-m-s-375-991/) - 7. Any person who pleads guilty or is found guilty of a fraudulent insurance act shall be ordered by the court to make restitution to any person or insurer for any financial loss sustained as a result of such violation. The court shall determine the extent and method of restitution.
- [Missouri-Placing Bogus Coverage-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-placing-bogus-coverage-v-a-m-s-375-991/) - 2. For the purposes of sections 375.991 to 375.994, a person commits a "fraudulent insurance act" if such person knowingly presents, causes to be presented, or prepares with knowledge or belief that it will be presented, to or by an insurer, purported insurer, broker, or any agent thereof, any oral or written statement including computer
- [Missouri-Practitioner Penalites-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-practitioner-penalites-v-a-m-s-375-991/) - 6. A fraudulent insurance act for a first offense is a class E felony. Any person who is found guilty of a fraudulent insurance act who has previously been found guilty of a fraudulent insurance act shall be guilty of a class D felony. 7. Any person who pleads guilty or is found guilty of
- [Missouri-Premium Fraud-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-premium-fraud-v-a-m-s-375-991/) - 2. For the purposes of sections 375.991 to 375.994, a person commits a "fraudulent insurance act" if such person knowingly presents, causes to be presented, or prepares with knowledge or belief that it will be presented, to or by an insurer, purported insurer, broker, or any agent thereof, any oral or written statement including computer
- [Missouri-Range of Criminal Penalties-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-range-of-criminal-penalties-v-a-m-s-375-991/) - 6. A fraudulent insurance act for a first offense is a class E felony. Any person who is found guilty of a fraudulent insurance act who has previously been found guilty of a fraudulent insurance act shall be guilty of a class D felony.
- [Missouri-Range of Civil Penalties-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-range-of-civil-penalties-v-a-m-s-375-991/) - 7. Any person who pleads guilty or is found guilty of a fraudulent insurance act shall be ordered by the court to make restitution to any person or insurer for any financial loss sustained as a result of such violation. The court shall determine the extent and method of restitution.
- [Missouri-Underwriting Fraud-V.A.M.S. 375.991](https://insurancefraud.org/statutes/missouri-underwriting-fraud-v-a-m-s-375-991/) - 2. For the purposes of sections 375.991 to 375.994, a person commits a "fraudulent insurance act" if such person knowingly presents, causes to be presented, or prepares with knowledge or belief that it will be presented, to or by an insurer, purported insurer, broker, or any agent thereof, any oral or written statement including computer
- [Missouri-Unauthorized Entities-V.A.M.S. 375.310](https://insurancefraud.org/statutes/missouri-unauthorized-entities-v-a-m-s-375-310/) - 1. It is unlawful for any person, association of individuals, or any corporation to transact in this state any insurance business unless the person, association, or corporation is duly authorized by the director under a certificate of authority or appropriate licensure, or is an insurance company exempt from certification under section 375.786. 2. If the
- [Mississippi-Aiding & Abetting-Miss. Code Ann. ¤ 7-5-303 (Proposed Legislation)](https://insurancefraud.org/statutes/mississippi-aiding-abetting-miss-code-ann-¤-7-5-303-proposed-legislation/) - (2) A person or entity shall not, with the intent to appropriate to himself or to another any benefit, knowingly execute, collude or conspire to execute or attempt to execute a scheme or artifice: (a) To defraud any insurance plan in connection with the delivery of, or payment for, insurance benefits, items, services or claims;
- [Mississippi-Anti-Runner Provisions-n/a](https://insurancefraud.org/statutes/mississippi-anti-runner-provisions-n-a/) - No statute found
- [Mississippi-Attempted Fraud-n/a](https://insurancefraud.org/statutes/mississippi-attempted-fraud-n-a/) - No staute found.
- [Mississippi-Claims Fraud-Miss. Code Ann. ¤ 7-5-303 (Proposed Legislation)](https://insurancefraud.org/statutes/mississippi-claims-fraud-miss-code-ann-¤-7-5-303-proposed-legislation/) - (2) A person or entity shall not, with the intent to appropriate to himself or to another any benefit, knowingly execute, collude or conspire to execute or attempt to execute a scheme or artifice: (a) To defraud any insurance plan in connection with the delivery of, or payment for, insurance benefits, items, services or claims;
- [Mississippi-Fraud Bureau-Miss. Code Ann. ¤ 7-5-301](https://insurancefraud.org/statutes/mississippi-fraud-bureau-miss-code-ann-¤-7-5-301/) - There is created within the Office of the Attorney General an Insurance Integrity Enforcement Bureau. The duty of the bureau is to investigate and prosecute claims of insurance abuses and crimes involving insurance. The Attorney General may employ the necessary personnel to carry out the provisions of Sections 7-5-301 through 7-5-311.
- [Mississippi-Insurance Fraud - Definition-Miss. Code Ann. ¤ 7-5-303 (Proposed Legislation)](https://insurancefraud.org/statutes/mississippi-insurance-fraud-definition-miss-code-ann-¤-7-5-303-proposed-legislation/) - (2) A person or entity shall not, with the intent to appropriate to himself or to another any benefit, knowingly execute, collude or conspire to execute or attempt to execute a scheme or artifice: (a) To defraud any insurance plan in connection with the delivery of, or payment for, insurance benefits, items, services or claims;
- [Mississippi-Mandatory Restitution-n/a](https://insurancefraud.org/statutes/mississippi-mandatory-restitution-n-a/) - No statute found
- [Mississippi-Placing Bogus Coverage-Miss. Code Ann. ¤ 7-5-303 (Proposed Legislation)](https://insurancefraud.org/statutes/mississippi-placing-bogus-coverage-miss-code-ann-¤-7-5-303-proposed-legislation/) - (2) A person or entity shall not, with the intent to appropriate to himself or to another any benefit, knowingly execute, collude or conspire to execute or attempt to execute a scheme or artifice: (a) To defraud any insurance plan in connection with the delivery of, or payment for, insurance benefits, items, services or claims;
- [Mississippi-Practitioner Penalites-Miss. Code Ann. ¤ 7-5-309](https://insurancefraud.org/statutes/mississippi-practitioner-penalites-miss-code-ann-¤-7-5-309/) - (1) A person who violates any provision of Section 7-5-303 shall be guilty of a felony and, upon conviction thereof, shall be punished by imprisonment for not more than three (3) years, or by a fine of not more than Five Thousand Dollars ($5,000.00) or double the value of the fraud, whichever is greater, or
- [Mississippi-Range of Criminal Penalties-Miss. Code Ann. ¤ 7-5-309](https://insurancefraud.org/statutes/mississippi-range-of-criminal-penalties-miss-code-ann-¤-7-5-309/) - (1) A person who violates any provision of Section 7-5-303 shall be guilty of a felony and, upon conviction thereof, shall be punished by imprisonment for not more than three (3) years, or by a fine of not more than Five Thousand Dollars ($5,000.00) or double the value of the fraud, whichever is greater, or
- [Mississippi-Range of Civil Penalties-Miss. Code Ann. ¤ 7-5-309](https://insurancefraud.org/statutes/mississippi-range-of-civil-penalties-miss-code-ann-¤-7-5-309/) - (1) A person who violates any provision of Section 7-5-303 shall be guilty of a felony and, upon conviction thereof, shall be punished by imprisonment for not more than three (3) years, or by a fine of not more than Five Thousand Dollars ($5,000.00) or double the value of the fraud, whichever is greater, or
- [Mississippi-Rating of an Insurance Policy-Miss. Code Ann. ¤ 83-2-3 (Proposed Legislation)](https://insurancefraud.org/statutes/mississippi-rating-of-an-insurance-policy-miss-code-ann-¤-83-2-3-proposed-legislation/) - (1) Rates shall comply with the following standards: (a) Rates shall not be excessive, inadequate or unfairly discriminatory. (b) A rate is excessive if it is likely to produce a profit that is unreasonably high for the insurance provided or if the expense provision included therein is unreasonably high in relation to the services rendered.
- [Mississippi-Underwriting Fraud-Miss. Code Ann. ¤ 7-5-303 (Proposed Legislation)](https://insurancefraud.org/statutes/mississippi-underwriting-fraud-miss-code-ann-¤-7-5-303-proposed-legislation/) - (2) A person or entity shall not, with the intent to appropriate to himself or to another any benefit, knowingly execute, collude or conspire to execute or attempt to execute a scheme or artifice: (a) To defraud any insurance plan in connection with the delivery of, or payment for, insurance benefits, items, services or claims;
- [Minnesota-Anti-Runner Provisions-M.S.A. ¤ 609.612](https://insurancefraud.org/statutes/minnesota-anti-runner-provisions-m-s-a-¤-609-612/) - Subdivision 1. Definitions. (a) As used in this section, the following terms have the meanings given. (b) "Public media" means telephone directories, professional directories, newspapers and other periodicals, radio and television, billboards, and mailed or electronically transmitted written communications that do not involve in-person contact with a specific prospective patient or client. (c) "Runner," "capper,"
- [Minnesota-Claims Fraud-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-claims-fraud-m-s-a-¤-609-611/) - (a) Presents, causes to be presented, or prepares with knowledge or reason to believe that it will be presented, by or on behalf of an insured, claimant, or applicant to an insurer, insurance professional, or premium finance company in connection with an insurance transaction or premium finance transaction, any information that contains a false representation
- [Minnesota-Fraud Bureau-M.S.A. ¤ 45.0135 (Proposed Legislation)](https://insurancefraud.org/statutes/minnesota-fraud-bureau-m-s-a-¤-45-0135-proposed-legislation/) - Subd. 2a. Authorization. The commissioner may appoint peace officers, as defined in section 626.84, subdivision 1, paragraph (c), and establish a law enforcement agency, as defined in section 626.84, subdivision 1, paragraph (f), known as the Commerce Fraud Bureau, to conduct investigations, and to make arrests under sections 629.30 and 629.34. The jurisdiction of the
- [Minnesota-Immunity-M.S.A. ¤ 60A.952](https://insurancefraud.org/statutes/minnesota-immunity-m-s-a-¤-60a-952/) - Subd. 3. Immunity from liability. If insurers, insurance support organizations as defined in section 72A.491, subdivision 12, agents acting on the insurers' behalf, or authorized persons release information in good faith under this section, whether orally or in writing, they are immune from any liability, civil or criminal, for the release or reporting of the
- [Minnesota-Insurance Fraud - Definition-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-insurance-fraud-definition-m-s-a-¤-609-611/) - Subdivision 1. Insurance fraud prohibited. Whoever with the intent to defraud for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to commit any of the following acts, is guilty of insurance fraud and may be sentenced as provided in subdivision 3: (a) Presents, causes
- [Minnesota-Licensing Board Notification-M.S.A. ¤ 60A.952](https://insurancefraud.org/statutes/minnesota-licensing-board-notification-m-s-a-¤-60a-952/) - Subdivision 1. Request. After receiving a written request from an authorized person stating that the authorized person has reason to believe that a crime or civil fraud has been committed in connection with an insurance claim, insurance transaction, payment, or application, an insurer must release to the authorized person all relevant information in the insurer's
- [Minnesota-Looting & diverting-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-looting-diverting-m-s-a-¤-609-611/) - Subdivision 1. Insurance fraud prohibited. Whoever with the intent to defraud for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to commit any of the following acts, is guilty of insurance fraud and may be sentenced as provided in subdivision 3: (e) Diverts, misappropriates,
- [Minnesota-Mandatory Restitution-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-mandatory-restitution-m-s-a-¤-609-611/) - Subd. 3. Sentence. Whoever violates this provision may be sentenced as provided in section 609.52, subdivision 3, based on the greater of (i) the value of property, services, or other benefit wrongfully obtained or attempted to obtain, or (ii) the aggregate economic loss suffered by any person as a result of the violation. A person
- [Minnesota-Placing Bogus Coverage-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-placing-bogus-coverage-m-s-a-¤-609-611/) - Subdivision 1. Insurance fraud prohibited. Whoever with the intent to defraud for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to commit any of the following acts, is guilty of insurance fraud and may be sentenced as provided in subdivision 3: (a) Presents, causes
- [Minnesota-Premium Fraud-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-premium-fraud-m-s-a-¤-609-611/) - Subdivision 1. Insurance fraud prohibited. Whoever with the intent to defraud for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to commit any of the following acts, is guilty of insurance fraud and may be sentenced as provided in subdivision 3: (a) Presents, causes
- [Minnesota-Range of Criminal Penalties-M.S.A. ¤ 609.52 (Proposed Legislation)](https://insurancefraud.org/statutes/minnesota-range-of-criminal-penalties-m-s-a-¤-609-52-proposed-legislation/) - Subd. 3. Sentence. Whoever commits theft may be sentenced as follows: (1) to imprisonment for not more than 20 years or to payment of a fine of not more than $100,000, or both, if the property is a firearm, or the value of the property or services stolen is more than $35,000 and the conviction
- [Minnesota-Range of Civil Penalties-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-range-of-civil-penalties-m-s-a-¤-609-611/) - Subd. 3. Sentence. Whoever violates this provision may be sentenced as provided in section 609.52, subdivision 3, based on the greater of (i) the value of property, services, or other benefit wrongfully obtained or attempted to obtain, or (ii) the aggregate economic loss suffered by any person as a result of the violation. A person
- [Minnesota-Rating of an Insurance Policy-M.S.A. ¤ 70A.04](https://insurancefraud.org/statutes/minnesota-rating-of-an-insurance-policy-m-s-a-¤-70a-04/) - Subdivision 1. Prohibitions. Rates shall not be excessive, inadequate or unfairly discriminatory, nor shall an insurer use rates to engage in unfair price competition. Subd. 2. Excessiveness; market test. (a) Rates are presumed not to be excessive if a reasonable degree of price competition exists at the consumer level with respect to the class of
- [Minnesota-Underwriting Fraud-M.S.A. ¤ 609.611](https://insurancefraud.org/statutes/minnesota-underwriting-fraud-m-s-a-¤-609-611/) - (b) Presents, causes to be presented, or prepares with knowledge or reason to believe that it will be presented, to or by an insurer, insurance professional, or a premium finance company in connection with an insurance transaction or premium finance transaction, any information that contains a false representation as to any material fact, or that
- [Minnesota-Unauthorized Entities-M.S.A. ¤ 72A.41](https://insurancefraud.org/statutes/minnesota-unauthorized-entities-m-s-a-¤-72a-41/) - Subdivision 1. Prohibition; exception. It is unlawful for any company to enter into a contract of insurance as an insurer or to transact insurance business in this state, as set forth in subdivision 2, without a certificate of authority from the commissioner; provided that this subdivision does not apply to: (a) contracts of insurance procured
- [Michigan-Aiding & Abetting-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-aiding-abetting-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (b) Prepares or assists, abets, solicits, or conspires with another to prepare or make an oral or written statement that is intended to be presented
- [Michigan-Anti-Runner Provisions-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-anti-runner-provisions-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (h) Employs, uses, or acts as a runner, capper, or steerer with the intent to falsely or fraudulently obtain benefits under a contract of insurance
- [Michigan-Attempted Fraud-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-attempted-fraud-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (f) Removes or attempts to remove the assets or records of assets, transactions, and affairs, or a material part of the assets or records, from
- [Michigan-Claims Fraud-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-claims-fraud-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (a) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer or any agent
- [Michigan-Immunity-M.C.L.A. 500.4509](https://insurancefraud.org/statutes/michigan-immunity-m-c-l-a-500-4509/) - Sec. 4509. (1) A person acting without malice is not subject to liability for filing a report or requesting or furnishing orally or in writing other information concerning suspected or completed insurance fraud, if the reports or information are provided to or received from the insurance bureau, the national association of insurance commissioners, any federal,
- [Michigan-Insurance Fraud - Definition-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-insurance-fraud-definition-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (a) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer or any agent
- [Michigan-Licensing Board Notification-M.C.L.A. 500.4507](https://insurancefraud.org/statutes/michigan-licensing-board-notification-m-c-l-a-500-4507/) - Sec. 4507. (1) Upon written request by an authorized agency to an insurer, the insurer or an agent authorized by the insurer to act on its behalf may release to the authorized agency, at the authorized agency's expense, any or all information that is considered important relating to any suspected insurance fraud. An authorized agency
- [Michigan-Looting & diverting-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-looting-diverting-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (g) Diverts, attempts to divert, or conspires to divert funds of an insurer or of other persons in connection with any of the following: (i)
- [Michigan-Placing Bogus Coverage-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-placing-bogus-coverage-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (a) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer or any agent
- [Michigan-Range of Criminal Penalties-M.C.L.A. 500.4511](https://insurancefraud.org/statutes/michigan-range-of-criminal-penalties-m-c-l-a-500-4511/) - Sec. 4511. (1) A person who commits a fraudulent insurance act under section 45031 is guilty of a felony punishable by imprisonment for not more than 4 years or a fine of not more than $50,000.00, or both, and shall be ordered to pay restitution as provided in section 1a of chapter IX of the
- [Michigan-Range of Civil Penalties-M.C.L.A. 500.4511](https://insurancefraud.org/statutes/michigan-range-of-civil-penalties-m-c-l-a-500-4511/) - Sec. 4511. (1) A person who commits a fraudulent insurance act under section 45031 is guilty of a felony punishable by imprisonment for not more than 4 years or a fine of not more than $50,000.00, or both, and shall be ordered to pay restitution as provided in section 1a of chapter IX of the
- [Michigan-Rating of an Insurance Policy-M.C.L.A. 500.2403](https://insurancefraud.org/statutes/michigan-rating-of-an-insurance-policy-m-c-l-a-500-2403/) - Sec. 2403. (1) All rates shall be made in accordance with this section and all of the following: (a) Due consideration shall be given to past and prospective loss experience within and outside this state; to catastrophe hazards; to a reasonable margin for underwriting profit and contingencies; to dividends, savings, or unabsorbed premium deposits allowed
- [Michigan-Underwriting Fraud-M.C.L.A. 500.4503 (Proposed Legislation)](https://insurancefraud.org/statutes/michigan-underwriting-fraud-m-c-l-a-500-4503-proposed-legislation/) - Sec. 4503. A fraudulent insurance act includes, but is not limited to, acts or omissions committed by any person who knowingly, and with an intent to injure, defraud, or deceive: (e) Solicits or accepts new or renewal insurance risks by or for an insolvent insurer. (f) Removes or attempts to remove the assets or records
- [Michigan-Unauthorized Entities-M.C.L.A. 500.451](https://insurancefraud.org/statutes/michigan-unauthorized-entities-m-c-l-a-500-451/) - Sec. 451. Any unauthorized insurer transacting insurance in this state shall be subject to a tax of 2% of premiums written in this state and to an additional regulatory fee of 0.5% on premiums written in this state. The tax required by this section shall be considered delinquent if not paid within 30 days after
- [Massachusetts-Aiding & Abetting-M.G.L.A. 266 ¤ 111A](https://insurancefraud.org/statutes/massachusetts-aiding-abetting-m-g-l-a-266-¤-111a/) - Whoever, in connection with or in support of any claim under any policy of insurance issued by any company, as defined in section one of chapter one hundred and seventy-five, and with intent to injure, defraud or deceive such company, presents to it, or aids or abets in or procures the presentation to it of,
- [Massachusetts-Anti-Runner Provisions-M.G.L.A. 266 ¤ 111C](https://insurancefraud.org/statutes/massachusetts-anti-runner-provisions-m-g-l-a-266-¤-111c/) - (a) As used in this section, the following words shall have the following meanings:-- "Provider", an attorney, a health care professional licensed pursuant to chapter 112, an owner or operator of a health care practice or facility, any person who creates the impression that he or his practice or facility can provide legal or health
- [Massachusetts-Claims Fraud-M.G.L.A. 266 ¤ 111A](https://insurancefraud.org/statutes/massachusetts-claims-fraud-m-g-l-a-266-¤-111a/) - Whoever, in connection with or in support of any claim under any policy of insurance issued by any company, as defined in section one of chapter one hundred and seventy-five, and with intent to injure, defraud or deceive such company, presents to it, or aids or abets in or procures the presentation to it of,
- [Massachusetts-Failing to Remit Premium-n/a](https://insurancefraud.org/statutes/massachusetts-failing-to-remit-premium-n-a/) - No statute found
- [Massachusetts-Fraud Bureau-M.G.L.A. 26 ¤ 8B](https://insurancefraud.org/statutes/massachusetts-fraud-bureau-m-g-l-a-26-¤-8b/) - There shall be in the division of insurance a fraudulent claims board, hereinafter called the board, consisting of the commissioner of insurance or his designee, the registrar of motor vehicles or his designee, and the director of the state rating bureau or his designee. The commissioner of insurance or his designee shall be the chairman
- [Massachusetts-Immunity-M.G.L.A 175I ¤ 21](https://insurancefraud.org/statutes/massachusetts-immunity-m-g-l-a-175i-¤-21/) - No cause of action in the nature of defamation, invasion of privacy or negligence shall arise against any person for disclosing personal or privileged information in accordance with this chapter; provided, however, this section shall provide no immunity: (1) for any person who discloses false information with malice or willful intent to injure any person;
- [Massachusetts-Insurance Fraud - Definition-M.G.L.A. 266 ¤ 111A](https://insurancefraud.org/statutes/massachusetts-insurance-fraud-definition-m-g-l-a-266-¤-111a/) - Whoever, in connection with or in support of any claim under any policy of insurance issued by any company, as defined in section one of chapter one hundred and seventy-five, and with intent to injure, defraud or deceive such company, presents to it, or aids or abets in or procures the presentation to it of,
- [Massachusetts-Mandatory Restitution-M.G.L.A. 266 ¤ 111B (Proposed Legislation)](https://insurancefraud.org/statutes/massachusetts-mandatory-restitution-m-g-l-a-266-¤-111b-proposed-legislation/) - The court shall, after conviction, conduct an evidentiary hearing to ascertain the extent of the damages or financial loss suffered as a result of the defendant's crime. A person found guilty of violating this section shall, in all cases, upon conviction, in addition to any other punishment, be ordered to make restitution to the insurer
- [Massachusetts-Practitioner Penalites-M.G.L.A. 175 ¤ 223D](https://insurancefraud.org/statutes/massachusetts-practitioner-penalites-m-g-l-a-175-¤-223d/) - (a) If a person is found guilty of committing a fraudulent life settlement act, that person shall also be guilty of committing insurance fraud and shall be subject to additional penalties. (b) The commissioner may levy a civil penalty, not to exceed $10,000 for each violation, upon any person, including those persons and their employees
- [Massachusetts-Premium Fraud-M.G.L.A. 175 ¤ 170](https://insurancefraud.org/statutes/massachusetts-premium-fraud-m-g-l-a-175-¤-170/) - An insurance agent or broker who knowingly procures by fraudulent representations payment or the obligation for the payment of any premium on any policy of insurance or any annuity or pure endowment contract shall be punished by a fine of not less than one hundred nor more than one thousand dollars or by imprisonment for
- [Massachusetts-Range of Criminal Penalties-M.G.L.A. 266 ¤ 111A](https://insurancefraud.org/statutes/massachusetts-range-of-criminal-penalties-m-g-l-a-266-¤-111a/) - Whoever, in connection with or in support of any claim under any policy of insurance issued by any company, as defined in section one of chapter one hundred and seventy-five, and with intent to injure, defraud or deceive such company, presents to it, or aids or abets in or procures the presentation to it of,
- [Massachusetts-Range of Civil Penalties-M.G.L.A. 266 ¤ 111A](https://insurancefraud.org/statutes/massachusetts-range-of-civil-penalties-m-g-l-a-266-¤-111a/) - Whoever, in connection with or in support of any claim under any policy of insurance issued by any company, as defined in section one of chapter one hundred and seventy-five, and with intent to injure, defraud or deceive such company, presents to it, or aids or abets in or procures the presentation to it of,
- [Massachusetts-Unauthorized Entities-M.G.L.A. 175 ¤ 3](https://insurancefraud.org/statutes/massachusetts-unauthorized-entities-m-g-l-a-175-¤-3/) - No company shall make a contract of insurance or annuity, including any such insurance or annuity contract which is a contract on a variable basis, upon or relative to any property or interests or lives in the commonwealth, or with any resident thereof, and no person shall negotiate, solicit, sell or in any manner aid
- [Maryland-Claims Fraud-MD Code, Insurance, ¤ 27-403](https://insurancefraud.org/statutes/maryland-claims-fraud-md-code-insurance-¤-27-403/) - It is a fraudulent insurance act for a person: (1) knowingly to fail to return any money or premiums paid for a policy to an insured, designee of the insured, or another person entitled to the money or premiums if the insurance contracted for is not ultimately provided; (2) to present or cause to be
- [Maryland-Failing to Remit Premium-MD Code, Insurance, ¤ 27-403](https://insurancefraud.org/statutes/maryland-failing-to-remit-premium-md-code-insurance-¤-27-403/) - It is a fraudulent insurance act for a person: (1) knowingly to fail to return any money or premiums paid for a policy to an insured, designee of the insured, or another person entitled to the money or premiums if the insurance contracted for is not ultimately provided; (2) to present or cause to be
- [Maryland-Fraud Bureau-MD Code, Insurance, ¤ 2-405](https://insurancefraud.org/statutes/maryland-fraud-bureau-md-code-insurance-¤-2-405/) - The Fraud Division: (1) has the authority to investigate each person suspected of engaging in insurance fraud; (2) if appropriate after an investigation: (i) shall refer suspected cases of insurance fraud to the Office of the Attorney General or appropriate local State's Attorney to prosecute the person criminally for insurance fraud; (ii) shall notify the
- [Maryland-Immunity-MD Code, Insurance, ¤ 27-802](https://insurancefraud.org/statutes/maryland-immunity-md-code-insurance-¤-27-802/) - (a)(1) An authorized insurer, its employees, fund producers, insurance producers, a viatical settlement provider, or a viatical settlement broker who in good faith has cause to believe that insurance fraud has been or is being committed shall report the suspected insurance fraud in writing to the Commissioner, the Fraud Division, or the appropriate federal, State,
- [Maryland-Insurance Fraud - Definition-MD Code, Insurance, ¤ 27-406](https://insurancefraud.org/statutes/maryland-insurance-fraud-definition-md-code-insurance-¤-27-406/) - It is a fraudulent insurance act for a person: (1) knowingly or willfully to make a false or fraudulent statement or representation in or with reference to an application for insurance; (2) to place insurance with an unauthorized insurer not regulated by the Commissioner and refuse to obey an order of the Commissioner to produce
- [Maryland-Licensing Board Notification-MD Code, Insurance, ¤ 27-802](https://insurancefraud.org/statutes/maryland-licensing-board-notification-md-code-insurance-¤-27-802/) - (a)(1) An authorized insurer, its employees, fund producers, insurance producers, a viatical settlement provider, or a viatical settlement broker who in good faith has cause to believe that insurance fraud has been or is being committed shall report the suspected insurance fraud in writing to the Commissioner, the Fraud Division, or the appropriate federal, State,
- [Maryland-Mandatory Restitution-MD Code, Insurance, ¤ 27-408](https://insurancefraud.org/statutes/maryland-mandatory-restitution-md-code-insurance-¤-27-408/) - (a)(1) A person that violates ¤ 27-407 of this subtitle, or another provision of this subtitle in which the claim or act that is the subject of the fraud has a value of $300 or more is guilty of a felony and on conviction, for each violation, is subject to: Administrative penalties and restitution (c)(1)
- [Maryland-Placing Bogus Coverage-MD Code, Insurance, ¤ 27-406](https://insurancefraud.org/statutes/maryland-placing-bogus-coverage-md-code-insurance-¤-27-406/) - It is a fraudulent insurance act for a person: (1) knowingly or willfully to make a false or fraudulent statement or representation in or with reference to an application for insurance; (2) to place insurance with an unauthorized insurer not regulated by the Commissioner and refuse to obey an order of the Commissioner to produce
- [Maryland-Range of Criminal Penalties-MD Code, Insurance, ¤ 2-406](https://insurancefraud.org/statutes/maryland-range-of-criminal-penalties-md-code-insurance-¤-2-406/) - Criminal prosecution for insurance fraud (a) Notwithstanding any other provision of law, a criminal prosecution for engaging in insurance fraud may be brought in any county in the State in which: (1) an element of the insurance fraud was committed; (2) the purported insured loss occurred; (3) the insurance policy in question provides coverage; (4)
- [Maryland-Range of Civil Penalties-MD Code, Insurance, ¤ 27-408](https://insurancefraud.org/statutes/maryland-range-of-civil-penalties-md-code-insurance-¤-27-408/) - (a)(1) A person that violates ¤ 27-407 of this subtitle, or another provision of this subtitle in which the claim or act that is the subject of the fraud has a value of $300 or more is guilty of a felony and on conviction, for each violation, is subject to: (i) liability for restoring to
- [Maryland-Rating of an Insurance Policy-MD Code, Insurance, ¤ 11-306](https://insurancefraud.org/statutes/maryland-rating-of-an-insurance-policy-md-code-insurance-¤-11-306/) - In general (a) The standards set forth in this section apply to the making and use of rates under this subtitle. Excessive, inadequate, or unfairly discriminatory rates prohibited (b)(1) Rates may not be: (i) excessive or inadequate, as defined under this subtitle; or (ii) unfairly discriminatory. (2) Except as provided in paragraph (4) of this
- [Maryland-Underwriting Fraud-MD Code, Insurance, ¤ 27-406](https://insurancefraud.org/statutes/maryland-underwriting-fraud-md-code-insurance-¤-27-406/) - It is a fraudulent insurance act for a person: (1) knowingly or willfully to make a false or fraudulent statement or representation in or with reference to an application for insurance; (2) to place insurance with an unauthorized insurer not regulated by the Commissioner and refuse to obey an order of the Commissioner to produce
- [Maryland-Unauthorized Entities-MD Code, Insurance, ¤ 4-203](https://insurancefraud.org/statutes/maryland-unauthorized-entities-md-code-insurance-¤-4-203/) - Application of section (a) This section does not apply to: (1) acceptance of service of process; (2) surplus lines insurance; (3) a transaction for which a certificate of authority is not required under ¤ 4-101(b) of this title; (4) reinsurance, as authorized under Title 5, Subtitle 9 of this article; (5) an adjuster while providing
- [Maine-Aiding & Abetting-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-aiding-abetting-24-a-m-r-s-a-¤-2186/) - A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (7) Attempting to commit, aiding or abetting in the commission of, or conspiring to commit the acts or omissions described in this subsection.
- [Maine-Attempted Fraud-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-attempted-fraud-24-a-m-r-s-a-¤-2186/) - A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (7) Attempting to commit, aiding or abetting in the commission of, or conspiring to commit the acts or omissions described in this subsection.
- [Maine-Claims Fraud-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-claims-fraud-24-a-m-r-s-a-¤-2186/) - A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (1) Presenting, or causing to be presented, or preparing any information containing false representations as to a material fact with knowledge or belief that the information will be presented by or on behalf of an
- [Maine-Failing to Remit Premium-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-failing-to-remit-premium-24-a-m-r-s-a-¤-2186/) - A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (2) Presenting, or causing to be presented, or preparing any information containing false representations as to a material fact with knowledge or belief that the information will be presented to or by an insurer, insurance
- [Maine-Immunity-24-A M.R.S.A. ¤ 2187](https://insurancefraud.org/statutes/maine-immunity-24-a-m-r-s-a-¤-2187/) - 1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Action" includes nonaction or the failure to take action. B. "Authorized agency" or "authorized agencies" means: (1) The Attorney General; (2) A district attorney responsible for prosecution in the municipality where the fraud occurred; (3)
- [Maine-Insurance Fraud - Definition-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-insurance-fraud-definition-24-a-m-r-s-a-¤-2186/) - 1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (1) Presenting, or causing to be presented, or preparing any information containing false representations as to
- [Maine-Licensing Board Notification-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-licensing-board-notification-24-a-m-r-s-a-¤-2186/) - 4. Reporting of fraudulent insurance acts. Fraudulent insurance acts must be reported in accordance with this subsection. A. An insurer shall, annually on or before March 1st or within any reasonable extension of time granted by the superintendent, file with the superintendent a report relating to fraudulent insurance acts that the insurer knew or reasonably
- [Maine-Looting & diverting-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-looting-diverting-24-a-m-r-s-a-¤-2186/) - A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (2) Presenting, or causing to be presented, or preparing any information containing false representations as to a material fact with knowledge or belief that the information will be presented to or by an insurer, insurance
- [Maine-Mandatory Restitution-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-mandatory-restitution-24-a-m-r-s-a-¤-2186/) - 6. Restitution. The superintendent may order restitution for any insured or applicant for insurance injured by a violation for which a civil penalty may be assessed pursuant to this section.
- [Maine-Practitioner Penalites-24-A M.R.S.A. ¤ 12-A](https://insurancefraud.org/statutes/maine-practitioner-penalites-24-a-m-r-s-a-¤-12-a/) - 1. Civil penalty. Civil penalties may be assessed against any person who: A. Violates any provision of this Title, Title 24 or any other law enforced by the superintendent; B. Violates any rule lawfully adopted by the superintendent; or C. Violates any lawful order of the superintendent that has not been stayed by order of
- [Maine-Premium Fraud-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-premium-fraud-24-a-m-r-s-a-¤-2186/) - A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (1) Presenting, or causing to be presented, or preparing any information containing false representations as to a material fact with knowledge or belief that the information will be presented by or on behalf of an
- [Maine-Range of Civil Penalties-24-A M.R.S.A. ¤ 12-A](https://insurancefraud.org/statutes/maine-range-of-civil-penalties-24-a-m-r-s-a-¤-12-a/) - 1. Civil penalty. Civil penalties may be assessed against any person who: A. Violates any provision of this Title, Title 24 or any other law enforced by the superintendent; B. Violates any rule lawfully adopted by the superintendent; or C. Violates any lawful order of the superintendent that has not been stayed by order of
- [Maine-Rating of an Insurance Policy-24-A M.R.S.A. ¤ 2303](https://insurancefraud.org/statutes/maine-rating-of-an-insurance-policy-24-a-m-r-s-a-¤-2303/) - 1. Rates shall be made in accordance with the following provisions. A. Manual, minimum, class rates, rating schedules or rating plans shall be made and adopted, except in the case of specific inland marine rates on risks specially rated. B. Rates shall not be excessive, inadequate or unfairly discriminatory. C. Due consideration must be given:
- [Maine-Underwriting Fraud-24-A M.R.S.A. ¤ 2186](https://insurancefraud.org/statutes/maine-underwriting-fraud-24-a-m-r-s-a-¤-2186/) - 1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Fraudulent insurance act" means any of the following acts or omissions when committed knowingly and with intent to defraud: (2) Presenting, or causing to be presented, or preparing any information containing false representations as to
- [Maine-Unauthorized Entities-24-A M.R.S.A. ¤ 2101](https://insurancefraud.org/statutes/maine-unauthorized-entities-24-a-m-r-s-a-¤-2101/) - 1. No person shall in this State directly or indirectly act as agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such business in this State, in the solicitation, negotiation, procurement or effectuation of insurance or annuity contracts, or renewal thereof, or forwarding of applications for
- [Louisiana-Claims Fraud-LSA-R.S. 22:1923](https://insurancefraud.org/statutes/louisiana-claims-fraud-lsa-r-s-221923/) - As used in this Part, the following terms shall have the meanings indicated in this Section: (1) "Claim" shall mean any request or demand for payment or benefit, whether paid or not, made by a person either in writing or filed electronically. (2) "Fraudulent insurance act" shall include but not be limited to acts or
- [Louisiana-Fraud Bureau-LSA-R.S. 40:1422](https://insurancefraud.org/statutes/louisiana-fraud-bureau-lsa-r-s-401422/) - A. There is hereby created an insurance fraud investigation unit in the Department of Public Safety and Corrections, public safety services, office of state police, and the unit shall be solely dedicated to the investigation of property and casualty, worker's compensation, life, and health insurance fraud. The purposes of this unit shall be to: (1)
- [Louisiana-Immunity-LSA-R.S. 22:1928](https://insurancefraud.org/statutes/louisiana-immunity-lsa-r-s-221928/) - A. No insurer, employees, or agents of any insurer, or any other person acting without malice, fraudulent intent, or bad faith, shall be subject to civil liability for libel, slander, or any other relevant tort, and no civil cause of action of any nature shall exist against such person or entity by virtue of the
- [Louisiana-Insurance Fraud - Definition-LSA-R.S. 22:1923](https://insurancefraud.org/statutes/louisiana-insurance-fraud-definition-lsa-r-s-221923/) - (2) "Fraudulent insurance act" shall include but not be limited to acts or omissions committed by any person who, knowingly and with intent to defraud: (a) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, reinsurer, purported insurer or reinsurer, producer, or any
- [Louisiana-Licensing Board Notification-LSA-R.S. 22:1926](https://insurancefraud.org/statutes/louisiana-licensing-board-notification-lsa-r-s-221926/) - A. Any person, company, or other legal entity including but not limited to those engaged in the business of insurance, including producers and adjusters, that suspects that a fraudulent insurance act will be, is being, or has been committed shall, within sixty days of the receipt of such notice, send to the division of insurance
- [Louisiana-Looting & diverting-LSA-R.S. 22:1923](https://insurancefraud.org/statutes/louisiana-looting-diverting-lsa-r-s-221923/) - (2) "Fraudulent insurance act" shall include but not be limited to acts or omissions committed by any person who, knowingly and with intent to defraud: (a) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, reinsurer, purported insurer or reinsurer, producer, or any
- [Louisiana-Mandatory Restitution-LSA-R.S. 22:1924](https://insurancefraud.org/statutes/louisiana-mandatory-restitution-lsa-r-s-221924/) - A. (1) Any person who, with the intent to injure, defraud, or deceive any insurance company, or the Department of Insurance, or any insured or other party in interest, or any third-party claimant commits any of the acts specified in Paragraph (2) or (3) of this Subsection is guilty of a felony and shall be
- [Louisiana-Practitioner Penalites-LSA-R.S. 22:2007](https://insurancefraud.org/statutes/louisiana-practitioner-penalites-lsa-r-s-222007/) - A. Any officer, manager, director, trustee, owner, employee, or agent of any insurer, or any other persons with authority over or in charge of any segment of the insurer's affairs, shall cooperate with the commissioner in any proceeding under this Chapter or any investigation preliminary to the proceeding. B. No person shall obstruct or interfere
- [Louisiana-Premium Fraud-LSA-R.S. 22:1923](https://insurancefraud.org/statutes/louisiana-premium-fraud-lsa-r-s-221923/) - (2) "Fraudulent insurance act" shall include but not be limited to acts or omissions committed by any person who, knowingly and with intent to defraud: (a) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, reinsurer, purported insurer or reinsurer, producer, or any
- [Louisiana-Range of Criminal Penalties-LSA-R.S. 22:1924](https://insurancefraud.org/statutes/louisiana-range-of-criminal-penalties-lsa-r-s-221924/) - A. (1) Any person who, with the intent to injure, defraud, or deceive any insurance company, or the Department of Insurance, or any insured or other party in interest, or any third-party claimant commits any of the acts specified in Paragraph (2) or (3) of this Subsection is guilty of a felony and shall be
- [Louisiana-Range of Civil Penalties-n/a](https://insurancefraud.org/statutes/louisiana-range-of-civil-penalties-n-a/) - No statute fou nd.
- [Louisiana-Underwriting Fraud-LSA-R.S. 22:1923](https://insurancefraud.org/statutes/louisiana-underwriting-fraud-lsa-r-s-221923/) - (2) "Fraudulent insurance act" shall include but not be limited to acts or omissions committed by any person who, knowingly and with intent to defraud: (b) Solicits or accepts new or renewal insurance risks by or for an insolvent insurer, reinsurer, or other entity regulated under the insurance laws of this state. (c) Removes or
- [Louisiana-Unauthorized Entities-LSA-R.S. 22:1902](https://insurancefraud.org/statutes/louisiana-unauthorized-entities-lsa-r-s-221902/) - A. Any of the following acts in this state, effected by mail or otherwise, by an unauthorized insurer or by any person acting with actual or apparent authority of the insurer, on behalf of the insurer, is deemed to constitute the transaction of an insurance business in or from this state: (1) The making of
- [Kentucky-Aiding & Abetting-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-aiding-abetting-krs-¤-304-47-020-proposed-legislation/) - (1) For the purposes of this subtitle, a person or entity commits a "fraudulent insurance act" if he or she engages in any of the following, including but not limited to matters relating to workers' compensation: (a) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or
- [Kentucky-Attempted Fraud-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-attempted-fraud-krs-¤-304-47-020-proposed-legislation/) - (1) For the purposes of this subtitle, a person or entity commits a "fraudulent insurance act" if he or she engages in any of the following, including but not limited to matters relating to workers' compensation: (a) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or
- [Kentucky-Claims Fraud-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-claims-fraud-krs-¤-304-47-020-proposed-legislation/) - (1) For the purposes of this subtitle, a person or entity commits a "fraudulent insurance act" if he or she engages in any of the following, including but not limited to matters relating to workers' compensation: (a) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or
- [Kentucky-Fraud Bureau-KRS ¤ 304.47-040](https://insurancefraud.org/statutes/kentucky-fraud-bureau-krs-¤-304-47-040/) - (1) There is created within the Department of Insurance a Division of Insurance Fraud Investigation. (2) (a) The commissioner shall appoint qualified persons to serve as special investigators for the Division of Insurance Fraud Investigation who shall have general police powers including the power to arrest, and they shall possess all of the common law
- [Kentucky-Immunity-KRS ¤ 304.47-060](https://insurancefraud.org/statutes/kentucky-immunity-krs-¤-304-47-060/) - (1) In the absence of malice, fraud, or gross negligence, a person shall not be subject to civil liability for libel, slander, or any other relevant tort by virtue of filing reports or furnishing other information required by this chapter or requested by the division or its authorized representative. No civil cause of action of
- [Kentucky-Insurance Fraud - Definition-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-insurance-fraud-definition-krs-¤-304-47-020-proposed-legislation/) - (1) For the purposes of this subtitle, a person or entity commits a "fraudulent insurance act" if he or she engages in any of the following, including but not limited to matters relating to workers' compensation: (a) Knowingly and with intent to defraud or deceive presents, causes to be presented, or prepares with knowledge or
- [Kentucky-Licensing Board Notification-KRS ¤ 304.47-050](https://insurancefraud.org/statutes/kentucky-licensing-board-notification-krs-¤-304-47-050/) - (1) Any person, other than those specified in subsection (2) of this section, having knowledge or believing that a fraudulent insurance act or any other act or practice which, upon conviction, constitutes a felony or misdemeanor under the subtitle is being or has been committed may send to the division a report of information pertinent
- [Kentucky-Mandatory Restitution-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-mandatory-restitution-krs-¤-304-47-020-proposed-legislation/) - (2) (a) Except as provided in paragraphs (b) and (c) of this subsection, a person convicted of a violation of subsection (1) of this section shall be guilty of a misdemeanor where the aggregate of the claim, benefit, or money referred to in subsection (1) of this section is less than or equal to five
- [Kentucky-Placing Bogus Coverage-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-placing-bogus-coverage-krs-¤-304-47-020-proposed-legislation/) - (1) For the purposes of this subtitle, a person or entity commits a "fraudulent insurance act" if he or she engages in any of the following, including but not limited to matters relating to workers' compensation: (c) Knowingly and with intent to defraud or deceive: 1. Receives money for the purpose of purchasing insurance, and
- [Kentucky-Practitioner Penalites-KRS ¤ 304.99-126](https://insurancefraud.org/statutes/kentucky-practitioner-penalites-krs-¤-304-99-126/) - (1) When a license issued under KRS 304.15-700 is suspended or revoked, the licensee, if the commissioner directs, shall proceed, immediately following the effective date of the suspension or revocation to conclude the affairs it is transacting under its license. The licensee shall not solicit, negotiate, advertise, or effectuate new contracts. The department shall retain
- [Kentucky-Range of Criminal Penalties-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-range-of-criminal-penalties-krs-¤-304-47-020-proposed-legislation/) - (2) (a) Except as provided in paragraphs (b) and (c) of this subsection, a person convicted of a violation of subsection (1) of this section shall be guilty of a misdemeanor where the aggregate of the claim, benefit, or money referred to in subsection (1) of this section is less than or equal to five
- [Kentucky-Range of Civil Penalties-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-range-of-civil-penalties-krs-¤-304-47-020-proposed-legislation/) - (2) (a) Except as provided in paragraphs (b) and (c) of this subsection, a person convicted of a violation of subsection (1) of this section shall be guilty of a misdemeanor where the aggregate of the claim, benefit, or money referred to in subsection (1) of this section is less than or equal to five
- [Kentucky-Rating of an Insurance Policy-n/a](https://insurancefraud.org/statutes/kentucky-rating-of-an-insurance-policy-n-a/) - Statute repealed. KRS ¤ 304.13-030.
- [Kentucky-Underwriting Fraud-KRS ¤ 304.47-020 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-underwriting-fraud-krs-¤-304-47-020-proposed-legislation/) - (c) Knowingly and with intent to defraud or deceive: 1. Receives money for the purpose of purchasing insurance, and fails to obtain insurance; 2. Fails to make payment or disposition of money or voucher as defined in KRS 304.17A-750, as required by agreement or legal obligation, that comes into his or her possession while acting
- [Kentucky-Unauthorized Entities-KRS ¤ 304.11-030 (Proposed Legislation)](https://insurancefraud.org/statutes/kentucky-unauthorized-entities-krs-¤-304-11-030-proposed-legislation/) - (1) It shall be unlawful for any company to enter into a contract of insurance as an insurer or to transact insurance business in this state, as set forth in subsection (2) of this section without a certificate of authority from the commissioner; provided, that this subsection shall not apply to: (a) The lawful transaction
- [Kansas-Claims Fraud-K.S.A. 40-2,118](https://insurancefraud.org/statutes/kansas-claims-fraud-k-s-a-40-2118/) - a) For purposes of this act a "fraudulent insurance act" means an act committed by any person who, knowingly and with intent to defraud, presents, causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any agent thereof, any written, electronic,
- [Kansas-Fraud Bureau-K.S.A. 40-113](https://insurancefraud.org/statutes/kansas-fraud-bureau-k-s-a-40-113/) - (a) There is hereby established within the insurance department a criminal anti-fraud division of the Kansas insurance department. The criminal anti-fraud division shall accept information and complaints regarding possible insurance fraud. The criminal anti-fraud division shall also investigate possible violations of Kansas criminal statutes pertaining to and related to insurance fraud. The criminal anti-fraud division
- [Kansas-Immunity-K.S.A. 40-2,119](https://insurancefraud.org/statutes/kansas-immunity-k-s-a-40-2119/) - In the absence of fraud, bad faith or malice, no person or insurer shall be subject to civil liability for libel, slander or any other relevant cause of action: (a) For filing reports or furnishing other information required by chapter 40 of the Kansas Statutes Annotated, and amendments thereto, or required by the commissioner under
- [Kansas-Insurance Fraud - Definition-K.S.A. 40-2,118](https://insurancefraud.org/statutes/kansas-insurance-fraud-definition-k-s-a-40-2118/) - (a) For purposes of this act a "fraudulent insurance act" means an act committed by any person who, knowingly and with intent to defraud, presents, causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any agent thereof, any written, electronic,
- [Kansas-Looting & diverting-n/a](https://insurancefraud.org/statutes/kansas-looting-diverting-n-a/) - No statue found.
- [Kansas-Mandatory Restitution-K.S.A. 40-2,118](https://insurancefraud.org/statutes/kansas-mandatory-restitution-k-s-a-40-2118/) - (f) In addition to any other penalty, a person who violates this statute shall be ordered to make restitution to the insurer or any other person or entity for any financial loss sustained as a result of such violation. An insurer shall not be required to provide coverage or pay any claim involving a fraudulent
- [Kansas-Practitioner Penalites-K.S.A. 40-2406](https://insurancefraud.org/statutes/kansas-practitioner-penalites-k-s-a-40-2406/) - (a) Whenever the commissioner has reason to believe that any such person has been engaged or is engaging in this state in any unfair method of competition or any unfair or deceptive act or practice, whether or not defined in K.S.A. 40-2404, and amendments thereto, and that a proceeding by the commissioner in respect thereto
- [Kansas-Range of Criminal Penalties-K.S.A. 40-2,118](https://insurancefraud.org/statutes/kansas-range-of-criminal-penalties-k-s-a-40-2118/) - (e) Except as otherwise specifically provided in K.S.A. 21-5812(a), and amendments thereto, and K.S.A. 44-5,125, and amendments thereto, a fraudulent insurance act shall constitute a severity level 6, nonperson felony if the amount involved is $25,000 or more; a severity level 7, nonperson felony if the amount is at least $5,000 but less than $25,000;
- [Kansas-Unauthorized Entities-K.S.A. 40-2001](https://insurancefraud.org/statutes/kansas-unauthorized-entities-k-s-a-40-2001/) - The purpose of this act is to subject certain insurers to the jurisdiction of courts of this state in suits by or on behalf of insureds or beneficiaries under insurance contracts. The legislature declares that it is a subject of concern that many residents of this state hold policies of insurance issued or delivered in
- [Iowa-Aiding & Abetting-I.C.A. ¤ 507E.3](https://insurancefraud.org/statutes/iowa-aiding-abetting-i-c-a-¤-507e-3/) - 2. A person commits a class "D" felony if the person, with the intent to defraud an insurer, does any of the following: b. Assists, abets, solicits, or conspires with another to present or cause to be presented to an insurer, any written document or oral statement, including a computer-generated document, that is intended to
- [Iowa-Claims Fraud-I.C.A. ¤ 507E.3](https://insurancefraud.org/statutes/iowa-claims-fraud-i-c-a-¤-507e-3/) - 2. A person commits a class "D" felony if the person, with the intent to defraud an insurer, does any of the following: a. Presents or causes to be presented to an insurer, any written document or oral statement, including a computer-generated document, as part of, or in support of, a claim for payment or
- [Iowa-Fraud Bureau-I.C.A. ¤ 507E.2](https://insurancefraud.org/statutes/iowa-fraud-bureau-i-c-a-¤-507e-2/) - An insurance fraud bureau is created within the insurance division. Upon a reasonable determination by the division, by its own inquiries or as a result of complaints filed with the division, that a person has engaged in, is engaging in, or may be engaging in an act or practice that violates this chapter or any
- [Iowa-Immunity-I.C.A. ¤ 507E.7](https://insurancefraud.org/statutes/iowa-immunity-i-c-a-¤-507e-7/) - 1. A person acting without malice, fraudulent intent, or bad faith is not liable civilly as a result of filing a report or furnishing, orally or in writing, other information concerning alleged acts in violation of this chapter, if the report or information is provided to or received from any of the following: a. Law
- [Iowa-Insurance Fraud - Definition-I.C.A. ¤ 507E.3](https://insurancefraud.org/statutes/iowa-insurance-fraud-definition-i-c-a-¤-507e-3/) - 2. A person commits a class "D" felony if the person, with the intent to defraud an insurer, does any of the following: a. Presents or causes to be presented to an insurer, any written document or oral statement, including a computer-generated document, as part of, or in support of, a claim for payment or
- [Iowa-Licensing Board Notification-I.C.A. ¤ 507E.6](https://insurancefraud.org/statutes/iowa-licensing-board-notification-i-c-a-¤-507e-6/) - An insurer which believes that a claim or application for insurance coverage is being made which is a violation of section 507E.3 shall provide, within sixty days of the receipt of such claim or application, written notification to the bureau of the claim or application on a form prescribed by the bureau, including any additional
- [Iowa-Placing Bogus Coverage-n/a](https://insurancefraud.org/statutes/iowa-placing-bogus-coverage-n-a/) - No statute found
- [Iowa-Practitioner Penalites-I.C.A. ¤ 507E.3A](https://insurancefraud.org/statutes/iowa-practitioner-penalites-i-c-a-¤-507e-3a/) - 1. A person commits the offense of fraudulent sales practices if the person, with the intent to defraud another person in connection with any sale, solicitation, or negotiation of insurance in this state, willfully does any of the following: a. Employs any deception, device, scheme, or artifice to defraud. b. Misrepresents, conceals, or suppresses any
- [Iowa-Range of Criminal Penalties-I.C.A. ¤ 507E.3](https://insurancefraud.org/statutes/iowa-range-of-criminal-penalties-i-c-a-¤-507e-3/) - 1. For purposes of this chapter, "statement" includes, but is not limited to, any notice, statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of property damage, bill for services, diagnosis, prescription, hospital or physician record, X ray, test result, or other evidence of loss, injury, or expense. 2. A person
- [Iowa-Range of Civil Penalties-I.C.A. ¤ 505.7A](https://insurancefraud.org/statutes/iowa-range-of-civil-penalties-i-c-a-¤-505-7a/) - Unless specifically provided for in this subtitle, penalties imposed under this subtitle by order of the commissioner of insurance after hearing shall not exceed one thousand dollars for each act or violation of this subtitle, up to an aggregate of ten thousand dollars, unless the person knew or reasonably should have known the person was
- [Iowa-Rating of an Insurance Policy-I.C.A. ¤ 515F.4](https://insurancefraud.org/statutes/iowa-rating-of-an-insurance-policy-i-c-a-¤-515f-4/) - Rates shall be made in accordance with the following: 1. Rates shall not be excessive, inadequate, or unfairly discriminatory. 2. Due consideration may be given to past and prospective loss experience within and outside this state; to the conflagration and catastrophe hazards; to a reasonable margin for profit and contingencies; to dividends, savings, or unabsorbed
- [Iowa-Underwriting Fraud-I.C.A. ¤ 507E.3A](https://insurancefraud.org/statutes/iowa-underwriting-fraud-i-c-a-¤-507e-3a/) - 1. A person commits the offense of fraudulent sales practices if the person, with the intent to defraud another person in connection with any sale, solicitation, or negotiation of insurance in this state, willfully does any of the following: a. Employs any deception, device, scheme, or artifice to defraud. b. Misrepresents, conceals, or suppresses any
- [Iowa-Unauthorized Entities-I.C.A. ¤ 507A.3](https://insurancefraud.org/statutes/iowa-unauthorized-entities-i-c-a-¤-507a-3/) - 1. Unless otherwise indicated, "insurer" as used in this section includes all corporations, associations, partnerships and individuals engaged in the business of insurance. Any of the following acts in this state, effected by mail or otherwise, by an unauthorized insurer is defined to be doing an insurance business in this state: a. The making of
- [Indiana-Attempted Fraud-n/a](https://insurancefraud.org/statutes/indiana-attempted-fraud-n-a/) - No statute found
- [Indiana-Claims Fraud-IC 35-43-5-4.5](https://insurancefraud.org/statutes/indiana-claims-fraud-ic-35-43-5-4-5/) - Sec. 4.5. (a) A person who, knowingly and with intent to defraud: (2) presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, an oral, a written, or an electronic statement that the person knows to contain materially false information as part of, in
- [Indiana-Immunity-IC 27-1-3-22](https://insurancefraud.org/statutes/indiana-immunity-ic-27-1-3-22/) - (c) A person who acts without malice, fraudulent intent, or bad faith is not subject to civil liability for filing a report or furnishing, orally or in writing, other information concerning a suspected, anticipated, or completed fraudulent insurance act if the report or other information is provided to or received from any of the following:
- [Indiana-Insurance Fraud - Definition-IC 35-43-5-4.5](https://insurancefraud.org/statutes/indiana-insurance-fraud-definition-ic-35-43-5-4-5/) - Sec. 4.5. (a) A person who, knowingly and with intent to defraud: (1) makes, utters, presents, or causes to be presented to an insurer or an insurance claimant, a claim statement that contains false, incomplete, or misleading information concerning the claim; (2) presents, causes to be presented, or prepares with knowledge or belief that it
- [Indiana-Licensing Board Notification-IC 33-23-8-4](https://insurancefraud.org/statutes/indiana-licensing-board-notification-ic-33-23-8-4/) - Sec. 4. If a practitioner is convicted under IC 35-43-5-4.5 of: (1) insurance fraud; (2) an attempt to commit insurance fraud; or (3) conspiracy to commit insurance fraud; the sentencing court shall provide notice of the conviction to each governmental body that has issued a license to the practitioner.
- [Indiana-Looting & diverting-IC 35-43-5-4.5](https://insurancefraud.org/statutes/indiana-looting-diverting-ic-35-43-5-4-5/) - Sec. 4.5. (a) A person who, knowingly and with intent to defraud: (5) diverts funds of an insurer or another person in connection with: (A) the transaction of insurance or reinsurance; (B) the conduct of business activities by an insurer or another entity regulated under IC 27; or (C) the formation, acquisition, or dissolution of
- [Indiana-Practitioner Penalites-IC 27-1-3-20](https://insurancefraud.org/statutes/indiana-practitioner-penalites-ic-27-1-3-20/) - (c) No company shall transact any business of insurance or hold itself out as a company in the business of insurance in Indiana until it shall have received a certificate of authority as prescribed in this section. (d) No company shall make, issue, deliver, sell, or advertise any kind or kinds of insurance not specified
- [Indiana-Premium Fraud-IC 27-1-3-22](https://insurancefraud.org/statutes/indiana-premium-fraud-ic-27-1-3-22/) - Sec. 4.5. (a) A person who, knowingly and with intent to defraud: (2) presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, an oral, a written, or an electronic statement that the person knows to contain materially false information as part of, in
- [Indiana-Range of Criminal Penalties-IC 35-50-2-7](https://insurancefraud.org/statutes/indiana-range-of-criminal-penalties-ic-35-50-2-7/) - Sec. 7. (a) A person who commits a Class D felony (for a crime committed before July 1, 2014) shall be imprisoned for a fixed term of between six (6) months and three (3) years, with the advisory sentence being one and one-half (1 _ ) years. In addition, the person may be fined not
- [Indiana-Rating of an Insurance Policy-IC 27-1-22-3](https://insurancefraud.org/statutes/indiana-rating-of-an-insurance-policy-ic-27-1-22-3/) - Sec. 3. (a) Rates shall be made in accordance with the following provisions: (1) Due consideration shall be given to the past and prospective loss experience within and outside this state, to conflagration and catastrophe hazards, if any, to a reasonable margin for underwriting profit and contingencies, to dividends or savings allowed or returned by
- [Indiana-Underwriting Fraud-n/a](https://insurancefraud.org/statutes/indiana-underwriting-fraud-n-a/) - No statute found
- [Indiana-Unauthorized Entities-IC 27-4-5-2](https://insurancefraud.org/statutes/indiana-unauthorized-entities-ic-27-4-5-2/) - Sec. 2. (a) It is a Class A infraction for an insurer to transact insurance business in this state, as set forth in subsection (b), without a certificate of authority from the commissioner. However, this section does not apply to the following: (1) The lawful transaction of surplus lines insurance. (2) The lawful transaction of
- [Illinois-Attempted Fraud-720 ILCS 5/17-10.5 (Proposed Legislation)](https://insurancefraud.org/statutes/illinois-attempted-fraud-720-ilcs-5-17-10-5-proposed-legislation/) - ¤ 17-10.5. Insurance fraud. (a) Insurance fraud. (1) A person commits insurance fraud when he or she knowingly obtains, attempts to obtain, or causes to be obtained, by deception, control over the property of an insurance company or self-insured entity by the making of a false claim or by causing a false claim to be
- [Illinois-Claims Fraud-720 ILCS 5/17-10.5 (Proposed Legislation)](https://insurancefraud.org/statutes/illinois-claims-fraud-720-ilcs-5-17-10-5-proposed-legislation/) - ¤ 17-10.5. Insurance fraud. (a) Insurance fraud. (1) A person commits insurance fraud when he or she knowingly obtains, attempts to obtain, or causes to be obtained, by deception, control over the property of an insurance company or self-insured entity by the making of a false claim or by causing a false claim to be
- [Illinois-Immunity-215 ILCS 5/132.7; 215 ILCS 5/1022](https://insurancefraud.org/statutes/illinois-immunity-215-ilcs-5-132-7-215-ilcs-5-1022/) - ¤ 132.7. Immunity from liability. (a) No cause of action shall arise nor shall any liability be imposed against the Director, the Director's authorized representatives, or any examiner appointed by the Director for any statements made or conduct performed in good faith while carrying out the provisions of this Code. (b) No cause of action
- [Illinois-Insurance Fraud - Definition-720 ILCS 5/17-10.5 (Proposed Legislation)](https://insurancefraud.org/statutes/illinois-insurance-fraud-definition-720-ilcs-5-17-10-5-proposed-legislation/) - (a) Insurance fraud. (1) A person commits insurance fraud when he or she knowingly obtains, attempts to obtain, or causes to be obtained, by deception, control over the property of an insurance company or self-insured entity by the making of a false claim or by causing a false claim to be made on any policy
- [Illinois-Placing Bogus Coverage-n/a](https://insurancefraud.org/statutes/illinois-placing-bogus-coverage-n-a/) - No statute found
- [Illinois-Practitioner Penalites-720 ILCS 5/17-10.5 (Proposed Legislation)](https://insurancefraud.org/statutes/illinois-practitioner-penalites-720-ilcs-5-17-10-5-proposed-legislation/) - (g) Actions by State licensing agencies. (1) All State licensing agencies, the Illinois State Police, and the Department of Financial and Professional Regulation shall coordinate enforcement efforts relating to acts of insurance fraud. (2) If a person who is licensed or registered under the laws of the State of Illinois to engage in a business
- [Illinois-Range of Criminal Penalties-720 ILCS 5/17-10.5 (Proposed Legislation)](https://insurancefraud.org/statutes/illinois-range-of-criminal-penalties-720-ilcs-5-17-10-5-proposed-legislation/) - ¤ 17-10.5. Insurance fraud. (a) Insurance fraud. (1) A person commits insurance fraud when he or she knowingly obtains, attempts to obtain, or causes to be obtained, by deception, control over the property of an insurance company or self-insured entity by the making of a false claim or by causing a false claim to be
- [Illinois-Range of Civil Penalties-720 ILCS 5/17-10.5 (Proposed Legislation)](https://insurancefraud.org/statutes/illinois-range-of-civil-penalties-720-ilcs-5-17-10-5-proposed-legislation/) - (e) Civil damages for insurance fraud. (1) A person who knowingly obtains, attempts to obtain, or causes to be obtained, by deception, control over the property of any insurance company by the making of a false claim or by causing a false claim to be made on a policy of insurance issued by an insurance
- [Illinois-Rating of an Insurance Policy-n/a](https://insurancefraud.org/statutes/illinois-rating-of-an-insurance-policy-n-a/) - No statue found. Many provisions repealed.
- [Illinois-Unauthorized Entities-215 ILCS 5/121](https://insurancefraud.org/statutes/illinois-unauthorized-entities-215-ilcs-5-121/) - ¤ 121. Transacting Business Without Certificate of Authority Prohibited. (1) It shall be unlawful for any company to enter into a contract of insurance as an insurer or to transact insurance business in this State, without a certificate of authority from the Director; provided that this subsection shall not apply to contracts procured by agents
- [Idaho-Aiding & Abetting-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-aiding-abetting-i-c-¤-41-293/) - (b) Any person who, with intent to defraud or deceive an insurer assists, abets, solicits, or conspires with another to prepare or make any statement that is intended to be presented to any insurer, producer, practitioner or other person, in connection with, or in support of, any claim for payment or other benefit, knowing that
- [Idaho-Anti-Runner Provisions-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-anti-runner-provisions-i-c-¤-41-293/) - (i) Any practitioner or any other person who, with intent to defraud or deceive, employs, uses or acts as a runner for the purpose of submitting a claim containing false, incomplete, or misleading information concerning any fact or thing material to such claim;
- [Idaho-Attempted Fraud-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-attempted-fraud-i-c-¤-41-293/) - (b) Any person who, with intent to defraud or deceive an insurer assists, abets, solicits, or conspires with another to prepare or make any statement that is intended to be presented to any insurer, producer, practitioner or other person, in connection with, or in support of, any claim for payment or other benefit, knowing that
- [Idaho-Claims Fraud-I.C. ¤ 41-293*](https://insurancefraud.org/statutes/idaho-claims-fraud-i-c-¤-41-293/) - Insurance fraud includes: (1)(a) Any person who, with the intent to defraud or deceive an insurer for the purpose of obtaining any money or benefit, presents or causes to be presented to any insurer, producer, practitioner or other person, any statement as part of, or in support of, a claim for payment or other benefit,
- [Idaho-Failing to Remit Premium-I.C. ¤ 41-293*](https://insurancefraud.org/statutes/idaho-failing-to-remit-premium-i-c-¤-41-293/) - (d) Any insurance producer or other person who, with intent to defraud or deceive, willfully takes premium money knowing that insurance coverage will not be effected;
- [Idaho-Immunity-I.C. ¤ 41-292*](https://insurancefraud.org/statutes/idaho-immunity-i-c-¤-41-292/) - (1) The director of the department of insurance, state fire marshal or any authorized agency may, in writing, require the insurance company at interest to release to the requesting agency any or all relevant information or evidence deemed important to the authorized agency, director or state fire marshal which the company may have in its
- [Idaho-Insurance Fraud - Definition-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-insurance-fraud-definition-i-c-¤-41-293/) - Insurance fraud includes: (1)(a) Any person who, with the intent to defraud or deceive an insurer for the purpose of obtaining any money or benefit, presents or causes to be presented to any insurer, producer, practitioner or other person, any statement as part of, or in support of, a claim for payment or other benefit,
- [Idaho-Licensing Board Notification-I.C. ¤ 41-292*](https://insurancefraud.org/statutes/idaho-licensing-board-notification-i-c-¤-41-292/) - (1) The director of the department of insurance, state fire marshal or any authorized agency may, in writing, require the insurance company at interest to release to the requesting agency any or all relevant information or evidence deemed important to the authorized agency, director or state fire marshal which the company may have in its
- [Idaho-Looting & diverting-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-looting-diverting-i-c-¤-41-293/) - (g) Anyone who offers or accepts a direct or indirect inducement to file or solicits another person to file a false statement, with intent to defraud or deceive an insurer; (h) Any person who, with intent to defraud or deceive, transacts insurance of any kind or character, or transmits for a person other than himself
- [Idaho-Mandatory Restitution-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-mandatory-restitution-i-c-¤-41-293/) - (4) Any violator of this section is guilty of a felony and shall be subject to a term of imprisonment not to exceed fifteen (15) years, or a fine not to exceed fifteen thousand dollars ($15,000), or both and shall be ordered to make restitution to the insurer or any other person for any financial
- [Idaho-Placing Bogus Coverage-I.C. ¤ 41-293*](https://insurancefraud.org/statutes/idaho-placing-bogus-coverage-i-c-¤-41-293/) - (d) Any insurance producer or other person who, with intent to defraud or deceive, willfully takes premium money knowing that insurance coverage will not be effected; (e) Any practitioner or other person who willfully submits a false or altered statement, with the intent of deceiving an insurer or other person in connection with an insurance
- [Idaho-Practitioner Penalites-I.C. ¤ 41-117](https://insurancefraud.org/statutes/idaho-practitioner-penalites-i-c-¤-41-117/) - Each violation of this code for which a greater penalty is not provided by another provision of this code or by other applicable laws of this state, shall in addition to any applicable prescribed denial, suspension, or revocation of certificate of authority or license be punishable by an administrative penalty of not more than one
- [Idaho-Premium Fraud-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-premium-fraud-i-c-¤-41-293/) - (d) Any insurance producer or other person who, with intent to defraud or deceive, willfully takes premium money knowing that insurance coverage will not be effected;
- [Idaho-Range of Criminal Penalties-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-range-of-criminal-penalties-i-c-¤-41-293/) - (4) Any violator of this section is guilty of a felony and shall be subject to a term of imprisonment not to exceed fifteen (15) years, or a fine not to exceed fifteen thousand dollars ($15,000), or both and shall be ordered to make restitution to the insurer or any other person for any financial
- [Idaho-Range of Civil Penalties-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-range-of-civil-penalties-i-c-¤-41-293/) - (4) Any violator of this section is guilty of a felony and shall be subject to a term of imprisonment not to exceed fifteen (15) years, or a fine not to exceed fifteen thousand dollars ($15,000), or both and shall be ordered to make restitution to the insurer or any other person for any financial
- [Idaho-Rating of an Insurance Policy-I.C. ¤ 41-1437](https://insurancefraud.org/statutes/idaho-rating-of-an-insurance-policy-i-c-¤-41-1437/) - (1) As to all rates which are subject to this chapter, due consideration shall be given to past and prospective loss experience within and outside this state, to the conflagration and catastrophe hazards, to a reasonable margin for underwriting profit and contingencies, to dividends, savings or unabsorbed premium deposits allowed or returned by insurers to
- [Idaho-Underwriting Fraud-I.C. ¤ 41-293](https://insurancefraud.org/statutes/idaho-underwriting-fraud-i-c-¤-41-293/) - (d) Any insurance producer or other person who, with intent to defraud or deceive, willfully takes premium money knowing that insurance coverage will not be effected; (e) Any practitioner or other person who willfully submits a false or altered statement, with the intent of deceiving an insurer or other person in connection with an insurance
- [Idaho-Unauthorized Entities-I.C. ¤ 41-1201](https://insurancefraud.org/statutes/idaho-unauthorized-entities-i-c-¤-41-1201/) - (1) No person shall in this state directly or indirectly act as agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state, in the solicitation, negotiation, procurement or effectuation of insurance or annuity contracts, or renewal thereof, or forwarding of applications for
- [Hawaii-Aiding & Abetting-HRS ¤ 431:2-403](https://insurancefraud.org/statutes/hawaii-aiding-abetting-hrs-¤-4312-403/) - (a) A person commits the offense of insurance fraud if the person: (2) Intentionally or knowingly aids, agrees, or attempts to aid, solicit, or conspire with any person who engages in anunlawful act as defined under this section;
- [Hawaii-Attempted Fraud-HRS ¤ 431:2-403](https://insurancefraud.org/statutes/hawaii-attempted-fraud-hrs-¤-4312-403/) - (a) A person commits the offense of insurance fraud if the person: (2) Intentionally or knowingly aids, agrees, or attempts to aid, solicit, or conspire with any person who engages in anunlawful act as defined under this section;
- [Hawaii-Claims Fraud-HRS ¤ 431:2-403](https://insurancefraud.org/statutes/hawaii-claims-fraud-hrs-¤-4312-403/) - (a) A person commits the offense of insurance fraud if the person: (1) Intentionally or knowingly misrepresents or conceals material facts, opinions, intention, or law to obtain or attempt to obtain coverage, benefits, recovery, or compensation: (B) When presenting, or causing or permitting to be presented, false information on a claim for payment; (C) When
- [Hawaii-Fraud Bureau-HRS ¤ 431:2-402](https://insurancefraud.org/statutes/hawaii-fraud-bureau-hrs-¤-4312-402/) - (a) There is established in the insurance division the insurance fraud investigations branch for the purposes set forth in this part. (b) The branch shall: (1) Conduct a statewide program for the prevention of insurance fraud under title 24, including chapters 431, 432, and 432D; provided that the branch shall not have jurisdiction over workers'
- [Hawaii-Immunity-HRS ¤ 431:2-301.8](https://insurancefraud.org/statutes/hawaii-immunity-hrs-¤-4312-301-8/) - (a) No cause of action shall arise nor shall any liability be imposed against any examiner appointed or otherwise designated as an examiner by the commissioner for any statements made or conduct performed in good faith while carrying out the provisions of the insurance code. (b) No cause of action shall arise, nor shall any
- [Hawaii-Insurance Fraud - Definition-HRS ¤ 431:2-403](https://insurancefraud.org/statutes/hawaii-insurance-fraud-definition-hrs-¤-4312-403/) - (a) A person commits the offense of insurance fraud if the person: (1) Intentionally or knowingly misrepresents or conceals material facts, opinions, intention, or law to obtain or attempt to obtain coverage, benefits, recovery, or compensation: (A) When presenting, or causing or permitting to be presented, an application, whether written, typed, or transmitted through electronic
- [Hawaii-Licensing Board Notification-HRS ¤ 431:2-409](https://insurancefraud.org/statutes/hawaii-licensing-board-notification-hrs-¤-4312-409/) - (a) Within sixty days of an insurer or other licensee's employee or agent discovering credible information indicating a violation of section 431:2-403, or as soon thereafter as practicable, the insurer or licensee shall provide to the branch information, including documents and other evidence, regarding the alleged violation of section 431:2-403. The insurance fraud investigations branch
- [Hawaii-Mandatory Restitution-HRS ¤ 431:2-404](https://insurancefraud.org/statutes/hawaii-mandatory-restitution-hrs-¤-4312-404/) - Any person convicted under this part shall be ordered by a court to make restitution to any insurer, person, or licensee for any financial loss sustained by that insurer, person, or licensee that was caused by the act or acts for which the person was convicted.
- [Hawaii-Placing Bogus Coverage-HRS ¤ 431:2-403*](https://insurancefraud.org/statutes/hawaii-placing-bogus-coverage-hrs-¤-4312-403/) - (a) A person commits the offense of insurance fraud if the person: (1) Intentionally or knowingly misrepresents or conceals material facts, opinions, intention, or law to obtain or attempt to obtain coverage, benefits, recovery, or compensation: (A) When presenting, or causing or permitting to be presented, an application, whether written, typed, or transmitted through electronic
- [Hawaii-Premium Fraud-HRS ¤ 431:2-403*](https://insurancefraud.org/statutes/hawaii-premium-fraud-hrs-¤-4312-403/) - (a) A person commits the offense of insurance fraud if the person: (1) Intentionally or knowingly misrepresents or conceals material facts, opinions, intention, or law to obtain or attempt to obtain coverage, benefits, recovery, or compensation: (A) When presenting, or causing or permitting to be presented, an application, whether written, typed, or transmitted through electronic
- [Hawaii-Range of Criminal Penalties-HRS ¤ 431:2-403](https://insurancefraud.org/statutes/hawaii-range-of-criminal-penalties-hrs-¤-4312-403/) - (b) Violation of subsection (a) is a criminal offense and shall constitute: (1) A class B felony if the value of the benefits, recovery, or compensation obtained or attempted to be obtained exceeds $20,000; (2) A class C felony if the value of the benefits, recovery, or compensation obtained or attempted to be obtained exceeds
- [Hawaii-Range of Civil Penalties-HRS ¤ 431:2-405](https://insurancefraud.org/statutes/hawaii-range-of-civil-penalties-hrs-¤-4312-405/) - (a) In addition to or in lieu of criminal penalties under section 431:2-403(b), any person who commits insurance fraud as defined under section 431:2-403, may be subject to the administrative penalties in this section. (b) If a person is found to have knowingly committed insurance fraud under this part, the commissioner may assess any or
- [Hawaii-Rating of an Insurance Policy-HRS ¤ 431:14-103](https://insurancefraud.org/statutes/hawaii-rating-of-an-insurance-policy-hrs-¤-43114-103/) - (a) Rates shall be made in accordance with the following provisions: (1) Rates shall not be excessive, inadequate, or unfairly discriminatory. (2) Due consideration shall be given to: (A) Past and prospective loss experience within and outside this State; provided that if the claim does not exceed the selected deductible amount pursuant to section 386-100,
- [Hawaii-Unauthorized Entities-HRS ¤ 431:8-201](https://insurancefraud.org/statutes/hawaii-unauthorized-entities-hrs-¤-4318-201/) - It shall be unlawful for any insurer to transact an insurance business in this State, as defined in section 431:1-215, without a certificate of authority; provided that this section shall not apply to: (1) The lawful transaction of surplus lines insurance; (2) The lawful transaction of reinsurance by insurers; (3) Transactions in this State involving
- [Georgia-Aiding & Abetting-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-aiding-abetting-ga-code-ann-¤-33-1-9/) - (a) Any natural person who knowingly or willfully: (1) Makes or aids in the making of any false or fraudulent statement or representation of any material fact or thing: (A) In any written statement or certificate; (B) In the filing of a claim; (C) In the making of an application for a policy of insurance;
- [Georgia-Claims Fraud-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-claims-fraud-ga-code-ann-¤-33-1-9/) - (a) Any natural person who knowingly or willfully: (1) Makes or aids in the making of any false or fraudulent statement or representation of any material fact or thing: (A) In any written statement or certificate; (B) In the filing of a claim; (C) In the making of an application for a policy of insurance;
- [Georgia-Immunity-Ga. Code Ann., ¤ 33-39-22; ¤ 33-1-16](https://insurancefraud.org/statutes/georgia-immunity-ga-code-ann-¤-33-39-22-¤-33-1-16/) - No cause of action in the nature of defamation, invasion of privacy, or negligence shall arise against any person for disclosing personal or privileged information in accordance with this chapter, nor shall such a cause of action arise against any person for furnishing personal or privileged information to an insurance institution, agent, or insurance-support organization;
- [Georgia-Insurance Fraud - Definition-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-insurance-fraud-definition-ga-code-ann-¤-33-1-9/) - (a) Any natural person who knowingly or willfully: (1) Makes or aids in the making of any false or fraudulent statement or representation of any material fact or thing: (A) In any written statement or certificate; (B) In the filing of a claim; (C) In the making of an application for a policy of insurance;
- [Georgia-Licensing Board Notification-n/a](https://insurancefraud.org/statutes/georgia-licensing-board-notification-n-a/) - No Statute found
- [Georgia-Looting & diverting-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-looting-diverting-ga-code-ann-¤-33-1-9/) - (a) Any natural person who knowingly or willfully: (1) Makes or aids in the making of any false or fraudulent statement or representation of any material fact or thing: (A) In any written statement or certificate; (B) In the filing of a claim; (C) In the making of an application for a policy of insurance;
- [Georgia-Placing Bogus Coverage-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-placing-bogus-coverage-ga-code-ann-¤-33-1-9/) - (b) Any natural person who knowingly and willfully or with reckless disregard engages in the following activities, either directly or indirectly, as an agent for, as a representative of, or on behalf of an insurer not authorized to transact insurance in this state commits the crime of insurance fraud: (1) Soliciting, negotiating, procuring, or effectuating
- [Georgia-Practitioner Penalites-Ga. Code Ann., ¤ 33-1-7 (Proposed legislation)](https://insurancefraud.org/statutes/georgia-practitioner-penalites-ga-code-ann-¤-33-1-7-proposed-legislation/) - Any insurer, or any officer or agent thereof, issuing or delivering to any person in this state any policy in violation of any provision of this title shall be guilty of a misdemeanor.
- [Georgia-Premium Fraud-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-premium-fraud-ga-code-ann-¤-33-1-9/) - (a) Any natural person who knowingly or willfully: (1) Makes or aids in the making of any false or fraudulent statement or representation of any material fact or thing: (A) In any written statement or certificate; (B) In the filing of a claim; (C) In the making of an application for a policy of insurance;
- [Georgia-Range of Criminal Penalties-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-range-of-criminal-penalties-ga-code-ann-¤-33-1-9/) - (e) A natural person convicted of a violation of this Code section shall be guilty of a felony and shall be punished by imprisonment for not less than two nor more than ten years, or by a fine of not more than $10,000.00, or both.
- [Georgia-Range of Civil Penalties-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-range-of-civil-penalties-ga-code-ann-¤-33-1-9/) - (e) A natural person convicted of a violation of this Code section shall be guilty of a felony and shall be punished by imprisonment for not less than two nor more than ten years, or by a fine of not more than $10,000.00, or both.
- [Georgia-Rating of an Insurance Policy-Ga. Code Ann., ¤ 33-9-4 (Proposed legislation)](https://insurancefraud.org/statutes/georgia-rating-of-an-insurance-policy-ga-code-ann-¤-33-9-4-proposed-legislation/) - The following standards shall apply to the making and use of rates pertaining to all classes of insurance to which this chapter is applicable: (1) Rates shall not be excessive or inadequate, as defined in this Code section, nor shall they be unfairly discriminatory; (2) No rate shall be held to be excessive unless such
- [Georgia-Underwriting Fraud-Ga. Code Ann., ¤ 33-1-9](https://insurancefraud.org/statutes/georgia-underwriting-fraud-ga-code-ann-¤-33-1-9/) - (b) Any natural person who knowingly and willfully or with reckless disregard engages in the following activities, either directly or indirectly, as an agent for, as a representative of, or on behalf of an insurer not authorized to transact insurance in this state commits the crime of insurance fraud: (1) Soliciting, negotiating, procuring, or effectuating
- [Georgia-Unauthorized Entities-Ga. Code Ann., ¤ 33-5-1](https://insurancefraud.org/statutes/georgia-unauthorized-entities-ga-code-ann-¤-33-5-1/) - (a) No person in this state shall: (1) Represent an insurer who is not at the time duly authorized to transact insurance in this state in the solicitation, negotiation, or effectuation of insurance, inspection of risks, fixing of rates, investigation or adjustment of losses, collection of premiums, or in any other manner in the transaction
- [Florida-Claims Fraud-West's F.S.A. ¤ 817.234*](https://insurancefraud.org/statutes/florida-claims-fraud-wests-f-s-a-¤-817-234/) - (1)(a) A person commits insurance fraud punishable as provided in subsection (11) if that person, with the intent to injure, defraud, or deceive any insurer: 1. Presents or causes to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to an insurance
- [Florida-Fraud Bureau-West's F.S.A. ¤ 626.989](https://insurancefraud.org/statutes/florida-fraud-bureau-wests-f-s-a-¤-626-989/) - Investigation by department or Division of Insurance Fraud; compliance; immunity; confidential information; reports to division; division investigator's power of arrest (1) For the purposes of this section, a person commits a "fraudulent insurance act" if the person knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that
- [Florida-Immunity-West's F.S.A. ¤ 626.989](https://insurancefraud.org/statutes/florida-immunity-wests-f-s-a-¤-626-989/) - 4) (c) In the absence of fraud or bad faith, a person is not subject to civil liability for libel, slander, or any other relevant tort by virtue of filing reports, without malice, or furnishing other information, without malice, required by this section or required by the department or division under the authority granted in
- [Florida-Insurance Fraud - Definition-West's F.S.A. ¤ 817.234](https://insurancefraud.org/statutes/florida-insurance-fraud-definition-wests-f-s-a-¤-817-234/) - (1)(a) A person commits insurance fraud punishable as provided in subsection (11) if that person, with the intent to injure, defraud, or deceive any insurer: 1. Presents or causes to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to an insurance
- [Florida-Licensing Board Notification-West's F.S.A. ¤ 626.989](https://insurancefraud.org/statutes/florida-licensing-board-notification-wests-f-s-a-¤-626-989/) - Investigation by department or Division of Insurance Fraud; compliance; immunity; confidential information; reports to division; division investigator's power of arrest (1) For the purposes of this section, a person commits a "fraudulent insurance act" if the person knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that
- [Florida-Mandatory Restitution-West's F.S.A. ¤ 817.234](https://insurancefraud.org/statutes/florida-mandatory-restitution-wests-f-s-a-¤-817-234/) - (5) Any insurer damaged as a result of a violation of any provision of this section when there has been a criminal adjudication of guilt shall have a cause of action to recover compensatory damages, plus all reasonable investigation and litigation expenses, including attorneys' fees, at the trial and appellate courts.
- [Florida-Placing Bogus Coverage-West's F.S.A. ¤ 817.234*](https://insurancefraud.org/statutes/florida-placing-bogus-coverage-wests-f-s-a-¤-817-234/) - (1)(a) A person commits insurance fraud punishable as provided in subsection (11) if that person, with the intent to injure, defraud, or deceive any insurer: 1. Presents or causes to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to an insurance
- [Florida-Practitioner Penalites-West's F.S.A. ¤ 817.234](https://insurancefraud.org/statutes/florida-practitioner-penalites-wests-f-s-a-¤-817-234/) - (2)(a) Any physician licensed under chapter 458, osteopathic physician licensed under chapter 459, chiropractic physician licensed under chapter 460, or other practitioner licensed under the laws of this state who knowingly and willfully assists, conspires with, or urges any insured party to fraudulently violate any of the provisions of this section or part XI of
- [Florida-Range of Criminal Penalties-West's F.S.A. ¤ 817.234](https://insurancefraud.org/statutes/florida-range-of-criminal-penalties-wests-f-s-a-¤-817-234/) - (11) If the value of any property involved in a violation of this section: (a) Is less than $20,000, the offender commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Is $20,000 or more, but less than $100,000, the offender commits a felony of the
- [Florida-Range of Civil Penalties-West's F.S.A. ¤ 817.234](https://insurancefraud.org/statutes/florida-range-of-civil-penalties-wests-f-s-a-¤-817-234/) - (12) In addition to any criminal liability, a person convicted of violating any provision of this section for the purpose of receiving insurance proceeds from a motor vehicle insurance contract is subject to a civil penalty. (a) Except for a violation of subsection (9), the civil penalty shall be: 1. A fine up to $5,000
- [Florida-Rating of an Insurance Policy-West's F.S.A. ¤ 627.062](https://insurancefraud.org/statutes/florida-rating-of-an-insurance-policy-wests-f-s-a-¤-627-062/) - (1) The rates for all classes of insurance to which the provisions of this part are applicable may not be excessive, inadequate, or unfairly discriminatory. (2) As to all such classes of insurance: (a) Insurers or rating organizations shall establish and use rates, rating schedules, or rating manuals that allow the insurer a reasonable rate
- [Florida-Unauthorized Entities-West's F.S.A. ¤ 624.401](https://insurancefraud.org/statutes/florida-unauthorized-entities-wests-f-s-a-¤-624-401/) - (1) No person shall act as an insurer, and no insurer or its agents, attorneys, subscribers, or representatives shall directly or indirectly transact insurance, in this state except as authorized by a subsisting certificate of authority issued to the insurer by the office, except as to such transactions as are expressly otherwise provided for in
- [District of Columbia-Anti-Runner Provisions-DC ST ¤ 22-3225.02](https://insurancefraud.org/statutes/district-of-columbia-anti-runner-provisions-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Claims Fraud-DC ST ¤ 22-3225.02](https://insurancefraud.org/statutes/district-of-columbia-claims-fraud-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Failing to Remit Premium-DC ST ¤ 22-3225.02](https://insurancefraud.org/statutes/district-of-columbia-failing-to-remit-premium-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Fraud Bureau-DC ST ¤ 31-103](https://insurancefraud.org/statutes/district-of-columbia-fraud-bureau-dc-st-¤-31-103/) - (a) The functions and duties contained and referenced herein are transferred to the Department and shall be performed by the following major organizational components of the Department. (1) All duties and responsibilities in respect to the regulation of life and health and property and casualty insurance, insurers, and health maintenance organizations that heretofore have been
- [District of Columbia-Immunity-DC ST ¤ 22-3225.13](https://insurancefraud.org/statutes/district-of-columbia-immunity-dc-st-¤-22-3225-13/) - No person shall be subject to civil liability or criminal prosecution for reporting any suspected insurance fraud if: (1) The report was made to: (A) The Department of Insurance, Securities, and Banking, the Metropolitan Police Department, or any other law enforcement authority; or (B) Any insurer, insurance agent, or other person who collects, reviews, or
- [District of Columbia-Insurance Fraud - Definition-](https://insurancefraud.org/statutes/district-of-columbia-insurance-fraud-definition/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Licensing Board Notification-DC ST ¤ 22-3225.08](https://insurancefraud.org/statutes/district-of-columbia-licensing-board-notification-dc-st-¤-22-3225-08/) - (a) Based upon a reasonable belief, an insurer, insurance professional, and any other pertinent person, shall report to the Metropolitan Police Department or the Department of Insurance, Securities, and Banking, actions that may constitute the commission of insurance fraud, and assist in the investigation of insurance fraud by reasonably providing information when required by an
- [District of Columbia-Looting & diverting-DC ST ¤ 22-3225.02](https://insurancefraud.org/statutes/district-of-columbia-looting-diverting-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Mandatory Restitution-DC ST ¤ 22-3225.05](https://insurancefraud.org/statutes/district-of-columbia-mandatory-restitution-dc-st-¤-22-3225-05/) - (a) In addition to the penalties provided under ¤ 22-3225.04, a person convicted under this subchapter shall make monetary restitution for any loss caused by the offense. The court shall determine the form and method of payment which, if by installment, shall not exceed 5 years. (b) Any person, including the District, injured as the
- [District of Columbia-Placing Bogus Coverage-DC ST ¤ 22-3225.02*](https://insurancefraud.org/statutes/district-of-columbia-placing-bogus-coverage-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Practitioner Penalites-DC ST ¤ 22-3225.07](https://insurancefraud.org/statutes/district-of-columbia-practitioner-penalites-dc-st-¤-22-3225-07/) - (a) Notwithstanding any other provisions of law, the offenses of insurance fraud in the first degree or the second degree shall be deemed a crime of moral turpitude for the purposes of professional or trade license. (b) The Commissioner, court, or prosecutor shall notify the appropriate licensing authority, and the person who is injured by
- [District of Columbia-Premium Fraud-DC ST ¤ 22-3225.02](https://insurancefraud.org/statutes/district-of-columbia-premium-fraud-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Range of Criminal Penalties-DC ST ¤ 22-3225.04; DC ST ¤ 22-3571.01](https://insurancefraud.org/statutes/district-of-columbia-range-of-criminal-penalties-dc-st-¤-22-3225-04-dc-st-¤-22-3571-01/) - (a) Any person convicted of insurance fraud in the first degree shall be fined not more than the amount set forth in ¤ 22-3571.01 or imprisoned for not more than 15 years, or both. (b)(1) Except as provided in paragraph (2) of this subsection, any person convicted of insurance fraud in the second degree shall
- [District of Columbia-Range of Civil Penalties-DC ST ¤ 22-3225.04.](https://insurancefraud.org/statutes/district-of-columbia-range-of-civil-penalties-dc-st-¤-22-3225-04/) - a) Any person convicted of insurance fraud in the first degree shall be fined not more than the amount set forth in ¤ 22-3571.01 or imprisoned for not more than 15 years, or both. (b) (1) Except as provided in paragraph (2) of this subsection, any person convicted of insurance fraud in the second degree
- [District of Columbia-Rating of an Insurance Policy-DC ST ¤ 31-2703](https://insurancefraud.org/statutes/district-of-columbia-rating-of-an-insurance-policy-dc-st-¤-31-2703/) - (a) Rates for insurance within the scope of this chapter shall not be excessive, inadequate, or unfairly discriminatory. (b) Due consideration shall be given to past and prospective loss experience within and outside the District, to physical hazards, to safety and loss prevention factors, to underwriting practice and judgment, to catastrophe hazards, if any, to
- [District of Columbia-Underwriting Fraud-DC ST ¤ 22-3225.02*](https://insurancefraud.org/statutes/district-of-columbia-underwriting-fraud-dc-st-¤-22-3225-02/) - A person commits the offense of insurance fraud in the first degree if that person knowingly engages in the following conduct with the intent to defraud or to fraudulently obtain property of another and thereby obtains property of another or causes another to lose property and the value of the property obtained or lost is
- [District of Columbia-Unauthorized Entities-DC ST ¤ 31-231 (Proposed legislation)](https://insurancefraud.org/statutes/district-of-columbia-unauthorized-entities-dc-st-¤-31-231-proposed-legislation/) - No person shall act as an insurer, or engage in any other activity, directly or indirectly, which is regulated in acts codified in Chapters 1 through 55 of this title unless performed within the scope of a certificate of authority issued by the Commissioner as provided by this chapter. The prohibitions in this chapter shall
- [Delaware-Aiding & Abetting-18 Del.C. ¤ 2407](https://insurancefraud.org/statutes/delaware-aiding-abetting-18-del-c-¤-2407/) - (a) It shall be a fraudulent insurance act for a person to knowingly, by act or omission, with intent to injure, defraud or deceive: (3) Assist, abet, solicit or conspire with another to prepare or present any oral or written statement, including computer-generated documents, that is intended to be presented to any insurer in connection
- [Delaware-Attempted Fraud-n/a](https://insurancefraud.org/statutes/delaware-attempted-fraud-n-a/) - No statute found
- [Delaware-Claims Fraud-18 Del.C. ¤ 2407](https://insurancefraud.org/statutes/delaware-claims-fraud-18-del-c-¤-2407/) - (a) It shall be a fraudulent insurance act for a person to knowingly, by act or omission, with intent to injure, defraud or deceive: (2) Prepare, present or cause to be presented to any insurer, any oral or written statement including computer-generated documents as part of, or in support of, a claim for payment or
- [Delaware-Fraud Bureau-18 Del.C. ¤ 2404](https://insurancefraud.org/statutes/delaware-fraud-bureau-18-del-c-¤-2404/) - (a) The Delaware Insurance Fraud Prevention Bureau is hereby established within the Department of Insurance and authorized to employ investigators and appropriate support staff as is necessary to carry out its mandate. (b) The Commissioner shall appoint the full-time supervisory and investigative personnel of the Bureau including the Director and Chief Investigator, who shall hold
- [Delaware-Immunity-18 Del.C. ¤ 2409](https://insurancefraud.org/statutes/delaware-immunity-18-del-c-¤-2409/) - In the absence of fraud or bad faith, no person shall be subject to civil liability (for libel, slander or any other relevant tort cause of action by virtue of filing reports, without malice, or furnishing other information, written or oral, without malice, required by this chapter or required by the Commissioner under the authority
- [Delaware-Insurance Fraud - Definition-18 Del.C. ¤ 2407](https://insurancefraud.org/statutes/delaware-insurance-fraud-definition-18-del-c-¤-2407/) - (a) It shall be a fraudulent insurance act for a person to knowingly, by act or omission, with intent to injure, defraud or deceive: (1) Present, cause to be presented, prepare, assist, abet, solicit or conspire with another to prepare or make any oral or written statement with knowledge or belief that it will be
- [Delaware-Mandatory Restitution-18 Del.C. ¤ 2411](https://insurancefraud.org/statutes/delaware-mandatory-restitution-18-del-c-¤-2411/) - (d) Any person who is found to have committed an act of insurance fraud, or violated an order of the Commissioner pursuant to a hearing, shall be liable for costs incurred by the Bureau. The assessment for costs shall be 15% of each penalty assessed pursuant to this section. (e) In addition to the above,
- [Delaware-Placing Bogus Coverage-18 Del.C. ¤ 2407](https://insurancefraud.org/statutes/delaware-placing-bogus-coverage-18-del-c-¤-2407/) - (c) It shall be a fraudulent insurance act for any insurer or any person acting on behalf of such insurer to knowingly, by act or omission, with intent to injure, defraud or deceive: (1) Present or cause to be presented to an insurance claimant false, incomplete or misleading information regarding the nature, extent and terms
- [Delaware-Practitioner Penalites-18 Del.C. ¤ 4507](https://insurancefraud.org/statutes/delaware-practitioner-penalites-18-del-c-¤-4507/) - (a) The Commissioner shall have the power to examine and investigate the activities of any person that the Commissioner reasonably believes has been or is engaged in an act or practice prohibited by this chapter. (b) The Commissioner shall have the power to enforce the provisions of this chapter, including the authority to issue orders
- [Delaware-Premium Fraud-18 Del.C. ¤ 2407*](https://insurancefraud.org/statutes/delaware-premium-fraud-18-del-c-¤-2407/) - (a) It shall be a fraudulent insurance act for a person to knowingly, by act or omission, with intent to injure, defraud or deceive: (1) Present, cause to be presented, prepare, assist, abet, solicit or conspire with another to prepare or make any oral or written statement with knowledge or belief that it will be
- [Delaware-Range of Criminal Penalties-11 Del.C. ¤ 913 (Proposed)](https://insurancefraud.org/statutes/delaware-range-of-criminal-penalties-11-del-c-¤-913-proposed/) - Insurance fraud is a class G felony. (b) All insurance claims forms shall contain a statement that clearly states in substance the following: "Any person who knowingly, and with intent to injure, defraud or deceive any insurer, files a statement of claim containing any false, incomplete or misleading information is guilty of a felony." The
- [Delaware-Range of Civil Penalties-18 Del.C. ¤ 2411](https://insurancefraud.org/statutes/delaware-range-of-civil-penalties-18-del-c-¤-2411/) - (a) The matters of enforcement, investigations, hearings, administrative penalties and appeals shall be conducted in accordance with Chapter 3 of this title and Chapter 101 of Title 29 to the extent that such provisions are not in conflict with the provisions set forth in this chapter. (b) Upon a showing by a preponderance of evidence
- [Delaware-Rating of an Insurance Policy-18 Del.C. ¤ 2503](https://insurancefraud.org/statutes/delaware-rating-of-an-insurance-policy-18-del-c-¤-2503/) - (a) Rates shall be made in accordance with the following provisions: (1) Manual, minimum, class rates, rating schedules or rating plans shall be made and adopted, except in the case of specific inland marine rates on risks specially rated; (2) Rates shall not be excessive, inadequate or unfairly discriminatory; (3) Due consideration shall be given:
- [Delaware-Underwriting Fraud-18 Del.C. ¤ 2407](https://insurancefraud.org/statutes/delaware-underwriting-fraud-18-del-c-¤-2407/) - (c) It shall be a fraudulent insurance act for any insurer or any person acting on behalf of such insurer to knowingly, by act or omission, with intent to injure, defraud or deceive: (1) Present or cause to be presented to an insurance claimant false, incomplete or misleading information regarding the nature, extent and terms
- [Delaware-Unauthorized Entities-18 Del.C. ¤ 2101](https://insurancefraud.org/statutes/delaware-unauthorized-entities-18-del-c-¤-2101/) - (a) No person shall in this State directly or indirectly act as agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such business in this State in the solicitation, negotiation, procurement or effectuation of insurance or annuity contracts, or renewal thereof, or forwarding of applications for
- [Connecticut-Aiding & Abetting-C.G.S.A. ¤ 53a-215](https://insurancefraud.org/statutes/connecticut-aiding-abetting-c-g-s-a-¤-53a-215/) - (a) A person is guilty of insurance fraud when the person, with the intent to injure, defraud or deceive any insurance company: (2) assists, abets, solicits, or conspires with another to prepare or make any written or oral statement that is intended to be presented to any insurance company in connection with, or in support
- [Connecticut-Anti-Runner Provisions-n/a](https://insurancefraud.org/statutes/connecticut-anti-runner-provisions-n-a/) - No statute found. Proposed legislation under HB 6642
- [Connecticut-Claims Fraud-C.G.S.A. ¤ 53a-215](https://insurancefraud.org/statutes/connecticut-claims-fraud-c-g-s-a-¤-53a-215/) - (a) A person is guilty of insurance fraud when the person, with the intent to injure, defraud or deceive any insurance company: (1) Presents or causes to be presented to any insurance company, any written or oral statement including computer-generated documents as part of, or in support of, any application for any policy of insurance
- [Connecticut-Failing to Remit Premium-C.G.S.A. ¤ 38a-712](https://insurancefraud.org/statutes/connecticut-failing-to-remit-premium-c-g-s-a-¤-38a-712/) - (a) Each insurance company authorized or permitted to do business in this state and each residual market mechanism established pursuant to section 38a-329 shall report to the Insurance Commissioner (1) any failure on the part of an insurance producer or surplus lines broker to remit premiums for policies or endorsements issued to insureds directly or
- [Connecticut-Immunity-C.G.S.A. ¤ 38a-318a](https://insurancefraud.org/statutes/connecticut-immunity-c-g-s-a-¤-38a-318a/) - (a) Notwithstanding any provision of the general statutes, each insurer authorized to issue policies of liability insurance in the state shall, upon the filing of any claim for damages because of bodily injury or death for a resident of this state, provide notice of such claim to the Commissioner of Administrative Services for the purposes
- [Connecticut-Insurance Fraud - Definition-C.G.S.A. ¤ 53a-215](https://insurancefraud.org/statutes/connecticut-insurance-fraud-definition-c-g-s-a-¤-53a-215/) - (a) A person is guilty of insurance fraud when the person, with the intent to injure, defraud or deceive any insurance company: (1) Presents or causes to be presented to any insurance company, any written or oral statement including computer-generated documents as part of, or in support of, any application for any policy of insurance
- [Connecticut-Mandatory Restitution-C.G.S.A. ¤ 53-443](https://insurancefraud.org/statutes/connecticut-mandatory-restitution-c-g-s-a-¤-53-443/) - Any person who violates any provision of sections 53-440 to 53-443, inclusive, shall be subject to the penalties for larceny under sections 53a-122 to 53a-125b, inclusive. Each act shall be considered a separate offense. In addition to any fine or term of imprisonment imposed, including any order of probation, any such person shall make restitution
- [Connecticut-Placing Bogus Coverage-C.G.S.A. ¤ 38a-275.](https://insurancefraud.org/statutes/connecticut-placing-bogus-coverage-c-g-s-a-¤-38a-275/) - Contracts entered into by unauthorized insurers are unenforceable. Any contract effective in this state and entered into by an unauthorized insurer in violation of sections 38a-27 and 38a-271 to 38a-278, inclusive, shall be unenforceable by such insurer. If any such unauthorized insurer fails to pay any claim or loss within the provisions of such insurance
- [Connecticut-Premium Fraud-C.G.S.A. ¤ 53a-215](https://insurancefraud.org/statutes/connecticut-premium-fraud-c-g-s-a-¤-53a-215/) - (a) A person is guilty of insurance fraud when the person, with the intent to injure, defraud or deceive any insurance company: (1) Presents or causes to be presented to any insurance company, any written or oral statement including computer-generated documents as part of, or in support of, any application for any policy of insurance
- [Connecticut-Range of Criminal Penalties-C.G.S.A. ¤ 53a-215](https://insurancefraud.org/statutes/connecticut-range-of-criminal-penalties-c-g-s-a-¤-53a-215/) - (d) Insurance fraud is a class D felony.
- [Connecticut-Range of Civil Penalties-C.G.S.A. ¤ 38a-2.](https://insurancefraud.org/statutes/connecticut-range-of-civil-penalties-c-g-s-a-¤-38a-2/) - Any person or corporation violating any provision of this title for the violation of which no other penalty is provided shall be fined not more than fifteen thousand dollars.
- [Connecticut-Rating of an Insurance Policy-C.G.S.A. ¤ 38a-668 C.G.S.A. ¤ 38a-668](https://insurancefraud.org/statutes/connecticut-rating-of-an-insurance-policy-c-g-s-a-¤-38a-668-c-g-s-a-¤-38a-668/) - Members and subscribers of rating or advisory organizations may use the rates, rating systems, underwriting rules or policy or bond form of such organizations, either consistently or intermittently, but, except as provided in sections 38a-667, 38a-670 and 38a-672, shall not agree with each other or rating organizations or others to adhere thereto. The fact that
- [Connecticut-Unauthorized Entities-C.G.S.A. ¤ 38a-278](https://insurancefraud.org/statutes/connecticut-unauthorized-entities-c-g-s-a-¤-38a-278/) - (a) Any unauthorized insurer who does any act of an insurance business as set forth in section 38a-271 shall be fined not more than fifty thousand dollars. (b) In addition to the penalty provided in subsection (a) of this section or otherwise provided by law, any person or insurer violating section 38a-27 or 38a-271 to
- [Colorado-Claims Fraud-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-claims-fraud-c-r-s-a-¤-18-5-211/) - (1) A person commits insurance fraud if the person does any of the following: (b) With an intent to defraud presents or causes to be presented any insurance claim, which claim contains false material information or withholds material information; (d) With an intent to defraud presents or causes to be presented an insurance claim where
- [Colorado-Failing to Remit Premium-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-failing-to-remit-premium-c-r-s-a-¤-18-5-211/) - (2) A person commits insurance fraud if he or she knowingly moves, diverts, or misappropriates premium funds belonging to an insurer or unearned premium funds belonging to an insured or applicant for insurance from a trust or other account without the authorization of the owner of the funds or other lawful justification.
- [Colorado-Fraud Bureau-C.R.S.A. ¤ 24-31-104.5](https://insurancefraud.org/statutes/colorado-fraud-bureau-c-r-s-a-¤-24-31-104-5/) - (1) (a) For the purpose of providing adequate funds to the Colorado department of law for the investigation and prosecution of allegations of insurance fraud, in addition to any other fee collected pursuant to section 10-3-207 (1), C.R.S., each entity regulated by the division of insurance shall pay to the division a nonrefundable annual fee.
- [Colorado-Immunity-C.R.S.A. ¤ 10-1-128; C.R.S.A. ¤ 10-4-1005](https://insurancefraud.org/statutes/colorado-immunity-c-r-s-a-¤-10-1-128-c-r-s-a-¤-10-4-1005/) - (4)(a) Each insurance company licensed to do business in this state that, in a lawsuit involving a fraudulent insurance act, obtains a judgment or settlement against a person who is licensed by the state of Colorado and whose services are compensated in whole or in part, directly or indirectly, by insurance claim proceeds shall send
- [Colorado-Insurance Fraud - Definition-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-insurance-fraud-definition-c-r-s-a-¤-18-5-211/) - (1) A person commits insurance fraud if the person does any of the following: (a) With an intent to defraud presents or causes to be presented in written, verbal, or digital form an application or request for the issuance, modification, or renewal of an insurance policy, which application or request, or documentation in support of
- [Colorado-Licensing Board Notification-C.R.S.A. ¤ 10-1-128](https://insurancefraud.org/statutes/colorado-licensing-board-notification-c-r-s-a-¤-10-1-128/) - (4)(a) Each insurance company licensed to do business in this state that, in a lawsuit involving a fraudulent insurance act, obtains a judgment or settlement against a person who is licensed by the state of Colorado and whose services are compensated in whole or in part, directly or indirectly, by insurance claim proceeds shall send
- [Colorado-Looting & diverting-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-looting-diverting-c-r-s-a-¤-18-5-211/) - (2) A person commits insurance fraud if he or she knowingly moves, diverts, or misappropriates premium funds belonging to an insurer or unearned premium funds belonging to an insured or applicant for insurance from a trust or other account without the authorization of the owner of the funds or other lawful justification.
- [Colorado-Mandatory Restitution-C.R.S.A. ¤ 10-3-105](https://insurancefraud.org/statutes/colorado-mandatory-restitution-c-r-s-a-¤-10-3-105/) - (4)(a) The commissioner may order an insurer to pay restitution to a person, if, after notice to the insurer and after a hearing held in accordance with sections 24-4-104 and 24-4-105, C.R.S., the commissioner finds that the insurer has violated this title or that the insurer is financially responsible for the unfair business practices of
- [Colorado-Placing Bogus Coverage-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-placing-bogus-coverage-c-r-s-a-¤-18-5-211/) - (1) A person commits insurance fraud if the person does any of the following: (d) With an intent to defraud presents or causes to be presented an insurance claim where the loss or damage claimed occurred outside of the period of time that coverage was in effect for the applicable contract of insurance or policy
- [Colorado-Practitioner Penalites-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-practitioner-penalites-c-r-s-a-¤-18-5-211/) - (5) The commissioner of insurance shall revoke the license to conduct business in this state of any licensed insurance producer under article 2 of title 10, C.R.S., who is convicted of any provision under this section.
- [Colorado-Premium Fraud-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-premium-fraud-c-r-s-a-¤-18-5-211/) - (2) A person commits insurance fraud if he or she knowingly moves, diverts, or misappropriates premium funds belonging to an insurer or unearned premium funds belonging to an insured or applicant for insurance from a trust or other account without the authorization of the owner of the funds or other lawful justification.
- [Colorado-Range of Criminal Penalties-C.R.S.A. ¤ 18-5-211](https://insurancefraud.org/statutes/colorado-range-of-criminal-penalties-c-r-s-a-¤-18-5-211/) - (4) Insurance fraud committed in violation of paragraph (a) of subsection (1) of this section is a class 1 misdemeanor. Insurance fraud committed in violation of paragraphs (b) to (e) of subsection (1) of this section or subsection (2) or (3) of this section is a class 5 felony.
- [Colorado-Rating of an Insurance Policy-C.R.S.A. ¤ 10-4-403](https://insurancefraud.org/statutes/colorado-rating-of-an-insurance-policy-c-r-s-a-¤-10-4-403/) - (1) Rates shall not be excessive, inadequate, or unfairly discriminatory. The following rate standards shall apply: (a) Rates are excessive if they are likely to produce a long run profit that is unreasonably high for the insurance provided or if expenses are unreasonably high in relation to services rendered. (b) Concerning inadequacy, rates are not
- [Colorado-Unauthorized Entities-C.R.S.A. ¤ 10-3-104](https://insurancefraud.org/statutes/colorado-unauthorized-entities-c-r-s-a-¤-10-3-104/) - Except for reinsurance by an authorized insurer or insurance effected pursuant to the provisions of article 5 or article 15 of this title, it is unlawful for any person, company, or corporation in this state to procure, receive, or forward applications for insurance in, or to issue or to deliver policies for, any company not
- [California-Aiding & Abetting-West's Ann.Cal.Ins.Code ¤ 1871.4](https://insurancefraud.org/statutes/california-aiding-abetting-wests-ann-cal-ins-code-¤-1871-4/) - (a) It is unlawful to do any of the following: (a) It is unlawful to do any of the following: (3) Knowingly assist, abet, conspire with, or solicit a person in an unlawful act under this section.
- [California-Anti-Runner Provisions-West's Ann.Cal.Ins.Code ¤ 1871.7](https://insurancefraud.org/statutes/california-anti-runner-provisions-wests-ann-cal-ins-code-¤-1871-7/) - (a) It is unlawful to knowingly employ runners, cappers, steerers, or other persons to procure clients or patients to perform or obtain services or benefits pursuant to Division 4 (commencing with Section 3200) of the Labor Code or to procure clients or patients to perform or obtain services or benefits under a contract of insurance
- [California-Attempted Fraud-West's Ann.Cal.Ins.Code ¤ 1871.4](https://insurancefraud.org/statutes/california-attempted-fraud-wests-ann-cal-ins-code-¤-1871-4/) - (a) It is unlawful to do any of the following: (3) Knowingly assist, abet, conspire with, or solicit a person in an unlawful act under this section.
- [California-Claims Fraud-West's Ann.Cal.Ins.Code ¤ 1871.4](https://insurancefraud.org/statutes/california-claims-fraud-wests-ann-cal-ins-code-¤-1871-4/) - (2) Present or cause to be presented a knowingly false or fraudulent written or oral material statement in support of, or in opposition to, a claim for compensation for the purpose of obtaining or denying any compensation, as defined in Section 3207 of the Labor Code.
- [California-Fraud Bureau-West's Ann.Cal.Ins.Code ¤ 1872](https://insurancefraud.org/statutes/california-fraud-bureau-wests-ann-cal-ins-code-¤-1872/) - There is created within the department the Fraud Division to enforce the provisions of Sections 549,1 and 550 of the Penal Code, and to administer the provisions of Article 3 (commencing with Section 1873).
- [California-Immunity-](https://insurancefraud.org/statutes/california-immunity/) - In the absence of fraud or malice, no insurer, or any employee or agent authorized by an insurer to act on behalf of the insurer, and no authorized governmental agency or its respective employees, shall be subject to any civil liability for libel, slander, or any other relevant cause of action by virtue of releasing
- [California-Insurance Fraud - Definition-West's Ann.Cal.Ins.Code ¤ 1871.4](https://insurancefraud.org/statutes/california-insurance-fraud-definition-wests-ann-cal-ins-code-¤-1871-4/) - (a) It is unlawful to do any of the following: (1) Make or cause to be made a knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying any compensation, as defined in Section 3207 of the Labor Code. (2) Present or cause to be presented a knowingly false
- [California-Licensing Board Notification-West's Ann.Cal.Ins.Code ¤ 1873](https://insurancefraud.org/statutes/california-licensing-board-notification-wests-ann-cal-ins-code-¤-1873/) - (a) Upon written request to an insurer by officers designated in subdivisions (a) and (b) of Section 830.1 and subdivision (a) of Section 830.2, and subdivisions (a), (c), and (i) of Section 830.3 of the Penal Code, an insurer, or agent authorized by that insurer to act on behalf of the insurer, shall release to
- [California-Mandatory Restitution-West's Ann.Cal.Ins.Code ¤ 1871.4](https://insurancefraud.org/statutes/california-mandatory-restitution-wests-ann-cal-ins-code-¤-1871-4/) - (b) Every person who violates subdivision (a) shall be punished by imprisonment in a county jail for one year, or pursuant to subdivision (h) of Section 1170 of the Penal Code, for two, three, or five years, or by a fine not exceeding one hundred fifty thousand dollars ($150, 000) or double the value of
- [California-Practitioner Penalites-West's Ann.Cal.Ins.Code ¤ 804](https://insurancefraud.org/statutes/california-practitioner-penalites-wests-ann-cal-ins-code-¤-804/) - Any insurer willfully violating any provision of this article is guilty of a misdemeanor and is punishable by a fine not exceeding one thousand dollars ($1,000) for each violation thereof, or the commissioner may suspend the certificate of authority of such insurer for the remainder of the term thereof.
- [California-Premium Fraud-West's Ann.Cal.Ins.Code ¤ 1871.4](https://insurancefraud.org/statutes/california-premium-fraud-wests-ann-cal-ins-code-¤-1871-4/) - (a) It is unlawful to do any of the following: (1) Make or cause to be made a knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying any compensation, as defined in Section 3207 of the Labor Code. (2) Present or cause to be presented a knowingly false
- [California-Range of Criminal Penalties-West's Ann.Cal.Penal Code ¤ 550](https://insurancefraud.org/statutes/california-range-of-criminal-penalties-wests-ann-cal-penal-code-¤-550/) - (c)(1) Every person who violates paragraph (1), (2), (3), (4), or (5) of subdivision (a) is guilty of a felony punishable by imprisonment pursuant to subdivision (h) of Section 1170 for two, three, or five years, and by a fine not exceeding fifty thousand dollars ($50,000), or double the amount of the fraud, whichever is
- [California-Rating of an Insurance Policy-West's Ann.Cal.Ins.Code ¤ 1852](https://insurancefraud.org/statutes/california-rating-of-an-insurance-policy-wests-ann-cal-ins-code-¤-1852/) - Repealed.
- [California-Underwriting Fraud-West's Ann.Cal.Ins.Code ¤ 804](https://insurancefraud.org/statutes/california-underwriting-fraud-wests-ann-cal-ins-code-¤-804/) - Any insurer willfully violating any provision of this article is guilty of a misdemeanor and is punishable by a fine not exceeding one thousand dollars ($1,000) for each violation thereof, or the commissioner may suspend the certificate of authority of such insurer for the remainder of the term thereof.
- [Arkansas-Aiding & Abetting-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-aiding-abetting-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (F) Attempts to commit, aids or abets the commission of, or conspires to commit the acts or omissions specified in this subsection;
- [Arkansas-Attempted Fraud-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-attempted-fraud-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (F) Attempts to commit, aids or abets the commission of, or conspires to commit the acts or omissions specified in this subsection;
- [Arkansas-Claims Fraud-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-claims-fraud-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (A) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to an insurer, a reinsurer, broker or its agent, or by a broker or
- [Arkansas-Failing to Remit Premium-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-failing-to-remit-premium-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (D) Embezzles, abstracts, purloins, or converts moneys, funds, premiums, credits, or other property of an insurer, reinsurer, or person engaged in the business of insurance;
- [Arkansas-Fraud Bureau-A.C.A. ¤ 23-66-508](https://insurancefraud.org/statutes/arkansas-fraud-bureau-a-c-a-¤-23-66-508/) - There is created within the department the Fraud Division to enforce the provisions of Sections 549,1 and 550 of the Penal Code, and to administer the provisions of Article 3 (commencing with Section 1873).
- [Arkansas-Immunity-A.C.A. ¤ 23-60-111; A.C.A. 23-66-506](https://insurancefraud.org/statutes/arkansas-immunity-a-c-a-¤-23-60-111-a-c-a-23-66-506/) - (a) In the absence of fraud or bad faith, no civil cause of action of any nature shall arise against the person for supplying any information: (1) Relating to suspected fraudulent insurance acts furnished to or received from law enforcement officials or their agents and employees; (2) Relating to suspected fraudulent insurance acts furnished to
- [Arkansas-Insurance Fraud - Definition-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-insurance-fraud-definition-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (A) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to an insurer, a reinsurer, broker or its agent, or by a broker or
- [Arkansas-Mandatory Restitution-A.C.A. ¤ 23-66-512](https://insurancefraud.org/statutes/arkansas-mandatory-restitution-a-c-a-¤-23-66-512/) - (2)(A) A person convicted of a violation of ¤ 23-66-502 by a court of competent jurisdiction shall be guilty of a Class D felony. (B) A person convicted of a violation of ¤ 23-66-502 shall be ordered to pay restitution to persons aggrieved by the violation of this subchapter. (C) Restitution shall be ordered in
- [Arkansas-Placing Bogus Coverage-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-placing-bogus-coverage-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent:(G) Issues false, fake, or counterfeit insurance policies, certificates of insurance, insurance identification cards, policy declaration pages or policy covers, or insurance binders or other temporary contracts of insurance; (H) Possesses or
- [Arkansas-Practitioner Penalites-A.C.A. ¤ 23-66-512](https://insurancefraud.org/statutes/arkansas-practitioner-penalites-a-c-a-¤-23-66-512/) - A person who violates this subchapter is subject to the following: (1)(A) Suspension or revocation of license, civil penalties of up to ten thousand dollars ($10,000) per violation, or both. (B) Suspension or revocation of license and imposition of civil penalties shall be pursuant to an order of the Insurance Commissioner issued under ¤ 23-61-301
- [Arkansas-Premium Fraud-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-premium-fraud-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (A) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to an insurer, a reinsurer, broker or its agent, or by a broker or
- [Arkansas-Range of Criminal Penalties-A.C.A. ¤ 23-66-512](https://insurancefraud.org/statutes/arkansas-range-of-criminal-penalties-a-c-a-¤-23-66-512/) - (2)(A) A person convicted of a violation of ¤ 23-66-502 by a court of competent jurisdiction shall be guilty of a Class D felony. (B) A person convicted of a violation of ¤ 23-66-502 shall be ordered to pay restitution to persons aggrieved by the violation of this subchapter.
- [Arkansas-Range of Civil Penalties-A.C.A. ¤ 23-60-108](https://insurancefraud.org/statutes/arkansas-range-of-civil-penalties-a-c-a-¤-23-60-108/) - Unless a greater penalty is provided by another law of this state, a violation of a statute or regulation enforceable by the Insurance Commissioner is punishable: (1) By the refusal, suspension, revocation, or nonrenewal of a license or certificate of authority; and (2) A fine no greater than one thousand dollars ($1,000) per violation, not
- [Arkansas-Rating of an Insurance Policy-A.C.A. ¤ 23-67-208](https://insurancefraud.org/statutes/arkansas-rating-of-an-insurance-policy-a-c-a-¤-23-67-208/) - (a) Rates shall not be excessive, inadequate, or unfairly discriminatory. (b) A rate in a competitive market is assumed not to be excessive. A rate is excessive in a competitive or noncompetitive market if it is likely to produce a profit from Arkansas business that is unreasonably high in relation to past and prospective loss
- [Arkansas-Underwriting Fraud-A.C.A. ¤ 23-66-501](https://insurancefraud.org/statutes/arkansas-underwriting-fraud-a-c-a-¤-23-66-501/) - (4) "Fraudulent insurance act" means an act or omission committed by a person who, knowingly and with intent to defraud, deceive, conceal, or misrepresent: (A) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to an insurer, a reinsurer, broker or its agent, or by a broker or
- [Arkansas-Unauthorized Entities-A.C.A ¤ 23-65-101.](https://insurancefraud.org/statutes/arkansas-unauthorized-entities-a-c-a-¤-23-65-101/) - (a)(1) No person or entity in this state shall act as agent or broker for or otherwise represent or aid any insurer, health maintenance organization, multiple employer welfare arrangement, multiple employer trust, association, or any other person or entity in the solicitation, negotiation, or effectuation of insurance, inspection of risks, fixing of rates, investigation or
- [Arizona-Aiding & Abetting-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-aiding-abetting-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Anti-Runner Provisions-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-anti-runner-provisions-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Attempted Fraud-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-attempted-fraud-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 3. Conceal or attempt to conceal from the department or remove or attempt to remove from the home office, place of safekeeping or other place of business of any insurer, reinsurer or other entity licensed to transact insurance business in this state
- [Arizona-Claims Fraud-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-claims-fraud-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Failing to Remit Premium-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-failing-to-remit-premium-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Fraud Bureau-A.R.S. ¤ 20-466](https://insurancefraud.org/statutes/arizona-fraud-bureau-a-r-s-¤-20-466/) - A. A fraud unit is established in the department of insurance. B. The fraud unit shall work in conjunction with the department of public safety. C. The director may investigate any act or practice of fraud prohibited by ¤ 20-466.01 and any other act or practice of fraud against an insurer or entity licensed under
- [Arizona-Immunity-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-immunity-a-r-s-¤-20-463/) - B. A person who acts without malice, fraudulent intent or bad faith is not subject to liability for filing reports or furnishing orally or in writing other information concerning suspected, anticipated or completed fraudulent insurance acts if the reports or information is provided to or received from: 1. The director or the department. 2. Law
- [Arizona-Insurance Fraud - Definition-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-insurance-fraud-definition-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Looting & diverting-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-looting-diverting-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 4. Divert or attempt or conspire to divert the monies of an insurer, reinsurer, entity licensed to transact insurance business in this state or other person in connection with: (a) The transaction of insurance or reinsurance. (b) The conduct of business activities
- [Arizona-Mandatory Restitution-A.R.S. ¤ 20-466.02](https://insurancefraud.org/statutes/arizona-mandatory-restitution-a-r-s-¤-20-466-02/) - A. On request by the director, the attorney general may seek and obtain in an action in the superior court an injunction that prohibits a person from engaging in practices or doing any acts that violate ¤ 20-463, 20-463.01 or 23-1028. The court may enter any order or judgment that is necessary to: 2. Return
- [Arizona-Placing Bogus Coverage-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-placing-bogus-coverage-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Practitioner Penalites-A.R.S. ¤ 20-220](https://insurancefraud.org/statutes/arizona-practitioner-penalites-a-r-s-¤-20-220/) - A. The director may after a hearing refuse to renew or may revoke or suspend an insurer's certificate of authority, in addition to other grounds therefor in this title, if the insurer: 1. Violates any provision of this title other than a provision as to which refusal, suspension or revocation is mandatory. 2. Knowingly fails
- [Arizona-Premium Fraud-A.R.S. ¤ 20-463](https://insurancefraud.org/statutes/arizona-premium-fraud-a-r-s-¤-20-463/) - A. It is a fraudulent practice and unlawful for a person to knowingly: 1. Present, cause to be presented or prepare with the knowledge or belief that it will be presented an oral or written statement, including computer generated documents, to or by an insurer, reinsurer, purported insurer or reinsurer, insurance producer or agent of
- [Arizona-Range of Civil Penalties-A.R.S. ¤ 20-466.02](https://insurancefraud.org/statutes/arizona-range-of-civil-penalties-a-r-s-¤-20-466-02/) - A. On request by the director, the attorney general may seek and obtain in an action in the superior court an injunction that prohibits a person from engaging in practices or doing any acts that violate ¤ 20-463, 20-463.01 or 23-1028. The court may enter any order or judgment that is necessary to: 1. Prevent
- [Arizona-Rating of an Insurance Policy-A.R.S. ¤ 20-356](https://insurancefraud.org/statutes/arizona-rating-of-an-insurance-policy-a-r-s-¤-20-356/) - All rates subject to this article shall be made in accordance with the following provisions: 1. Rates shall not be excessive, inadequate or unfairly discriminatory. No rate shall be held to be inadequate unless the director finds that the loss experience of the insurer in the classification covered by the rate has been adverse for
- [Arizona-Unauthorized Entities-A.R.S. ¤ 20-401.01](https://insurancefraud.org/statutes/arizona-unauthorized-entities-a-r-s-¤-20-401-01/) - A. It is unlawful for any insurer to transact insurance business, as provided by ¤ 20-106, in this state without a certificate of authority from the director. B. The provisions of subsection A of this section do not apply to: 1. The lawful transaction of surplus lines insurance. 2. The lawful transaction of reinsurance by
- [Alaska-Aiding & Abetting-¤ 21.36.360](https://insurancefraud.org/statutes/alaska-aiding-abetting-¤-21-36-360/) - *(b) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive; (3) assists or conspires with another to prepare or make a written or oral statement that is presented to an insurer in support of a claim for a benefit under an insurance policy, knowing that the statement
- [Alaska-Claims Fraud-AS ¤ 21.36.360](https://insurancefraud.org/statutes/alaska-claims-fraud-as-¤-21-36-360/) - *(b) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive; (2) presents to an insurer a written or oral statement in support of a claim for payment or other benefit under an insurance policy, knowing that the statement contains false, incomplete, or misleading information or omits information
- [Alaska-Failing to Remit Premium-AS ¤ 21.36.360](https://insurancefraud.org/statutes/alaska-failing-to-remit-premium-as-¤-21-36-360/) - (b) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive,(5) fails to make disposition of funds received or held or misappropriates funds received or held representing premiums or return premiums;
- [Alaska-False Claims Act-n/a](https://insurancefraud.org/statutes/alaska-false-claims-act-n-a/) - No statute found. Legislation pending under HB 347.
- [Alaska-Immunity-AS ¤ 21.36.365](https://insurancefraud.org/statutes/alaska-immunity-as-¤-21-36-365/) - (a) A person is not liable for civil damages for filing a report with or furnishing other information whether written or oral, concerning suspected, anticipated, or completed fraudulent acts to (1) law enforcement officials, their agents, and employees; (2) the National Association of Insurance Commissioners, the division of insurance, an agency in a state that
- [Alaska-Insurance Fraud - Definition-AS ¤ 21.36.360](https://insurancefraud.org/statutes/alaska-insurance-fraud-definition-as-¤-21-36-360/) - (b) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive, (1) collects a sum as premium or charge for insurance if the insurance has not been provided or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an
- [Alaska-Licensing Board Notification-AS ¤ 21.36.390.](https://insurancefraud.org/statutes/alaska-licensing-board-notification-as-¤-21-36-390/) - (a) An insurer or licensee that has reason to believe that a fraudulent claim has been made against it shall send the director a report disclosing information that the director may require. (b) An insurer or licensee that has reason to believe that an insurance producer with which it is doing business is involved in
- [Alaska-Looting & diverting-AS ¤ 21.36.360.](https://insurancefraud.org/statutes/alaska-looting-diverting-as-¤-21-36-360/) - *(b) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive;(4) wilfully collects as premium or charge for insurance a sum in excess of the premium or charge applicable to the insurance as specified in the policy by the insurer in accordance with the applicable classifications and rates
- [Alaska-Mandatory Restitution-AS ¤ 12.55.045](https://insurancefraud.org/statutes/alaska-mandatory-restitution-as-¤-12-55-045/) - Section 12.55.045 (a) The court shall, when presented with credible evidence, unless the victim or other person expressly declines restitution, order a defendant convicted of an offense to make restitution as provided in this section, including restitution to the victim or other person injured by the offense, to a public, private, or private nonprofit organization
- [Alaska-Placing Bogus Coverage-n/a](https://insurancefraud.org/statutes/alaska-placing-bogus-coverage-n-a/) - Nostatute found.
- [Alaska-Practitioner Penalites-AS ¤ 21.09.260](https://insurancefraud.org/statutes/alaska-practitioner-penalites-as-¤-21-09-260/) - An insurer that the director determines, following an appropriate hearing as provided in AS 21.06.170 - 21.06.230, has violated the provisions of AS 21.09.250 is subject to a civil penalty of not more than $2,500 for each violation. The director may suspend or revoke the license of the insurer for a violation of AS 21.09.250,
- [Alaska-Premium Fraud-AS ¤ 21.36.360](https://insurancefraud.org/statutes/alaska-premium-fraud-as-¤-21-36-360/) - (b) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive, (1) collects a sum as premium or charge for insurance if the insurance has not been provided or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an
- [Alaska-Range of Criminal Penalties-AS¤ 21.22.175](https://insurancefraud.org/statutes/alaska-range-of-criminal-penalties-as¤-21-22-175/) - (q) A fraudulent or criminal insurance act described in (1) (b) of this section that is committed to obtain $10,000 or more is a class B felony; (2) (c), (d), or (p)(4) of this section is a class B felony; (3) (b) of this section that is committed to obtain $500 or more but less
- [Alaska-Range of Civil Penalties-AS ¤ 21.33.065](https://insurancefraud.org/statutes/alaska-range-of-civil-penalties-as-¤-21-33-065/) - (a) A person other than an insured, who in this state represents or aids a nonadmitted insurer in violation of AS 21.33.037, is subject to a civil penalty of not more than $50,000 in addition to applicable criminal penalties and other penalties prescribed in this title. (b) In addition to any other penalty provided, a
- [Alaska-Rating of an Insurance Policy-AS ¤ 21.39.030](https://insurancefraud.org/statutes/alaska-rating-of-an-insurance-policy-as-¤-21-39-030/) - (a) Rates, including loss costs under AS 21.39.043 or any other provision of law, shall be made in accordance with the following provisions: (1) rates shall not be excessive, inadequate, or unfairly discriminatory; (2) consideration shall be given to past and prospective loss experience inside and outside this state; to the conflagration and catastrophe hazards;
- [Alaska-Underwriting Fraud-AS ¤ 21.36.360](https://insurancefraud.org/statutes/alaska-underwriting-fraud-as-¤-21-36-360/) - (o) A fraudulent insurance act is committed by a person who, with intent to injure, defraud, or deceive, knowingly makes a false or fraudulent statement or representation in or with reference to an application for insurance
- [Alaska-Unauthorized Entities-AS ¤ 21.33.011](https://insurancefraud.org/statutes/alaska-unauthorized-entities-as-¤-21-33-011/) - The legislature declares that insurance transactions with nonadmitted insurers are so affected with a public interest as to require regulation, taxation, supervision, and control of the transactions and matters relating to nonadmitted insurance as provided in this chapter in order to (1) protect the insureds and claimants of this state in transactions involving the purchase
- [Alabama-Aiding & Abetting-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-aiding-abetting-¤-27-12a-2/) - A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (1) The solicitation or acceptance of new or renewal insurance risks on behalf of an insurer, reinsurer, or other person engaged in the
- [Alabama-Anti-Runner Provisions-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-anti-runner-provisions-¤-27-12a-2/) - A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (1) The solicitation or acceptance of new or renewal insurance risks on behalf of an insurer, reinsurer, or other person engaged in the
- [Alabama-Claims Fraud-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-claims-fraud-¤-27-12a-2/) - A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (4) Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer,
- [Alabama-Failing to Remit Premium-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-failing-to-remit-premium-¤-27-12a-2/) - A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (4) Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer,
- [Alabama-Fraud Bureau-¤ 27-12A-40](https://insurancefraud.org/statutes/alabama-fraud-bureau-¤-27-12a-40/) - (a) There is hereby established within the department the Insurance Fraud Unit. The commissioner shall appoint the necessary full-time supervisory and investigative personnel of the unit who shall be qualified by training and experience to perform the duties of their positions. The commissioner shall furnish offices, equipment, operating expenses, and necessary personnel to maintain and
- [Alabama-Immunity-¤ 27-12A-22](https://insurancefraud.org/statutes/alabama-immunity-¤-27-12a-22/) - (a) Except as otherwise provided in subsection (b), there shall be no civil liability imposed on and no cause of action shall arise against a person for furnishing or receiving information concerning suspected, anticipated, or completed insurance fraud. This shall not abrogate or modify common law or statutory privileges or immunities enjoyed by a person,
- [Alabama-Insurance Fraud - Definition-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-insurance-fraud-definition-¤-27-12a-2/) - A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (1) The solicitation or acceptance of new or renewal insurance risks on behalf of an insurer, reinsurer, or other person engaged in the
- [Alabama-Licensing Board Notification-¤ 27-12A-8](https://insurancefraud.org/statutes/alabama-licensing-board-notification-¤-27-12a-8/) - (c) The commissioner shall also notify the proper licensing authority of a practitioner for the appropriate disciplinary action including the revocation or suspension of any professional license when a practitioner is convicted of a violation of this chapter and whose services are compensated in whole or in part, directly or indirectly, by insurance proceeds.
- [Alabama-Mandatory Restitution-¤ 27-12A-20](https://insurancefraud.org/statutes/alabama-mandatory-restitution-¤-27-12a-20/) - *(a) A fraud warning shall be included on at least one of the following: Claim release forms, applications, reinstatements for insurance, participation agreements, declaration pages, and claim documents, regardless of the method or form of transmission and shall contain the following statement or a substantially similar statement: "Any person who knowingly presents a false or
- [Alabama-Placing Bogus Coverage-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-placing-bogus-coverage-¤-27-12a-2/) - *A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (1) The solicitation or acceptance of new or renewal insurance risks on behalf of an insurer, reinsurer, or other person engaged in the
- [Alabama-Practitioner Penalites-¤ 27-12A-8](https://insurancefraud.org/statutes/alabama-practitioner-penalites-¤-27-12a-8/) - (a) A producer who violates this chapter may be subject to the suspension or revocation of any insurance license held by the producer or civil penalties of up to five thousand dollars ($5,000) per violation, or both. Suspension or revocation of an insurance license or certificate of authority and the imposition of civil penalties shall
- [Alabama-Premium Fraud-¤ 27-12A-2](https://insurancefraud.org/statutes/alabama-premium-fraud-¤-27-12a-2/) - A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning, one or more of the following acts: (4) Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer,
- [Alabama-Range of Criminal Penalties-¤ 27-12A-6](https://insurancefraud.org/statutes/alabama-range-of-criminal-penalties-¤-27-12a-6/) - (a) No prosecution may be commenced under this article more than two years after the alleged violation was detected. (b) An individual who has been convicted of insurance fraud in the first degree or insurance fraud in the second degree shall be disqualified from engaging in the business of insurance in this state. (c) A
- [Alabama-Rating of an Insurance Policy-¤ 27-13-1](https://insurancefraud.org/statutes/alabama-rating-of-an-insurance-policy-¤-27-13-1/) - The purpose of this chapter is to promote the public welfare by regulating insurance rates to the end that they shall not be excessive, inadequate or unfairly discriminatory and to authorize and regulate cooperative action among insurers in rate-making and in other matters within the scope of this chapter. Nothing in this chapter is intended:
- [Alabama-Unauthorized Entities-¤ 27-10-1l](https://insurancefraud.org/statutes/alabama-unauthorized-entities-¤-27-10-1l/) - (a) No person shall in this state, directly or indirectly, act as agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state in the solicitation, negotiation, or effectuation of insurance or annuity contracts, forwarding of applications, delivery of policies or contracts, inspection

## Current Legislation

- [Counterfeit Airbags](https://insurancefraud.org/current_legislation/counterfeit-airbags-2/) - 2026 Carryover: AK HB 74 establishes the crime of airbag fraud. Date introduced: 1/29/2025 Key Sponsor: Frank Tomaszewski Committee: Judiciary
- [Workers Compensation](https://insurancefraud.org/current_legislation/workers-compensation-4/) - CA AB 1331 would limit the use of workplace surveillance tools by employers, including by prohibiting an employer from monitoring or surveilling workers in employee-only, employer-designated areas. Would subject an employer who violates the bill to a specified civil penalty and authorizes a public prosecutor to bring specified enforcement actions. Passed Assembly on 6/5/12025 to
- [Towing](https://insurancefraud.org/current_legislation/towing-11/) - CA AB 987 provides that existing law makes an insurer that is responsible for reasonable storage and towing charges liable to the person providing those services when a vehicle is towed and stored as a result of an accident or stolen recovery. Expands the list of presumptively unreasonable fees to include storage fees charged for
- [Fraud Bureau Authority](https://insurancefraud.org/current_legislation/fraud-bureau-authority-2/) - MN HB 2432 transfers financial crimes and fraud investigations to the Financial Crimes and Fraud Section in the Bureau of Criminal Apprehension. Passed House to Senate 4/25/2025. Substituted for SB 1417. Passed House to Senate on 4/25/2025. Passed Senate and to House for concurrence. House concurred and eligible for Governor on 5/18/2025. Date introduced: 3/17/2025
- [Telematics](https://insurancefraud.org/current_legislation/telematics/) - LA HB 549 provides a premium discount for commercial motor vehicles with dashboard cameras and telematics systems to enhance public safety, reduce insurance fraud, and lower costs of claims. Passed House to Senate on 4/28/2025. Passed Senate to Governor on 5/20/2025. Date introduced: 4/14/2025 Key Sponsor: Rodney Schamerhorn Committee: Pending
- [Towing](https://insurancefraud.org/current_legislation/towing-12/) - ME SB 572 convenes a working group to evaluate potential regulation of the vehicle towing industry and the impact on state agencies and industries, stating that deceptive, irresponsible and predatory towing practices impose financial burdens and logistical hardships on those who rely on their vehicles for everyday use and that the towing industry affects many
- [Disaster Claims](https://insurancefraud.org/current_legislation/disaster-claims/) - HI SB 417 establishes as a class B felony the unlicensed performance of contractor work, during or within a specified year following a national emergency, state of emergency, or disaster proclamation, in an affected political subdivision. Date introduced: 1/15/2025 Key Sponsor: Angus McKelvey Committee: Judiciary
- [Immunity](https://insurancefraud.org/current_legislation/immunity/) - NJ SB 4225 broadens scope of information sharing and civil immunity therefor, related to insurance fraud. Date introduced: prefiled 3/3/2025 Key Sponsor: Joseph Lagana Committee: Commerce
- [Runners](https://insurancefraud.org/current_legislation/runners-2/) - NY SB 4874 criminalizes acting as a runner or soliciting or employing a runner to procure patients or clients. Date introduced: 2/13/2025 Key Sponsor: Patricia Fahy Committee: Codes
- [Runners](https://insurancefraud.org/current_legislation/runners/) - NY AB 7392 criminalizes acting as a runner or soliciting or employing a runner to procure patients or clients. Date introduced: 3/25/2025 Key Sponsor: J. Garry Petlow Committee: Codes
- [Staged Accidents](https://insurancefraud.org/current_legislation/staged-accidents-6/) - NY AB 7322 permits an insurer to rescind or retroactively cancel a policy in circumstance involving an accident staged to defraud an insurer. Date introduced: 3/25/2025 Key Sponsor: J. Garry Petlow Committee: Insurance
- [Staged Accidents](https://insurancefraud.org/current_legislation/staged-accidents-5/) - NY SB 5052 permits an insurer to rescind or retroactively cancel a policy in circumstance involving an accident staged to defraud an insurer. Date introduced: 2/18/2025 Key Sponsor: Jamaal Bailey Committee: Insurance
- [Counterfeit Airbags](https://insurancefraud.org/current_legislation/counterfeit-airbags/) - AK SB 17 establishes the crime of airbag fraud. Date introduced: 1/21/2025 Key Sponsor: Matt Claman Committee: Judiciary
- [Staged Accidents](https://insurancefraud.org/current_legislation/staged-accidents-4/) - NY AB 3800 (Crime of Staging Construction Site Accident) establishes the crime of staging a construction site accident which is a class E felony. Date introduced: 1/30/2025 Key Sponsor: David Weprin Committee: Codes
- [Staged Accidents](https://insurancefraud.org/current_legislation/staged-accidents-3/) - NY AB 3851 (Expanded Liability for Orchestrating Illegal Acts) provides that anyone who directs, hires, requests, encourages, orchestrates or invites another individual to cause a collision involving a motor vehicle shall be guilty of staging a motor vehicle accident in the second degree. Date introduced: 1/30/2025 Key Sponsor: David Weprin Committee: Codes
- [Bail Bond Antifraud Regulation](https://insurancefraud.org/current_legislation/bail-bond-antifraud-regulation/) - NC HB 718 revises the Laws related to bail bondsmen. Introduce new oversight tools by extending provisional licensing periods for new bondsmen, tightening supervisory responsibilities, and modernizing reporting and address requirements to help prevent underreporting bond amounts, failing to remit premium payments to surety companies, etc. The Coalition submitted a letter of support on 4/16/2025.
- [Bail Bond Antifraud Regulation](https://insurancefraud.org/current_legislation/fraud-bureau-authority-3/) - NC SB 251 revises the Laws related to bail bondsmen. Introduce new oversight tools by extending provisional licensing periods for new bondsmen, tightening supervisory responsibilities, and modernizing reporting and address requirements to help prevent underreporting bond amounts, failing to remit premium payments to surety companies, etc. The Coalition submitted a letter of support on 4/16/2025.
- [Staged Accidents](https://insurancefraud.org/current_legislation/staged-accidents-2/) - NY SB 5232 provides that anyone who directs, hires, requests, encourages, orchestrates or invites another individual to cause a collision involving a motor vehicle shall be guilty of staging a motor vehicle accident in the second degree. Date introduced: 2/19/2025 Key Sponsor: Leroy Comrie Committee: Codes
- [Staged Accidents](https://insurancefraud.org/current_legislation/staged-accidents/) - NY SB 5231 establishes the crime of staging a construction site accident which is a class E felony. Date introduced: 2/19/2025 Key Sponsor: Leroy Comrie Committee: Codes
- [Consumer Privacy](https://insurancefraud.org/current_legislation/consumer-privacy-3/) - PA HB 78 adds new types of data to the list of "sensitive data" and provides for the Consumer Data Privacy Act; provides that a consumer shall have specified rights; specifies the duties of controllers, defined as certain entities that sell consumer personal information; provides that a controller shall establish and describe in a privacy
- [Towing](https://insurancefraud.org/current_legislation/towing-10/) - OK HB 1753 provides that the Corporation Commission shall review the rates wrecker and tow services companies may charge for nonconsensual tows and, if necessary, change the rates, following notice and hearing; relates to motor vehicles; relates to maximum fees and charges; relates to rate calculations; relates to vehicle weight; relates to ees and charges
- [Towing](https://insurancefraud.org/current_legislation/towing-8/) - IL SB 2040 amends the Vehicle Code; provides that any personal property belonging to the vehicle owner in a vehicle subject to a lien shall be subject to that lien, except for the specified items, which may be claimed by immediate family members at the authorization of the vehicle owner; establishes registration requirements for commercial
- [Price Gouging](https://insurancefraud.org/current_legislation/price-gouging/) - CA SB 368 provides that under existing law, upon the proclamation of a state of emergency, it is a misdemeanor for a person, contractor, business, or other entity to sell or offer to sell certain goods or services for a price of more than a specified percent greater than the price charged by that person
- [Price Gouging](https://insurancefraud.org/current_legislation/towing-5/) - CA SB 36 provides that the Unfair Competition Law makes various practices unlawful and provides that a person who engages in unfair competition is liable for a civil penalty. Makes a person who violates those provisions, if the act or acts of unfair competition are perpetrated against one or more persons displaced due to a
- [Fraud Bureau Authority](https://insurancefraud.org/current_legislation/fraud-bureau-authority/) - LA SB 199 provides for the authority of the Department of Insurance, in instances of fraud, to take action against unlicensed persons engaged in the business of insurance. Date introduced: 4/15/2025 Key Sponsor: Brach Myers Committee: Insurance
- [Consumer Privacy](https://insurancefraud.org/current_legislation/consumer-privacy-2/) - CA SB 354 would enact the Insurance Consumer Privacy Protection Act of 2025 to establish new standards for the collection, processing, retaining, or sharing of consumers' personal information by insurance licensees and their third party service providers. Requires a licensee or third party service provider to obtain a consumer's consent to take specified actions, and
- [Staged Accidents](https://insurancefraud.org/current_legislation/insurer-practices-3/) - US HR 2662 would amend title 49, United States Code, to prohibit staged collisions with commercial motor vehicles. Date introduced: 4/7/2025 Key Sponsor: Michael Collins Committee: House Judiciary Committee
- [Fraud Reporting](https://insurancefraud.org/current_legislation/fraud-reporting-3/) - NY SB 6364 relates to insurance fraud; provides a provision for compensation to a person that reports insurance fraud to the authorities; establishes crimes of unlawful procurement of clients, patients or customers; aggravated insurance fraud in the second degree; aggravated insurance fraud in the first degree; provides that this act also increases the penalty for
- [Healthcare Fraud](https://insurancefraud.org/current_legislation/healthcare-fraud/) - AZ HB 2874 provides that if a health insurer notices a trend in the number of health care insurance claims that are filed by a health care provider for services provided to patients on any given workday exceeds the number of patients that the health care provider could reasonably be expected to treat on that
- [Towing](https://insurancefraud.org/current_legislation/towing-4/) - MO HB 745 enacts provisions relating to towing of commercial vehicles and establishes civil penalties for violations. Date introduced: 1/8/2025 Key Sponsor: Dave Griffith Committee: Pending
- [Towing](https://insurancefraud.org/current_legislation/towing-3/) - MA HB 3516 provides that the Department of Utilities establish a list of approved charges for towing and storage services provided by towing companies contracted by state or local police departments. Specifies penalties for towing companies in violation of. Date introduced: 2/27/2025 Key Sponsor: Michael Kushmerek Committee: Pending
- [Artificial Intelligence](https://insurancefraud.org/current_legislation/artificial-intelligence-2/) - MA HB 97 relates to consumers interactions with artificial intelligence systems. Specifies that high-risk AI systems do not include anti-fraud technology that does not use facial recognition technology and does not, when deployed, make, or are a substantial factor in making, a consequential decision. The bill does not restrict the ability to prevent, detect, protect
- [Towing](https://insurancefraud.org/current_legislation/towing-2/) - IL HB 3430 creates the Nonconsensual Towing Act; creates the Commercial Vehicle Towing Advisory Committee; sets forth members, terms, compensation, meetings, and record keeping; provides that the Committee shall establish rules and standards for the inclusion of a towing and recovery service on the tow list; establishes statewide maximum towing and storage rates for nonconsensual
- [Workers Compensation](https://insurancefraud.org/current_legislation/workers-compensation-3/) - NY SB 1514 empowers the commissioner of labor to issue stop-work orders against employers for misclassification of employees as independent contractors or for providing false, incomplete, or misleading information to an insurance company on the number of employees of such employer. Date introduced: 1/10/2025 Key Sponsor: Peter Harckham Committee: Assembly Labor Committee
- [Fraud Reporting](https://insurancefraud.org/current_legislation/fraud-reporting-7-2-2-2/) - WA HB 1793 modifies reports of fire losses, within 90 days of closing a claim related to a fire loss or damage. Date introduced: 1/31/2025 Key Sponsor: Dan Griffey Committee: Rules
- [Fraud Reporting](https://insurancefraud.org/current_legislation/fraud-reporting-7-2-2-2-2/) - CA SB 536 would require an insurer or licensed rating organization to notify the Employment Development Department, in addition to the local district attorney's office and Fraud Division on the Department of Insurance, of suspected fraud when the fraudulent act relates to premium fraud. Date introduced: 2/20/2025 Key Sponsor: Bob Archuleta Committee: Fiscal Committee
- [Artificial Intelligence](https://insurancefraud.org/current_legislation/artificial-intelligence-8-3-2-3-2/) - NY SB 1169 regulates the development and use of certain artificial intelligence systems to prevent algorithmic discrimination; requires independent audits of high risk ai systems; provides for enforcement by the attorney general as well as a private right of action. Date introduced: 1/8/2025 Key Sponsor: Kristen Gonzalez Committee: Internet and Technology Committee
- [Consumer Privacy](https://insurancefraud.org/current_legislation/state-anti-fraud-authority-2-2-2-2-4-2-2/) - OK SB 488 relates to unmanned aerial systems; defines term; prohibits certain purchase by state agencies after certain date; prohibits certain purchase by political subdivisions after certain date; directs the Office of Homeland Security; maintains certain list; relates to the State Open Records Act; provides for certain assessment to be confidential; updates statutory language; provides
- [Consumer Privacy](https://insurancefraud.org/current_legislation/state-anti-fraud-authority-2-2-2-2-4-2/) - TN SB 663 authorizes a consumer to designate an authorized agent who may opt the consumer out of the processing of the consumer's personal data; requires a controller to comply with an opt-out request from an authorized agent if certain conditions are met. Date introduced: 01/31/2025 Key Sponsor: Heidi Campbell Committee: Commerce and Labor Committee
- [Workers Compensation](https://insurancefraud.org/current_legislation/workers-compensation-2/) - OR SB 606 adds certain health care employees to the list of workers for whom certain stress disorders give rise to a presumption that a workers' compensation claim is compensable as an occupational disease. Date introduced: 1/21/2025 Key Sponsor: Winsvey Campos Committee: Labor and Business Committee
- [Assignment of Benefits](https://insurancefraud.org/current_legislation/assignment-of-benefits/) - CT HB 6967 concerns the assignment of post-loss homeowners and commercial property insurance benefits and home improvement contractors and salespersons; strengthens regulations for home improvement contractors by enhancing registration requirements, prohibiting fraudulent practices, and ensuring consumer protections in contracts. Date introduced: 02/13/2025 Key Sponsor: Joint Committee on Insurance and Real Estate Committee: Joint Committee on Insurance
- [Policy Misrepresentations](https://insurancefraud.org/current_legislation/policy-misrepresentations/) - IL HB 3795 amends the Insurance Code; removes provisions concerning the duties of the Director of Insurance to promulgate reasonable rules requiring insurers doing business in the state to report factual information in their possession that is pertinent to suspected fraudulent insurance claims, fraudulent insurance applications, or premium fraud after the Director has made a
- [Fraud Reporting](https://insurancefraud.org/current_legislation/fraud-reporting/) - NJ AB 5254 establishes Car Insurance Reduction Act; modifies current law addressing requirements of automobile insurers for underwriting, rate calculations and reductions, and reporting requirements to State. The bill requires insurers to report fraud-related data to the Department of Banking and Insurance and the Office of the Insurance Fraud Prosecutor. Date introduced: 01/30/2025 Key Sponsor: Heather
- [Fraud Act Updates](https://insurancefraud.org/current_legislation/fraud-act-updates/) - NY AB 3321 enacts the New York automobile insurance fraud and premium reduction act; provides that this act is aimed at reducing insurance fraud and thus lowering the cost of insurance premiums; provides a provision for compensation to a person that reports insurance fraud to the authorities; further provides that this act also increases the
- [Workers Compensation](https://insurancefraud.org/current_legislation/workers-compensation/) - NY AB 3418 relates to providing access to the workers' compensation system, timely and meaningful wage replacement benefits, and medical treatment; relates to improving efficiency of the system and cost savings. The amendment to Section 112-a defines knowingly understating payroll, misclassifying employees, or concealing relevant information as fraudulent practices, and imposes stricter penalties for employers who
- [Fraud Act Updates](https://insurancefraud.org/current_legislation/fraud-act-updates-2/) - NY AB 3690 authorizes the investigation of fraudulent activities; regards to individuals operating motor vehicles without insurance; increases the civil penalty for forging insurance documents; creates the crime of offering a false application for motor vehicle insurance or registration. Date introduced: 1/30/2025 Key Sponsor: David I. Weprin Committee: Assembly Insurance Committee
- [Fraud Act Updates](https://insurancefraud.org/current_legislation/fraud-act-updates-3/) - NY AB 3785 grants the superintendent of financial services authority to investigate fraudulent activities, such as motor vehicle operators who drive with no insurance coverage, and those who misrepresent their principal place of residence or where their motor vehicle is principally garaged and operated; authorizes such superintendent to accept reports of suspected fraudulent insurance actions;
- [Fraud Warnings](https://insurancefraud.org/current_legislation/fraud-warnings/) - PA HB 392 amends the act known as The Insurance Company Law, in casualty insurance; provides for billing. It establishes new notification requirements when an insurer reimburses a nonnetwork EMS agency and issues payment directly to the policyholder rather than the EMS provider. The amendment introduces a fraud warning by explicitly stating that misuse of EMS reimbursement
- [Insurance Fraud Prevention Act](https://insurancefraud.org/current_legislation/insurance-fraud-prevention-act-3-2/) - IL HB 266 makes a technical change in a section concerning the short title of the Illinois Insurance Fraud Prevention Act. Date introduced: 01/09/2025 Key Sponsor: Chris Welch Committee: Rules
- [Insurance Fraud Prevention Act](https://insurancefraud.org/current_legislation/insurance-fraud-prevention-act-3/) - IL HB 265 makes a technical change in a section concerning the short title of the Illinois Insurance Fraud Prevention Act. Date introduced: 01/09/2025 Key Sponsor: Chris Welch Committee: Rules
- [Insurance Fraud](https://insurancefraud.org/current_legislation/insurance-fraud-prevention-act-2/) - DE SB 45 would add a new crime of application insurance fraud under the Delaware criminal code. Date introduced: 01/16/2025 Key Sponsor: Spiros Mantzavinos Committee: Banking, Business, Insurance & Technology
- [Data Privacy](https://insurancefraud.org/current_legislation/data-privacy-34-2/) - IL HB 1252 would amend the Illinois Insurance Code. that the Amendatory Act may be referred to as the Motor Vehicle Insurance Fairness Act; provides that no insurer shall refuse to issue or renew a policy of automobile insurance based in whole or in part on specified prohibited underwriting or rating factors; sets forth factors
- [Dental Fraud](https://insurancefraud.org/current_legislation/dental-fraud/) - NY SB 229 establishes an elderly dental insurance coverage program; specifies eligibility requirements; specifies penalties for fraud and abuse. Date Introduced: 01/08/2025 Key Sponsor: James Tedisco Committee: Finance Committee
- [Health Insurance](https://insurancefraud.org/current_legislation/insurance-fraud-prevention-act-2-2-2/) - WA SB 5477 improves access to appropriate mental health and substance use disorder services. Does not prevent a health carrier from denying coverage based on insurance fraud. Provides that a health carrier may not request a refund of amounts paid to a provider from that provider for mental health services more than 180 days after
- [Data Privacy](https://insurancefraud.org/current_legislation/data-privacy-34-2-2/) - NY AB 974 enacts the New York privacy act to require companies to disclose their methods of de-identifying personal information, to place special safeguards around data sharing and to allow consumers to obtain the names of all entities with whom their information is shared. Does not apply to any nonprofit entity to the extent such
- [Data Privacy](https://insurancefraud.org/current_legislation/state-anti-fraud-authority-2-2-2-2-3-2/) - NY SB 3044 enacts the New York privacy act to require companies to disclose their methods of de-identifying personal information, to place special safeguards around data sharing and to allow consumers to obtain the names of all entities with whom their information is shared. Does not apply to any nonprofit entity to the extent such
- [Vehicle Photo Inspections](https://insurancefraud.org/current_legislation/insurer-practices-2-3/) - NY SB 1591 authorizes insurers to allow the insured to take and submit photographs of their automobile for purposes of the issuance or renewal of a policy of automobile physical damage insurance. The insured must certify the accuracy and completeness of the information recorded on the inspection form prescribed by the superintendent, under penalty of
- [Identity Theft](https://insurancefraud.org/current_legislation/artificial-intelligence-8-6/) - NY SB 74 relates to offenses involving theft of identity by knowingly and with intent to defraud assumes the identity of another; creates five tiers of crimes, based on the financial loss to the victim(s) and the number of people victimized. Date introduced: 01/08/2025 Key Sponsor: Brian Kavanagh Committee: Codes
- [Artificial Intelligence](https://insurancefraud.org/current_legislation/artificial-intelligence-8-5/) - NY AB 768 enacts the "New York artificial intelligence consumer protection act", in relation to preventing the use of artificial intelligence algorithms to discriminate against protected classes. High-risk artificial intelligence decision system does not include any anti-fraud technology that does not make use of facial recognition technology. Does not restrict, by any means other than
- [Consumer Privacy](https://insurancefraud.org/current_legislation/state-anti-fraud-authority-2-2-2-2-4/) - NY AB 219 relates to the furnishing of registration information by the commissioner of the Department of Motor Vehicles. Exempts the deletion requirement from use by any insurer or by a self-insured entity, or its agents, employees, or contractors, in connection with motor vehicle claims investigation activities, antifraud activities, rating or underwriting. Date introduced: 01/08/2025
- [Data Privacy](https://insurancefraud.org/current_legislation/data-privacy-27-2/) - NJ AB 5017 exempts certain personal information collected by insurance support organizations from certain requirements concerning notification and disclosure of personal data. Date introduced: 01/23/2025 Key Sponsor: Ellen Park Committee: Assembly Financial Institutions and Insurance
- [Artificial Intelligence](https://insurancefraud.org/current_legislation/artificial-intelligence-8-3/) - NE LB 642 adopts the Artificial Intelligence Consumer Protection Act. Specifies that a high-risk artificial intelligence system does not include antifraud technology and does not restrict the ability to prevent, detect, protect against, or respond to any security incident, identity theft, fraud, harassment, malicious or deceptive activity, or illegal activity. Date introduced: 1/22/2025 Key Sponsor:
- [Insurer Practices](https://insurancefraud.org/current_legislation/insurer-practices-2-2/) - CT HB 6437 would remove the requirement for insurance companies to provide the Insurance Commissioner annual reports detailing all information received or investigations conducted by such company during the past year concerning insurance fraud in any claim under a motor vehicle insurance policy. Date introduced: 01/22/2025 Key Sponsor: Joint Committee on Insurance and Real Estate
- [Workers Compensation](https://insurancefraud.org/current_legislation/insurer-practices-2-2-2/) - CT SB 828 establishes a working group to examine the Workers Compensation Program and to make recommendations for streamlining the program, including, but not limited to, updating the electronic filing system, including the reporting triggers and mechanisms, reducing prior authorization delays and reducing fraudulent claims. Date introduced: 01/21/2025 Key Sponsor: Paul Cicarella Committee: Joint Committee
- [Data Privacy](https://insurancefraud.org/current_legislation/data-privacy-27/) - NJ AB 1902 relates to the New Jersey Disclosure and Accountability Transparency Act (DATA); establishes certain requirements for disclosure and processing of personally identifiable information; establishes Office of Data Protection and Responsible Use in Division of Consumer Affairs. 2024/2025 bill. Date introduced: 01/09/2023 Key Sponsor: Ellen Park Committee: Science, Innovation, Technology
- [Insurer Practices](https://insurancefraud.org/current_legislation/insurer-practices-6/) - NJ AB 2592 revises New Jersey law concerning physical damage inspection of vehicle by automobile insurer. Date introduced: 01/09/2023 Key Sponsor: Jessica Ramirez Committee: Financial Institutions and Insurance
- [Insurance Fraud Penalties](https://insurancefraud.org/current_legislation/insurance-fraud-penalties/) - NJ AB 3109 would create a New Jersey White Collar Crime Registry. Includes the offense of insurance fraud. Date introduced: 01/09/2023 Key Sponsor: Craig Coughlin Committee: Judiciary
- [Public Adjusters](https://insurancefraud.org/current_legislation/public-adjusters-5/) - NJ SB 1320 is a New Jersey carryover into 2025. Requires certain information be included in certain contracts with licensed public adjusters. Has support and labeled as a 2024-2025 bill. Date introduced: 01/09/2023 Key Sponsor: Nellie Pou Committee: Commerce
- [State Anti-Fraud Authority](https://insurancefraud.org/current_legislation/state-anti-fraud-authority/) - NJ SB 1463 clarifies that a violation of New Jersey State Insurance Fraud Prevention Act would result in loss of motor vehicle liability insurance coverage in certain circumstances; also provides coverage for innocent persons in certain situations involving insurance fraud. Date introduced: 01/09/2023 Key Sponsor: Joseph Lagana Committee: Commerce
- [Insurance Fraud Prevention Act](https://insurancefraud.org/current_legislation/insurance-fraud-prevention-act/) - NJ SB 2558 would add self-insured entities and plans under certain provisions to the New Jersey Insurance Fraud Prevention Act. Date introduced: 02/05/2024 Key Sponsor: Robert Singer Committee: Pending
- [Towing](https://insurancefraud.org/current_legislation/state-anti-fraud-authority-2-2/) - AZ HB 2283 relates to towing price regulations and unlawful practices during emergencies. Date introduced: 01/15/2025 Key Sponsor: Cesar Aguilar Committee: Commerce Committee
- [Towing](https://insurancefraud.org/current_legislation/state-anti-fraud-authority-2-2-2/) - AZ SB 1127 relates to vehicle towing rates; relates to regulation. On monitor only, relates to private property tows. Date introduced: 01/15/2025 Key Sponsor: Kevin Payne Committee: Government Committee

## News Archives

- [Mississippi will audit Medicaid providers as a part of federal fraud probe](https://insurancefraud.org/news_archives/mississippi-will-audit-medicaid-providers-as-a-part-of-federal-fraud-probe/) - Mississippi by June will begin reviewing the eligibility of Medicaid providers deemed high risk for fraud as part of a Trump administration effort to weed out potential waste and abuse in the program. Dr. Mehmet Oz, administrator for the Centers for Medicare and Medicaid Services, sent a letter on April 23 to Republican Gov. Tate Reeves and Mississippi
- [Candidates Weigh Hypothetical Jail Time for Insurance Executives](https://insurancefraud.org/news_archives/candidates-weigh-hypothetical-jail-time-for-insurance-executives/) - Four Republican candidates for insurance commissioner appearing Tuesday on an OETA forum fielded a question on whether insurance executives found to have acted in bad faith should be subjected to potential incarceration. The answers provided distinctions between the candidates as they vie to lead a department that commands substantial authority over Oklahomans’ finances, but is widely regarded
- [Court Upholds Prison Sentences For Michigan And Ohio Pharmacists In $13M Fraud Ring](https://insurancefraud.org/news_archives/court-upholds-prison-sentences-for-michigan-and-ohio-pharmacists-in-13m-fraud-ring/) - A federal appeals court has shut down a final bid for freedom by a group of Midwest pharmacists who operated a massive, years-long billing scheme that defrauded taxpayers and insurers out of more than $13 million. On June 12, 2026, the Sixth Circuit Court of Appeals affirmed the convictions and prison sentences of Raef Hamaed,
- [Metro Atlanta business owner pleads guilty to Medicaid fraud, fake genetic testing services](https://insurancefraud.org/news_archives/metro-atlanta-business-owner-pleads-guilty-to-medicaid-fraud-fake-genetic-testing-services/) - Georgia Attorney General Chris Carr announced a Lawrenceville business owner pled guilty to defrauding Medicaid of $330,000. According to the Attorney General's Office, Averil Johnson, 47 of Lawrenceville, pled guilty to two counts of Medicaid Fraud for filing false claims for genetic testing services that were never given. Carr's office said Johnson was ordered to
- [America doesn’t have to start at Square 1 to fight Medicare fraud](https://insurancefraud.org/news_archives/america-doesnt-have-to-start-at-square-1-to-fight-medicare-fraud/) - Last month, the Centers for Medicare and Medicaid Services announced a six-month moratorium on new Medicare enrollment for new home health and hospice agencies, its latest move to combat fraud in federal health programs. The government is right to focus on fraud, waste and abuse. But its oversight efforts should be targeted, data-driven and aligned with demonstrated risk. The good
- [Arson investigators probe repeat house fire](https://insurancefraud.org/news_archives/arson-investigators-probe-repeat-house-fire/) - A second fire in three days at a north St. Louis home is now under investigation by bomb and arson investigators. Smoke poured from a home in the 4500 block of Birch Blvd. in the Penrose neighborhood early Friday morning, drawing firefighters back to the same property for the second time this week. Neighbor Gail
- [NCDOI working to catch roofing companies committing fraud](https://insurancefraud.org/news_archives/ncdoi-working-to-catch-roofing-companies-committing-fraud/) - The North Carolina Department of Insurance Fraud Control Group worked with insurance companies to find roofing companies that might be committing fraud. They were able to collect evidence that can be used in court to prosecute possible offenders. Kristen Mercer, a NCDOI special agent, says, “This is an issue that hits from Murphy to Manteo
- [Improving Clinical Trials Reporting in Medicare Claims](https://insurancefraud.org/news_archives/improving-clinical-trials-reporting-in-medicare-claims/) - Clinical trials generate valuable evidence about new treatments, but linking participation in those trials to real-world data remains difficult. Medicare claims data is a critical link, but clinical trial participation must be documented accurately and consistently. Since 2014, the Centers for Medicare & Medicaid Services has required providers to include an eight-digit National Clinical Trial
- [Steve McBee Sr.'s Legal Case Explained](https://insurancefraud.org/news_archives/steve-mcbee-sr-s-legal-case-explained/) - Steven McBee Sr. was convicted of federal crop insurance fraud on Nov. 5, 2024, and is now serving out his two-year sentence in prison. The McBee Dynasty: Real American Cowboys patriarch left for prison in late 2025, where he is currently, leaving his sons and family members to tend to their Gallatin, Missouri farm and
- [Synthetic identity fraud surges as criminals weaponize AI: study](https://insurancefraud.org/news_archives/synthetic-identity-fraud-surges-as-criminals-weaponize-ai-study/) - Dive Brief: Synthetic identity fraud, in which criminals build fake identities using a mix of real and fabricated data, is emerging as a major driver of financial crime as generative artificial intelligence accelerates its scale and sophistication, according to a new report from Mitek and Datos Insights. U.S. unsecured credit losses tied to synthetic identity fraud are
- [Eli Lilly Wins Court Order in Fraud Allegations Against Florida, TN Pharmacy Groups](https://insurancefraud.org/news_archives/eli-lilly-wins-court-order-in-fraud-allegations-against-florida-tn-pharmacy-groups/) - Eli Lilly, one of the world’s largest pharmaceutical makers, has won a federal court order against leaders of a Tennessee church and Florida and Tennessee-based pharmacy groups, after the drugmaker said the participants had crafted a years-long scheme that bilked Lilly of some $200 million in rebates for its popular weight-loss drug. “Through extensive pre-litigation
- [Oak Park woman accused of defrauding state out of $30,000 in childcare benefits](https://insurancefraud.org/news_archives/oak-park-woman-accused-of-defrauding-state-out-of-30000-in-childcare-benefits/) - Felony charges have been filed against an Oak Park woman who allegedly defrauded the state out of more than $30,000 in childcare assistance funds by claiming her father was taking care of her children when he was actually living in a long-term care facility. Krystal May, a 40-year-old Oak Park resident, has been charged with
- [Ramey pleads not guilty to insurance fraud charges](https://insurancefraud.org/news_archives/ramey-pleads-not-guilty-to-insurance-fraud-charges/) - A Murray insurance agent pleaded not guilty Thursday afternoon in Graves County Circuit Court after being indicted on multiple felony charges related to alleged insurance fraud and theft. Glen David Ramey, 59, of Murray, appeared before Graves Circuit Judge Kevin Bishop for arraignment on a three-count indictment returned by a Graves County grand jury. Bishop
- [How TDI enforces the insurance code and protects consumers](https://insurancefraud.org/news_archives/how-tdi-enforces-the-insurance-code-and-protects-consumers/) - The Texas Department of Insurance (TDI) makes sure insurance companies and agents follow state law. When they don't, the Fraud and Enforcement Division steps in to protect consumers, stop illegal activity, and help Texans get the money owed to them. Here are answers to common questions about how the division holds the insurance industry accountable
- [Pierce County prosecutes first insurance fraud case under partnership with OIC](https://insurancefraud.org/news_archives/pierce-county-prosecutes-first-insurance-fraud-case-under-partnership-with-oic/) - The Pierce County Prosecuting Attorney’s Office filed its first insurance fraud charges under an interagency agreement with the Office of the Insurance Commissioner on June 4, 2026. The OIC asked the Legislature for an appropriation during the 2025 session to support a proposed partnership, which provides funding to the Pierce County prosecutor to address insurance
- [Healthcare billing fraud: 10 recent cases](https://insurancefraud.org/news_archives/healthcare-billing-fraud-10-recent-cases-4/) - From two health plan vendors agreeing to settle Medicare Advantage fraud allegations, to the conviction of a New York clinic owner in a $52 million scheme, here are 10 healthcare billing fraud cases that Becker’s reported on since May 19: 1. A former Brookline, Mass. physician was sentenced to 58 months in prison for healthcare fraud, money laundering and
- [Multi-Million-Dollar Prescription Fraud Scheme Results In Prison Sentence For Three East Tennesseans](https://insurancefraud.org/news_archives/multi-million-dollar-prescription-fraud-scheme-results-in-prison-sentence-for-three-east-tennesseans/) - On June 11, 2026, Barbara A. Smith, 75, of Powell, Tennessee, was sentenced to 37 months’ imprisonment and one year of supervised release by the Honorable Katharine A. Crytzer, in the United States District Court for the Eastern District of Tennessee at Knoxville. Smith was also ordered to pay restitution in the amount of $4,810,878.
- [What A CMS Fraud Chief Learned By Caring For Her Parents In Hospice](https://insurancefraud.org/news_archives/what-a-cms-fraud-chief-learned-by-caring-for-her-parents-in-hospice/) - The realization came to Dara Corrigan in late August, when she and her younger sister had to place both of their parents into hospice care within days of each other. Corrigan was not a typical stressed relative, navigating end-of-life care. She’d worked for decades in senior federal service, serving as the Acting Inspector General for
- [Jacksonville chiropractor sentenced in $250K health insurance fraud case](https://insurancefraud.org/news_archives/jacksonville-chiropractor-sentenced-in-250k-health-insurance-fraud-case/) - https://www.wandtv.com/jacksonville-chiropractor-sentenced-in-250k-health-insurance-fraud-case/video_bb82f190-83f1-5546-90f0-8b114b4b5868.html
- [Indian-American arrested in California for allegedly defrauding bank of $100 million](https://insurancefraud.org/news_archives/indian-american-arrested-in-california-for-allegedly-defrauding-bank-of-100-million/) - A 44-year-old Indian-American man was arrested in California for allegedly defrauding a bank of nearly $100 million by manipulating title records of insurance policies. "Mahender Makhijani, a lawful permanent resident from India living in Corona del Mar, was arrested this Wednesday (June 10, 2026) morning on a federal criminal complaint charging him with defrauding a
- [Attorney General James Secures $36.5 Million from CVS for Defrauding Medicaid](https://insurancefraud.org/news_archives/attorney-general-james-secures-36-5-million-from-cvs-for-defrauding-medicaid/) - New York Attorney General Letitia James joined a bipartisan coalition of 36 other attorneys general and the United States Department of Justice (DOJ) in securing $36.5 million from CVS Pharmacy, Inc. (CVS) for fraudulently overbilling Medicaid for insulin prescriptions. From 2010 to 2020, CVS knowingly dispensed more insulin to customers than they needed while maintaining that
- ['Ask me about candles': $460K Miami Medicare data ring allegedly used code to cover tracks](https://insurancefraud.org/news_archives/ask-me-about-candles-460k-miami-medicare-data-ring-allegedly-used-code-to-cover-tracks/) - Two Miami residents are facing federal charges after investigators say they spent years buying and selling stolen Medicare patient information tied to a South Florida health care network. A federal grand jury in the Southern District of Florida indicted Kenia Marrero, 46, who prosecutors say led the scheme. In a related case, Joan Navarro Bruguet,
- [Video from insurance investigation shows NC roofers ripping shingles, defrauding state and companies](https://insurancefraud.org/news_archives/video-from-insurance-investigation-shows-nc-roofers-ripping-shingles-defrauding-state-and-companies/) - Newly obtained investigative video from the North Carolina Department of Insurance shows contractors allegedly damaging roofs on purpose to try to defraud the state and insurance companies. "We're not saying every roofer does this. There's a select few doing this," Kristen Mercer says, Special Agent in Charge with the Department of Insurance's Fraud Control Group.
- [Fraud report highlights missed signals, slow action over plagued Minnesota-run programs](https://insurancefraud.org/news_archives/fraud-report-highlights-missed-signals-slow-action-over-plagued-minnesota-run-programs/) - A new congressional report released Monday dissects internal problems in state government that could have allowed fraud to fester in Minnesota-run programs. The 205-page report by Republicans who lead the U.S. House Committee on Oversight and Government Reform retraces fraud in nutrition and Medicaid programs and what was done about it. The report is based on documents
- [Charlotte doctor sentenced in Medicare fraud case involving millions](https://insurancefraud.org/news_archives/charlotte-doctor-sentenced-in-medicare-fraud-case-involving-millions/) - A Charlotte doctor was sentenced Monday to house arrest and probation for making false statements as part of a scheme that defrauded federal medical programs and landed her in federal court. Sudipta Mazumder, a former Atrium Health doctor, faced up to 11 years in prison after a federal jury in 2023 found her guilty of
- [Montgomery County Man Charged with Stealing More Than $100K from Disabled Former Stepson](https://insurancefraud.org/news_archives/montgomery-county-man-charged-with-stealing-more-than-100k-from-disabled-former-stepson/) - Attorney General Dave Sunday announced the arrest of a Montgomery County man charged with stealing more than $100,000 in life insurance payouts from his 19-year-old disabled former stepson, following the death of the victim’s mother. The Office of Attorney General charged 38-year-old Christopher O. Johnson with felony counts of financial exploitation of a care-dependent person
- [Orlando Man Sentenced to Prison for Construction Payroll Scheme that Defrauded the IRS and Workers’ Compensation Insurers](https://insurancefraud.org/news_archives/orlando-man-sentenced-to-prison-for-construction-payroll-scheme-that-defrauded-the-irs-and-workers-compensation-insurers/) - Santiago Humberto Erazo-Zelaya (32, Orlando) has been sentenced by U.S. District Judge Marcia Morales Howard to one year and two months in federal prison for conspiracy to commit tax fraud and conspiracy to commit wire fraud. The court also ordered Erazo-Zelaya to pay $765,446.00 in restitution to the IRS for unpaid payroll taxes and $26,720.12
- [Santa Paula Farm Labor Contractor Held to Answer for Workers’ Compensation Insurance Fraud](https://insurancefraud.org/news_archives/santa-paula-farm-labor-contractor-held-to-answer-for-workers-compensation-insurance-fraud/) - Ventura County District Attorney Erik Nasarenko announced that Juana Patricia Barajas (DOB 08/01/71), of Santa Paula, has been held to answer on all charges, following a preliminary hearing, related to workers’ compensation insurance fraud, grand theft, and operating without required workers’ compensation insurance coverage while running Barajas Farm Labor Contracting. Barajas is charged with two
- [Stretch Your Dollar | How to protect yourself as AI fraud and schemes are on the rise](https://insurancefraud.org/news_archives/stretch-your-dollar-how-to-protect-yourself-as-ai-fraud-and-schemes-are-on-the-rise/) - That frantic phone call from a loved one asking for money may not be real. The FBI is warning that criminals are increasingly using artificial intelligence to clone voices, create fake online identities and make fraud attempts look more convincing. The agency said victims reported nearly $900 million in losses tied to AI-related fraud last
- [Former Brookline Doctor Sentenced to More Than Four Years in Prison for Health Care Fraud and Tax Fraud](https://insurancefraud.org/news_archives/former-brookline-doctor-sentenced-to-more-than-four-years-in-prison-for-health-care-fraud-and-tax-fraud/) - A former Brookline, Mass. physician was sentenced on June 5, 2026 in federal court in Boston for health care fraud, money laundering, tax evasion and conspiring to defraud the Internal Revenue Service (IRS). Dr. Pankaj Merchia, 52, of Brookline, Mass. and Boca Raton, Fla., was sentenced by U.S. Senior District Court Judge Nathaniel M. Gorton
- [Lawsuit: Former employee accuses Madison County nursing home of staffing fraud](https://insurancefraud.org/news_archives/lawsuit-former-employee-accuses-madison-county-nursing-home-of-staffing-fraud/) - A former employee at Madison Health and Rehabilitation Center has filed a whistleblower lawsuit, claiming she was asked to falsify staffing records and was forced out after refusing to participate. Her attorney, Justin Peterson, says she raised concerns about what she believed were improper staffing practices and ultimately resigned after refusing to carry out requests
- [Right-wing media’s focus on fraud paves the way for cuts to Medicaid home healthcare services](https://insurancefraud.org/news_archives/right-wing-medias-focus-on-fraud-paves-the-way-for-cuts-to-medicaid-home-healthcare-services/) - Right-wing media figures have spent weeks manufacturing a panic about supposedly epidemic levels of healthcare fraud in Ohio in what appears to be a pretext to slash a crucial Medicaid program. On June 4, the Trump administration announced nine fraud indictments in Ohio, most of which had to do with healthcare spending. The Columbus Dispatch reports that the cases
- [United States Obtains $3.4M in a False Claims Act Judgment Against Nebraska Pharmacist](https://insurancefraud.org/news_archives/united-states-obtains-3-4m-in-a-false-claims-act-judgment-against-nebraska-pharmacist/) - On May 29, 2026, the United States District Court for the District of Nebraska entered a default judgment for the United States totaling $3,423,389.84 against Joan Kicken and AME P.C. d/b/a Campbell Drug, for violations of the False Claims Act. The court entered this judgment after Kicken and AME failed to defend against the United
- [Insurance agent in Palm Beach County accused of keeping $90K meant for coverage](https://insurancefraud.org/news_archives/insurance-agent-in-palm-beach-county-accused-of-keeping-90k-meant-for-coverage/) - A Palm Beach Gardens insurance agent is facing felony charges after investigators say she collected more than $90,000 in insurance premiums but never sent the money to the company that issued the coverage. Checree Bryant, 51, was arrested on June 5 following an investigation by the Florida Department of Financial Services’ Criminal Investigations Division. According
- [As Ohio targets Medicaid fraud, elderly Ohioans and those with disabilities fear losing their independence](https://insurancefraud.org/news_archives/as-ohio-targets-medicaid-fraud-elderly-ohioans-and-those-with-disabilities-fear-losing-their-independence/) - Allegations that Medicaid is losing billions of dollars to fraud have sent Ohio Republicans racing to overhaul the state’s home-care system before their summer break. But as conservatives rush forward with a sweeping reform bill, critics are questioning whether lawmakers are moving too quickly to understand how the changes could harm elderly and disabled Ohioans
- [Ohio suspends payments to 49 Medicaid providers following fraud allegations](https://insurancefraud.org/news_archives/ohio-suspends-payments-to-49-medicaid-providers-following-fraud-allegations/) - The Ohio Department of Medicaid suspended pay to 49 Medicaid home health providers investigators deemed to be “high-risk” due to exhibiting potential fraud red flags, according to the department, with nearly all being located in Columbus. The suspensions followed an executive order by Gov. Mike DeWine to establish emergency rules to make the immediate suspensions
- [States agree to share data with DOJ to fight Medicaid fraud](https://insurancefraud.org/news_archives/states-agree-to-share-data-with-doj-to-fight-medicaid-fraud/) - Dr. Mehmet Oz, the U.S. Centers for Medicare & Medicaid's top official, was with FBI Director Kash Patel and other high-ranking officials from the U.S. Department of Justice and two state governments at a press conference in Columbus, Ohio, on Thursday to make three announcements about the fight against healthcare fraud. While the goal is
- [BCBA from New Jersey sentenced in Hartford over $102K health insurance fraud scheme](https://insurancefraud.org/news_archives/bcba-from-new-jersey-sentenced-in-hartford-over-102k-health-insurance-fraud-scheme/) - A New Jersey man was sentenced in Hartford Superior Court on Thursday for committing health insurance fraud while living in East Hartford and working in Glastonbury. Glenroy Patterson, 49, was sentenced to three years in prison, execution of that time suspended with five years conditional discharge. A report from the Connecticut Division of Criminal Justice
- [Multi-agency investigation recovers $630K in stolen vehicles; 2 arrested, SBI says](https://insurancefraud.org/news_archives/multi-agency-investigation-recovers-630k-in-stolen-vehicles-2-arrested-sbi-says/) - A multi-agency investigation has led to the recovery of more than $630,000 worth of stolen commercial vehicles and the arrest of two men on felony charges, according to the North Carolina State Bureau of Investigation. SBI agents executed search warrants Wednesday morning at properties in Hope Mills and Hoke County as part of the ongoing
- [The Buyer Who Never Existed: Synthetic Fraud in RV Sales](https://insurancefraud.org/news_archives/the-buyer-who-never-existed-synthetic-fraud-in-rv-sales/) - How often do you enter personal information online without a second thought? It’s routine when opening a new account, applying for financing or completing a purchase. What you don’t see is where that information goes. Each submission feeds a growing web of digital records designed to quickly verify identity and speed up transactions. Online shortcuts
- [Former Maumee-area doctor sentenced to time served after Medicare fraud convictions vacated](https://insurancefraud.org/news_archives/former-maumee-area-doctor-sentenced-to-time-served-after-medicare-fraud-convictions-vacated/) - A former Maumee-area doctor who was previously sentenced to more than two years in prison in a Medicare fraud case has now been sentenced to time served after her original convictions were vacated on appeal. Federal court records show Judge Jack Zouhary accepted a plea agreement for Ankita Singh on June 2 and sentenced her
- [Former metro Atlanta insurance business owner indicted on fraud charges after ANF investigation](https://insurancefraud.org/news_archives/former-metro-atlanta-insurance-business-owner-indicted-on-fraud-charges-after-anf-investigation/) - A former metro Atlanta insurance business owner who was the subject of an Atlanta News First investigation has been indicted on multiple felony insurance fraud charges after prosecutors said he took money from small business owners seeking insurance coverage and used it for personal gain. Last month, a Gwinnett County grand jury indicted Charles Curtis
- [Federal Watchdog Agency Finds Medicare Advantage Overpayments for Unsupported Diagnoses](https://insurancefraud.org/news_archives/federal-watchdog-agency-finds-medicare-advantage-overpayments-for-unsupported-diagnoses/) - A new report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that Medicare may have overpaid Medicare Advantage (MA) plans by millions for unsupported acute stroke diagnoses. Coding Abuses and MA Payment The Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage (MA) plans a set amount for
- [National Fraud Enforcement Division’s Healthcare Fraud Unit Secures Six Trial Convictions Involving over $1.1 Billion in Fraud In Under Three Weeks: Convictions Span five Federal Districts & six Distinct Categories of Healthcare Fraud](https://insurancefraud.org/news_archives/national-fraud-enforcement-divisions-healthcare-fraud-unit-secures-six-trial-convictions-involving-over-1-1-billion-in-fraud-in-under-three-weeks-convictions-span-five-federal-districts-am/) - The Justice Department’s National Fraud Enforcement Division today announced that its Health Care Fraud Unit, one of the most active white-collar litigating components across the Department, secured federal jury trial convictions in six trials in just under three weeks. The convictions in six trials between May 13 and June 1 spanned federal courtrooms across the
- [Luxury cars seized after alleged $30 million fraud ring involving children's health services busted, officials say](https://insurancefraud.org/news_archives/luxury-cars-seized-after-alleged-30-million-fraud-ring-involving-childrens-health-services-busted-officials-say/) - Federal law enforcement officials on Thursday announced that two Ohio state employees and two co-conspirators were indicted in connection with an alleged $30 million Medicaid billing fraud scheme involving children's behavioral health services that were never rendered. At a press conference in Ohio, acting Attorney General Todd Blanche said the Medicaid fraud case was just
- [Idaho Department of Insurance: Former agent convicted of felony fraud](https://insurancefraud.org/news_archives/idaho-department-of-insurance-former-agent-convicted-of-felony-fraud/) - The Idaho Department of Insurance announced that Stetzen Bailey, of Heyburn, Idaho, pled guilty on February 23, 2026, to one felony count of insurance fraud. Bailey is a former Farm Bureau insurance agent. The DOI Fraud Unit’s investigation found that Bailey knowingly backdated an insurance policy on a 2018 Bombardier snowmobile belonging to a family
- [AmTrust insurers sue New York law firm and surgeons over alleged fraud scheme](https://insurancefraud.org/news_archives/amtrust-insurers-sue-new-york-law-firm-and-surgeons-over-alleged-fraud-scheme/) - Insurers are fighting back. A trio of AmTrust carriers has filed a federal racketeering suit against a New York law firm, surgeons, and surgical centers. The complaint, filed June 2, 2026, in the Eastern District of New York, comes from Wesco Insurance Company, Technology Insurance Company, and Associated Industries Insurance Company, all owned by AmTrust Financial Services. The
- [New River Couple Sentenced for $12 Million AHCCCS Fraud Scheme](https://insurancefraud.org/news_archives/new-river-couple-sentenced-for-12-million-ahcccs-fraud-scheme/) - Thvoughn Lynden Curry, 34, and Alexis Daneen Curry, 34, both of New River, Arizona, were sentenced Monday by Senior U.S. District Judge G. Murray Snow for their role in a scheme to defraud the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, of over $12 million. Both defendants were previously convicted at trial
- [Workers’ compensation fraud scheme targets Spanish-speaking employees](https://insurancefraud.org/news_archives/workers-compensation-fraud-scheme-targets-spanish-speaking-employees/) - Washington Attorney General Nick Brown is alerting the public to a fraud scheme aimed at injured, Spanish-speaking workers throughout the Pacific Northwest. The Washington State Attorney General’s Office reported that scammers are reaching out to victims via phone calls, emails, text messages, and popular messaging platforms like WhatsApp and Facebook Messenger. The fraudsters pose as representatives of
- [Florida woman convicted for conspiracy to commit mail fraud](https://insurancefraud.org/news_archives/florida-woman-convicted-for-conspiracy-to-commit-mail-fraud/) - A Florida woman was convicted for her role in a multi-state scheme to fraudulently obtain unemployment insurance benefits. Cheryl Galloway, 67, of Yulee, Florida, was convicted of Conspiracy to Commit Mail Fraud in U.S. District Court, said Margaret E. “Meg” Heap, U.S. Attorney for the Southern District of Georgia. Galloway now faces up to 20
- [United States Announces $36.5 Million Settlement Of Medicare Fraud Lawsuit Against Matrix Medical Network](https://insurancefraud.org/news_archives/united-states-announces-36-5-million-settlement-of-medicare-fraud-lawsuit-against-matrix-medical-network/) - United States Attorney for the Southern District of New York, Jay Clayton, and Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), Naomi Gruchacz, announced that the United States has settled a civil healthcare fraud lawsuit against COMMUNITY CARE HEALTH
- [Nurse Practitioner Convicted for Illegal Distribution of Controlled Substances](https://insurancefraud.org/news_archives/nurse-practitioner-convicted-for-illegal-distribution-of-controlled-substances/) - A federal jury in the Middle District of Tennessee convicted a Tennessee woman yesterday for illegally distributing controlled substances. According to court documents and evidence presented at trial, Heather Marks, 43, of Murfreesboro, Tennessee, was an Advanced Registered Nurse Practitioner who was licensed by the Drug Enforcement Administration (DEA) to distribute controlled substances. Marks prescribed
- [Charlotte man charged with insurance fraud after lying about date of car wreck, prosecutors say](https://insurancefraud.org/news_archives/charlotte-man-charged-with-insurance-fraud-after-lying-about-date-of-car-wreck-prosecutors-say/) - A Charlotte man has been charged with insurance fraud and attempting to obtain property under false pretense for allegedly lying about when a car accident occurred to collect insurance money. Dominick Shevonta Phifer, 34, was involved in a vehicle accident on Nov. 30, 2025, according to a criminal summons. Phifer purchased an automobile insurance policy
- [Republicans Cry "Fraud" to Kick Seniors Out of Nursing Homes While Trump Pardons Convicted Fraudsters](https://insurancefraud.org/news_archives/republicans-cry-fraud-to-kick-seniors-out-of-nursing-homes-while-trump-pardons-convicted-fraudsters/) - On Wednesday, Republicans are holding another sham hearing where they will use bogus fraud claims as a cover to justify ripping away health care from millions of working Americans so they can fund tax breaks for billionaires and big corporations. Republicans can’t claim to be serious about fraud when Trump has repeatedly abused his power to pardon his fraudster
- [Kansas woman sentenced to prison for stealing deceased relative’s identity to fraudulently receive federal and state benefits](https://insurancefraud.org/news_archives/kansas-woman-sentenced-to-prison-for-stealing-deceased-relatives-identity-to-fraudulently-receive-federal-and-state-benefits/) - A Kansas woman was sentenced to 15 months in prison for fraudulently receiving approximately $450,000 by simultaneously collecting federal and state government benefits in her own name and through identity theft. According to court documents, Tamera Ruth Powers, 68, of Tonganoxie pleaded guilty to one count of wire fraud. Tamera Ruth Powers stole the identity
- [Bucks County public adjuster charged with insurance fraud after allegedly stealing from clients](https://insurancefraud.org/news_archives/bucks-county-public-adjuster-charged-with-insurance-fraud-after-allegedly-stealing-from-clients/) - A Bucks County public adjuster is facing charges that he stole from clients. Greg Micucci, 61, is accused of misappropriating more than $140,000 in insurance claims. Two of the nine victims were senior citizens. Micucci's alleged fraud came after a client reported that he failed to pay contractors for repairs after a storm. He faces
- [The New Face of Insurance Fraud Looks Just Like a Legitimate Claim](https://insurancefraud.org/news_archives/the-new-face-of-insurance-fraud-looks-just-like-a-legitimate-claim/) - Every week, my team reviews claims that look, on the surface, like open-and-shut cases. The injury is plausible. The treatment records are in order. The documentation is clean. And increasingly, that’s precisely the problem. The question we’ve had to learn how to ask is whether it’s actually real or just posing as legitimate enough to
- [HHS Expands Use of AI in Detection of Healthcare Fraud](https://insurancefraud.org/news_archives/hhs-expands-use-of-ai-in-detection-of-healthcare-fraud/) - The United States Department of Health and Human Services (“HHS”) announced at the end of May that it is expanding its use of AI to analyze the audit reports of states and other recipients of federal healthcare funding. This expanded use of AI is meant to reduce the risk of fraud and decrease wasteful spending.
- [Man convicted for scheme sending ‘imposter nurses’ to Washington care facilities](https://insurancefraud.org/news_archives/man-convicted-for-scheme-sending-imposter-nurses-to-washington-care-facilities/) - A man was convicted in Washington state for running a fraudulent business that sent “imposter nurses” to healthcare facilities across Washington state, officials announced Monday. The Washington Attorney General’s office said a King County jury found David Mungai Njenga guilty on 11 counts in the Medicaid fraud trial on May 28, including a felony charge
- [TDI analysts work behind the scenes to stop insurance fraud](https://insurancefraud.org/news_archives/tdi-analysts-work-behind-the-scenes-to-stop-insurance-fraud/) - TDI Fraud Unit analysts Anita Todd and Vivian Cervantez play a key role in unraveling insurance scams across Texas. Their job is to follow the financial paper trail—claims, receipts, bank records, and personal information—to reveal the full scope of a fraud scheme, identify victims, and support investigators building criminal cases. “Some people don’t even know
- [Police chief faked a staged theft for insurance fraud, appeals court affirms](https://insurancefraud.org/news_archives/police-chief-faked-a-staged-theft-for-insurance-fraud-appeals-court-affirms/) - A Texas police chief torched his wife's SUV, called it stolen, and collected on the claim. A federal court just upheld his fraud conviction. On June 1, 2026, the US Court of Appeals for the Fifth Circuit affirmed the conviction of Christopher Filline, former police chief of Castroville, Texas, for conspiracy to commit wire fraud.
- [Ways & Means Advances Anti-Fraud Bills](https://insurancefraud.org/news_archives/ways-means-advances-anti-fraud-bills/) - The House Ways and Means Committee approved several bills last week aimed at reducing waste, fraud, abuse, and errors in the federal budget as well as reauthorizing demonstration authority in the Social Security Disability Insurance (SSDI) program. Those bills include: The Protecting Seniors and Stopping Fraudsters Act (H.R. 8883), which would increase oversight of hospices and Home Health
- [Top 10 Recommendations for Addressing Fraud in NJ PIP Arbitration: A DRP’s Perspective](https://insurancefraud.org/news_archives/top-10-recommendations-for-addressing-fraud-in-nj-pip-arbitration-a-drps-perspective-2/) - A Maryland man pled guilty in federal court, today, to charges stemming from a social security disability benefits scam. Andrew Langford, 50, of Ft. Washington, is charged with one count of wire fraud in connection with the scheme. U.S. Social Security Administration (SSA) records show that from January 2014 through May 2021, Langford received more
- [Top 10 Recommendations for Addressing Fraud in NJ PIP Arbitration: A DRP’s Perspective](https://insurancefraud.org/news_archives/top-10-recommendations-for-addressing-fraud-in-nj-pip-arbitration-a-drps-perspective/) - New Jersey’s no fault PIP system presents a unique blend of statutory requirements, arbitration procedures, and evolving fraud schemes. For carriers, counsel, and SIU professionals, navigating this landscape effectively requires more than familiarity with the rules — it demands an understanding of how Dispute Resolution Professionals (DRPs) evaluate evidence, credibility, and patterns of abuse. Drawing
- [DOJ Announces $90 Million Medicaid Fraud Indictment in Minneapolis as Acting AG No-Shows](https://insurancefraud.org/news_archives/doj-announces-90-million-medicaid-fraud-indictment-in-minneapolis-as-acting-ag-no-shows/) - Federal prosecutors announced indictments May 21 against 15 people accused of defrauding Minnesota’s Medicaid program of $90 million, but the nation’s top law enforcement officer was absent from the Minneapolis press conference where the charges were unveiled. Acting U.S. Attorney General Todd Blanche did not attend the event, instead appearing in Washington to defend a
- [Community colleges use AI to fight fraudsters — but scammers keep finding new ways in - Local News Matters](https://insurancefraud.org/news_archives/community-colleges-use-ai-to-fight-fraudsters-but-scammers-keep-finding-new-ways-in-local-news-matters/) - YEARS SINCE FIRST BEING TARGETED by COVID-era financial aid scammers, California’s community colleges still can’t fully shake the fraud. It’s not for lack of trying. Colleges have made progress by using machine learning tools to sniff out many fake students created by fraudsters via artificial intelligence. Most colleges now use AI software to screen applicants. The problem, however,
- [OIG Updating Fraud, Waste and Abuse Detection Algorithms with AI](https://insurancefraud.org/news_archives/oig-updating-fraud-waste-and-abuse-detection-algorithms-with-ai/) - Teams within the OIG Data Operations Division recently launched new efficiency-focused tools that speed up data collection, analysis and distribution. Performance dashboard The Statistical Analysis and Data Visualization team has developed a Performance Metrics Dashboard that provides OIG leadership with a centralized, comprehensive view of both current and historical performance measures across the agency. The
- [“Fraud Department” Scam Drains Thousands While Another Victim Finds Insurance Policy Opened in His Name](https://insurancefraud.org/news_archives/fraud-department-scam-drains-thousands-while-another-victim-finds-insurance-policy-opened-in-his-name/) - One victim lost thousands buying gift cards for a fake computer technician. Another discovered someone had allegedly opened insurance-related accounts using his banking information. And deputies say both cases are part of a growing wave of fraud schemes hitting ordinary people who often don’t realize they’ve been targeted until money suddenly starts disappearing. According to
- [Lehigh Acres nurse accused of defrauding Medicaid program in Connecticut](https://insurancefraud.org/news_archives/lehigh-acres-nurse-accused-of-defrauding-medicaid-program-in-connecticut/) - A Lehigh Acres nurse was arrested on May 22 in Connecticut. She's accused of defrauding Connecticut's Medicaid program using false claims, according to a news release from the U.S. Attorney's Office in the District of Connecticut. According to the release, Marisol Rodriguez, 49, an Advanced Practice Registered Nurse (APRN), defrauded the Connecticut Medicaid Program by
- [Former missing woman now serving jail time after pleading guilty to insurance fraud](https://insurancefraud.org/news_archives/former-missing-woman-now-serving-jail-time-after-pleading-guilty-to-insurance-fraud/) - After previously being reported missing in April, 58-year-old Mandan woman Tammy Urness is now serving jail time after pleading guilty to insurance fraud. Urness, who was found two days after being reported missing, was charged with a Class A felony after she reportedly filed false insurance claims for services at Sanford Health, CHI St. Alexius,
- [Insurance companies accuse medical providers of fraudulent billing and kickback scheme](https://insurancefraud.org/news_archives/insurance-companies-accuse-medical-providers-of-fraudulent-billing-and-kickback-scheme/) - Allegations of fraudulent billing practices and illegal kickbacks have been raised in a new federal lawsuit that seeks to recover more than $1.6 million already paid for what are described as medically unnecessary treatments, with an additional $3.7 million in pending claims at stake. The complaint was filed by 21st Century Centennial Insurance Company, Bristol
- [Insurance regulation bills clear House](https://insurancefraud.org/news_archives/insurance-regulation-bills-clear-house/) - Gov. JB Pritzker says he looks forward to signing a pair of bills that cleared the Illinois House on Wednesday giving the state Insurance Department authority to regulate premiums charged for automobile and homeowners insurance. "Too many families have dealt with unexplained, unfair insurance price hikes on their homes and cars, so this legislation helps protect consumers while maintaining
- [New charges against former Mobile County sheriff’s sergeant involve double-billing, bogus insurance claims](https://insurancefraud.org/news_archives/new-charges-against-former-mobile-county-sheriffs-sergeant-involve-double-billing-bogus-insurance-claims/) - Daniel E. Holifield said nothing Friday afternoon after leaving the federal courthouse downtown, where he pleaded not guilty to new criminal charges. Details contained in a pair of new indictments paint the picture of a man who used his position as fleet supervisor at the Mobile County Sheriff’s Office to steal hundreds of thousands of
- [Before You Click That Fraud Alert Text, Do This Instead](https://insurancefraud.org/news_archives/before-you-click-that-fraud-alert-text-do-this-instead/) - Fraud alerts can quickly notify you of suspicious or unauthorized activity on your bank accounts. But sometimes fraud alerts themselves can be a scam. Some banks warn of fake fraud alerts in which scammers send you a text that appears to be from your bank warning you of suspicious activity. The text then prompts you to click
- [Amputee surgeon struck off for posing extreme risk](https://insurancefraud.org/news_archives/amputee-surgeon-struck-off-for-posing-extreme-risk/) - A convicted NHS vascular surgeon who froze his own legs so they had to be removed has been struck off the medical register. Neil Hopper, 50, of Truro, Cornwall, was sentenced in September to 32 months in prison and given an 10-year sexual harm prevention order for insurance fraud and possessing extreme pornography. On Friday,
- [Woman charged with insurance fraud](https://insurancefraud.org/news_archives/woman-charged-with-insurance-fraud/) - A woman is accused of insurance fraud, according to SLED. Authorities say 30-year-old Jasmine Shada Grate is charged with forgery valued at $10,000 or more and presenting a false insurance claim valued at $10,000 or more. The South Carolina Department of Insurance requested the investigation. According to the arrest warrant, Grate provided a false Employment
- [Dr. Kumar’s legal battle persists after 40-count fraud conviction](https://insurancefraud.org/news_archives/dr-kumars-legal-battle-persists-after-40-count-fraud-conviction/) - East Memphis doctor Sanjeev Kumar is back in federal court just months after being convicted on 40 counts. Kumar was found guilty in January on charges including healthcare fraud and misuse of medical devices. But his team says the case is not over and several legal issues remain before the court. A federal jury convicted
- [Lowell Man Pleads Guilty to Hiding More Than $6 Million in Payroll](https://insurancefraud.org/news_archives/lowell-man-pleads-guilty-to-hiding-more-than-6-million-in-payroll/) - A Lowell man pleaded guilty in federal court in Boston to his involvement in payroll tax avoidance and workers’ compensation insurance fraud. Henry Lam, 68, pleaded guilty to failure to collect and pay over taxes and mail fraud. U.S. District Court Chief Judge Denise J. Casper scheduled sentencing for Aug. 27, 2026. In July 2025,
- [Warning over new AI insurance scams](https://insurancefraud.org/news_archives/warning-over-new-ai-insurance-scams/) - Insurance fraud in the United States costs consumers an estimated $308.6 billion a year, and artificial intelligence is making it worse – and harder to detect. Data and AI firm SAS warned in a report that generative AI tools now allow virtually anyone with a computer to create or alter images for the purpose of
- [Massachusetts sues UnitedHealthcare over alleged MassHealth payment fraud](https://insurancefraud.org/news_archives/massachusetts-sues-unitedhealthcare-over-alleged-masshealth-payment-fraud/) - Massachusetts Attorney General Andrea Joy Campbell has sued UnitedHealthcare for allegedly misrepresenting members' health conditions to defraud the state. The insurer is accused of inflating patient care levels in its MassHealth Senior Care Options plan to wrongfully secure larger payments. The lawsuit filed in Suffolk Superior Court says MassHealth, Massachusetts’ Medicaid programme, was overcharged by
- [The "Inherent Risk" of Staged Collisions and the Limits of Sentencing Stipulations](https://insurancefraud.org/news_archives/the-inherent-risk-of-staged-collisions-and-the-limits-of-sentencing-stipulations/) - In a significant win for law enforcement and the insurance industry, the Tenth Circuit recently affirmed a 48-month sentence for a defendant who orchestrated a sophisticated, multi-year insurance fraud scheme involving staged car wrecks. The court’s ruling in United States v. Brown, No. 25-7026 (Dec. 30, 2025) underscores a powerful legal precedent: the act of staging
- [Appellate court upholds arson conviction of man who burned down his restaurant](https://insurancefraud.org/news_archives/appellate-court-upholds-arson-conviction-of-man-who-burned-down-his-restaurant/) - The Appellate Division Second Department of State Supreme Court has affirmed the conviction of Zef Gjurahsaj, 64, formerly of the Town of Newburgh, who was convicted of torching his restaurant to collect the insurance money. Gjurashaj and a co-defendant conspired to burn down Andiamo’s Restaurant at 5025 Route 9W in the Town of Newburgh in
- [IFB is Working With Tempcover on Anti-Fraud Strategies](https://insurancefraud.org/news_archives/ifb-is-working-with-tempcover-on-anti-fraud-strategies/) - The Insurance Fraud Bureau (IFB) has added market-leading temporary insurance provider Tempcover to its membership, integrating the specialist’s comprehensive data into the Bureau’s anti-fraud network. This partnership reinforces Tempcover’s commitment to protecting its 3.7 million users and supporting insurer partners by actively contributing to the fight against fraud within the temporary insurance market. As a digital-first leader,
- [California Drivers Arraigned for Insurance Fraud in Staged Crash Scheme](https://insurancefraud.org/news_archives/california-drivers-arraigned-for-insurance-fraud-in-staged-crash-scheme/) - Four Southern California drivers were arraigned in an alleged staged collision scheme tied to coordinated insurance fraud. The collisions reportedly endangered an innocent driver. The defendants are: Jhoiner Rodriguez Celis, 31, of Anaheim; Melissa Cervantes De La Torre, 30, of Upland; Nailer Mendez Diaz, 35, of Anaheim; and Plata Sampayo, 28, of Upland. Their arraignment
- [Clinic Manager Convicted of $8 Million Medicare Fraud Scheme](https://insurancefraud.org/news_archives/clinic-manager-convicted-of-8-million-medicare-fraud-scheme/) - Today, Olga Popovych was convicted by a federal jury in Brooklyn for her role in an $8 million health care fraud conspiracy. Popovych was an office manager of several physical therapy clinics in Brooklyn that paid cash kickbacks to ambulette drivers who recruited Medicare patients to transport to clinics. The verdict was returned after a
- [There’s no place like home — for health care fraud](https://insurancefraud.org/news_archives/theres-no-place-like-home-for-health-care-fraud/) - Some ideas are better on paper than in reality. That’s the case with state-subsidized home health care performed by relatives. In principle, it saves money to pay relatives for providing basic care that would be more expensive for the government in a hospital or nursing home. In practice, the policy has become riddled with fraud, almost everywhere it
- [Eight indicted in Medicaid fraud, nursing home theft cases](https://insurancefraud.org/news_archives/eight-indicted-in-medicaid-fraud-nursing-home-theft-cases/) - Indictments filed this month by the office of Ohio Attorney General Dave Yost accuse five Medicaid providers of stealing a combined $542,176 from the government health-care program for the needy. Three additional people face charges for allegedly stealing from nursing home residents. “Caregivers are meant to protect the vulnerable, not exploit them,” Yost said. “My
- [Insurers grapple with new fraud threat: AI-generated images](https://insurancefraud.org/news_archives/insurers-grapple-with-new-fraud-threat-ai-generated-images/) - Insurance fraud, unfortunately, is inevitable. A certain amount of fraud is priced into the product. The goal for insurers is to find the right balance – focusing on fraud prevention for the biggest cases without alienating trusted customers. But the AI age has introduced a new source of fraud that threatens that balance by making fraud simpler, easier and more widespread: images that have been
- [Calif. appeals court rejects bid to seal records in comp fraud case](https://insurancefraud.org/news_archives/calif-appeals-court-rejects-bid-to-seal-records-in-comp-fraud-case/) - A California appeals court affirmed the denial of an attorney’s petition to seal arrest records stemming from a workers compensation fraud and money laundering case. The California Court of Appeal, Fourth Appellate District, Division Two, on Wednesday held in People v. Rifat that Matthew David Murray Rifat was not entitled to have records sealed because
- [Levi Miles sentenced to 5 years in prison for role in David Aylor's death](https://insurancefraud.org/news_archives/levi-miles-sentenced-to-5-years-in-prison-for-role-in-david-aylors-death/) - Levi Miles, the man who pleaded guilty in January to his role in the 2023 death of prominent Lowcountry attorney David Aylor, was sentenced to five years in federal prison on Wednesday. Miles was charged with one count of conspiracy to possess fentanyl and oxycodone with intent to distribute and one count of possession of
- [Gen Z Is Using AI To Gamble The Insurance System And Exposing a Broken System](https://insurancefraud.org/news_archives/gen-z-is-using-ai-to-gamble-the-insurance-system-and-exposing-a-broken-system/) - Gen Z consumers are more likely to use AI to alter an insurance claim to make their claim more financially favorable, recent data suggests. But consumer advocates and members of the generation themselves say this is a mark of a bigger, more insidious issue within the fabric of the U.S. insurance market. A third of all consumers would
- [Two Minnesota Residents Arrested for $21 Million Medicaid Fraud Scheme](https://insurancefraud.org/news_archives/two-minnesota-residents-arrested-for-21-million-medicaid-fraud-scheme/) - The United States Department of Homeland Security (DHS) issued the following statement after U.S. Immigration and Customs Enforcement’s (ICE) Homeland Security Investigations (HSI) arrested two Minnesota residents on charges of health care fraud after stealing more than $21 million from American taxpayers. On May 21, HSI St. Paul reported the arrest of Shamso Ahmed Hassan
- [Farmland Title Fraud on the Rise as Scammers Target Rural Property Owners](https://insurancefraud.org/news_archives/farmland-title-fraud-on-the-rise-as-scammers-target-rural-property-owners/) - Concerns surrounding farmland real estate fraud in the ag sector continue to grow as scammers increasingly target rural landowners across the country. RFD News farm legal expert Roger McEowen, with Kansas’ Washburn School of Law, joined us on Wednesday’s Market Day Report to break down why agricultural property has become a growing target for criminals. According to McEowen, fraudsters are
- [Alleged fraud prompts long list of potential changes to Ohio Medicaid](https://insurancefraud.org/news_archives/alleged-fraud-prompts-long-list-of-potential-changes-to-ohio-medicaid/) - Reports of hundreds of millions of dollars in Medicaid fraud allegedly committed by home health care providers in Ohio have yet to be fully detailed and verified. But state lawmakers are already moving toward cracking down on holes they say scammers can use to exploit the system. The Ohio House Medicaid Committee began a three-hour
- [Oglethorpe Inc. and Top Executives Agree to Pay $32M to Resolve False Claims Act Allegations](https://insurancefraud.org/news_archives/oglethorpe-inc-and-top-executives-agree-to-pay-32m-to-resolve-false-claims-act-allegations/) - Oglethorpe Inc. (Oglethorpe), an operator of psychiatric hospitals headquartered in Tampa, Florida, along with its founder and principal owner, Robert Cohen, CEO John Picciano, and Chief Operating Office James O’Shea, have agreed to pay $32 million to resolve allegations that they violated the False Claims Act by knowingly failing to return overpayments received from the Medicare program
- [2 charged after Columbus arson investigators tie them to March fire](https://insurancefraud.org/news_archives/2-charged-after-columbus-arson-investigators-tie-them-to-march-fire/) - Two men are facing charges after a Columbus Fire & EMS investigation linked them to a blaze that took place earlier this spring. Arson investigators connected Emerson Myers and Kelvin Hall to a fire that broke out on March 7. Emergency crews responded to the incident in the 1400 block of 15th Street. Following a
- [Insurance fraudster sentenced for staging Tri-Cities crashes in $1M scam](https://insurancefraud.org/news_archives/insurance-fraudster-sentenced-for-staging-tri-cities-crashes-in-1m-scam/) - A California man was sentenced to prison in a Tri-Cities insurance fraud case that involved an elaborate scheme to buy cars and stage crashes to collect on fake injuries. As part of the case, he also admitted to threatening to kill the Eastern Washington family of a witness. Ahmad K. Bachay, 40, was one of
- [Four arrested in alleged insurance fraud scheme](https://insurancefraud.org/news_archives/four-arrested-in-alleged-insurance-fraud-scheme/) - Louisiana State Police have arrested four New Iberia residents in connection with an alleged automobile insurance fraud scheme. Rayshonte Oppenheimer, 29; Briannie Butler, 24; Passion Keal, 24; and Quandalyn Bernard, 33, were all arrested by investigators with the Louisiana State Police Insurance Fraud / Auto Theft Unit. The investigation began after a criminal referral from
- [Minnesota woman accused in $21 million autism fraud scheme pleads not guilty](https://insurancefraud.org/news_archives/minnesota-woman-accused-in-21-million-autism-fraud-scheme-pleads-not-guilty/) - A 55-year-old Minnesota woman accused in a $21 million autism fraud scheme pleaded not guilty to charges of healthcare fraud and money laundering Tuesday morning. According to the indictment, Shamso Ahmed Hassan was one of several owners of Smart Therapy Center and Star Autism Center. As part of the scheme, she submitted false claims to
- [Rochester man sentenced for defrauding Medicare](https://insurancefraud.org/news_archives/rochester-man-sentenced-for-defrauding-medicare/) - U.S. Attorney Michael DiGiacomo announced today that John Weinmann, 57, of Rochester, NY, who was convicted of knowingly receiving a kickback under a federal health care program, was sentenced to serve three years’ probation and a $2,000 fine by U.S. District Judge Lawrence J. Vilardo. This action is part of the Trump Administration’s Task Force
- [Feeding Our Future leader gets 41-year sentence in $250M fraud](https://insurancefraud.org/news_archives/feeding-our-future-leader-gets-41-year-sentence-in-250m-fraud/) - Historic sentence in pandemic fraud caseU.S. District Judge Nancy Brasel sentenced Aimee Bock to 500 months in prison and ordered nearly $243 million in restitution for orchestrating the Feeding Our Future scheme. Prosecutors said Bock certified each false claim, signed checks to sham distributors, and fought oversight, enabling $250 million in theft from child nutrition
- [Owner of Multinational Investment Company Sentenced in $2B Fraud, Money Laundering, and Bribery Schemes](https://insurancefraud.org/news_archives/owner-of-multinational-investment-company-sentenced-in-2b-fraud-money-laundering-and-bribery-schemes/) - Greg Lindberg, 56, of Tampa, Florida, and the founder and chairman of Eli Global LLC and owner of Global Bankers Insurance Group (GBIG) was sentenced today to a combined 12 years in prison for his role in a bribery conspiracy and multibillion-dollar fraud conspiracy that bankrupted multiple insurance companies with thousands of unpaid policyholder victims.
- [A quick and easy way to stop Medicaid fraud](https://insurancefraud.org/news_archives/a-quick-and-easy-way-to-stop-medicaid-fraud/) - Medicaid has been plagued with fraud for decades. But recent revelations indicate that the fraud isn’t just widespread — it is rampant. Fortunately, there is a way to stop the fraud, and it is one that Republicans have been proposing for decades. Recent news stories have uncovered Medicaid fraud rings in Minnesota and California that have been
- [AG's Office Secures Indictments Against Two West Brookfield Physicians for Illegally Prescribing Controlled Substances and Medicaid Fraud](https://insurancefraud.org/news_archives/ags-office-secures-indictments-against-two-west-brookfield-physicians-for-illegally-prescribing-controlled-substances-and-medicaid-fraud/) - The Massachusetts Attorney General’s Office (AGO) announced today that Dr. Jeffrey J. Jones and Dr. James C. Wilson III were indicted by a Worcester County Grand Jury on eight counts each of Illegal Prescribing of Controlled Substances – including combinations of opioids, stimulants, and benzodiazepines – and one count each of Medicaid False Claims. The
- [TikTok Insurance Advice Gone Wrong: Know the Difference Between Life Hack and Fraud](https://insurancefraud.org/news_archives/tiktok-insurance-advice-gone-wrong-know-the-difference-between-life-hack-and-fraud/) - With car insurance rates rising, particularly for young drivers and urban residents, Americans often look for tips and tricks to save money on their insurance premiums. But most online advice does not come from insurance experts, and some creators’ strategies cross the line into insurance fraud. The risks of committing fraud far outweigh the rewards.
- [Bowie insurance salesman indicted in connection with fraud, felony theft](https://insurancefraud.org/news_archives/bowie-insurance-salesman-indicted-in-connection-with-fraud-felony-theft/) - A Prince George’s County grand jury on Tuesday indicted Corrie Alston, 51, of Bowie, with felony theft scheme and insurance fraud for submitting multiple fraudulent life insurance applications, Attorney General Anthony G. Brown announced. The indictment includes one count of a felony theft scheme of $1,500-$25,000 and 21 counts of felony insurance fraud over $300.
- [Couple arrested on insurance fraud charges in West Haven](https://insurancefraud.org/news_archives/couple-arrested-on-insurance-fraud-charges-in-west-haven/) - Two New York residents turned themselves in to police after an investigation determined they staged an armed robbery to defraud an insurance company. West Haven police responded to a parking lot on Elm Street in December for a reported armed robbery. The victim told police she was robbed at gunpoint of all her jewelry. The
- [3 steps that could stop fraud and make healthcare more affordable for all Americans](https://insurancefraud.org/news_archives/3-steps-that-could-stop-fraud-and-make-healthcare-more-affordable-for-all-americans/) - Americans know something is broken in healthcare. Premiums keep rising, deductibles keep climbing and medical bills often arrive with charges no one can explain. Behind those frustrations is the fact that we operate within a healthcare system built around secrecy. On May 18, President Donald Trump took on drug pricing with the expansion of TrumpRX, a first-of-its kind platform
- [Prince George’s County Man Sentenced To 6 Years For Role In $3.5M CARES Act Scam](https://insurancefraud.org/news_archives/prince-georges-county-man-sentenced-to-6-years-for-role-in-3-5m-cares-act-scam/) - A Prince George’s County, Maryland, man learned his fate in federal court in connection with an unemployment insurance (UI) fraud conspiracy. District Judge Deborah L. Boardman sentenced Terry Chen, 26, to six years in federal prison, followed by three years of supervised release, for conspiracy to commit wire fraud and aggravated identity theft, in connection
- [GOP candidate for Ohio governor Vivek Ramaswamy announces proposal to curb medicaid fraud](https://insurancefraud.org/news_archives/gop-candidate-for-ohio-governor-vivek-ramaswamy-announces-proposal-to-curb-medicaid-fraud/) - ++SOUNDBITES SEPARATED BY BLACK FRAMES++ ASSOCIATED PRESSColumbus, Ohio – 19 May 2026 SOUNDBITE (English) Vivek Ramaswamy, Republican Candidate for Ohio Governor:“We live in a moment where advances in medicine allow people, should allow people to live longer and healthier lives, but that doesn't happen unless you're able to afford access to that healthcare. Too many
- [2 charged in DOJ's Medicaid fraud case appear in court](https://insurancefraud.org/news_archives/2-charged-in-dojs-medicaid-fraud-case-appear-in-court/) - Fifteen people are accused of stealing more than $90 million in taxpayer dollars in various fraud schemes impacting multiple Minnesota Medicaid programs, including one that the fraud crisis effectively wiped out. According to prosecutors, eight of the defendants took money from Housing Stabilization Services. It was designed to reimburse providers who helped get seniors or
- [This Week in Fraud: The Fraud Division Announced Expansion of Midwest Task Force and Authorization to Hire 15 New Medicaid Prosecutors, an Unprecedented Minnesota Health Care Fraud Takedown, and a $2 Billion Telemedicine Health Care Fraud Scheme](https://insurancefraud.org/news_archives/this-week-in-fraud-the-fraud-division-announced-expansion-of-midwest-task-force-and-authorization-to-hire-15-new-medicaid-prosecutors-an-unprecedented-minnesota-health-care-fraud-takedown-and-a-2/) - This week, the Justice Department’s National Fraud Enforcement Division continued to advance its mission to fight fraud and protect taxpayers. Assistant Attorney General Colin M. McDonald, along with HHS Secretary Robert F. Kennedy, Jr., Centers for Medicare & Medicaid Services Administrator Mehmet Oz, U.S. Attorney Daniel Rosen, and FBI Co-Deputy Director Christopher Raia, announced unprecedented charges against
- [Family therapist faces licensing issues after pleading guilty to theft and fraud](https://insurancefraud.org/news_archives/family-therapist-faces-licensing-issues-after-pleading-guilty-to-theft-and-fraud/) - A Des Moines therapist accused of business-related theft, fraud and forgery is now facing disciplinary charges from a state licensing board. The Iowa Board of Behavioral Health Professionals has charged state-licensed marital and family therapist Michelle Raye Stewart-Sandusky, 38, of Baxter with being convicted of an offense that directly relates to the duties and responsibilities
- [Four local residents charged in thefts from long-term care residents](https://insurancefraud.org/news_archives/four-local-residents-charged-in-thefts-from-long-term-care-residents/) - Four Columbus residents are among eight people recently indicted for health care fraud as part of an enforcement effort by the Ohio Attorney General's office. Attorney General Dave Yost announced the indictments on May 20. The four Columbus residents involved are: Kimberly Henry, 56, who is charged with felony theft and Medicaid fraud for billing
- [Investigators say C.R. man's life insurance claims for 3 children were fraudulent](https://insurancefraud.org/news_archives/investigators-say-c-r-mans-life-insurance-claims-for-3-children-were-fraudulent/) - A Cedar Rapids man is accused of theft and insurance fraud after investigators said he submitted life insurance claims for three children whose deaths could not be substantiated. Thompson Nagbe Jr., 37, made two fraudulent life insurance claims on policies he enrolled in through his employer, according to a Linn County criminal complaint. Nagbe initiated
- [Schmidt spotlights red flags during Contractor Fraud Awareness Week](https://insurancefraud.org/news_archives/schmidt-spotlights-red-flags-during-contractor-fraud-awareness-week/) - Severe weather in Kansas often means storm damage and insurance claims and many Kansans will be hiring contractors of different trades to help them recover and rebuild. But not every contractor that knocks on your door after a storm is legitimate. The National Insurance Crime Bureau (NICB) reported contractor fraud increased 38% from 2023 to
- [HHS launches AI-backed health fraud crackdown](https://insurancefraud.org/news_archives/hhs-launches-ai-backed-health-fraud-crackdown/) - The HHS is continuing its crackdown on healthcare fraud, launching a program that will use artificial intelligence to examine audits from states and other federal grant recipients — and potentially affect Medicaid funds. The Office of the Assistant Secretary for Financial Resources will look across all states to analyze at least five years of audits that grantees file
- [Minnesota autism, disabled services providers among 15 charged with Medicaid fraud](https://insurancefraud.org/news_archives/minnesota-autism-disabled-services-providers-among-15-charged-with-medicaid-fraud/) - The Justice Department on Thursday announced criminal charges against 15 people in Minnesota accused of defrauding Medicaid and several other state-run social services programs of more than $90 million. “The fraud here in Minnesota is shocking,” said Assistant Attorney General Colin McDonald during a press conference in Minneapolis. “This is not the end of our work.” Top officials, including Health
- [Avoiding Fraud After a Natural Disaster](https://insurancefraud.org/news_archives/avoiding-fraud-after-a-natural-disaster/) - As weather-driven catastrophes grow more frequent and severe, the risks to homeowners now go far beyond wind and water. In 2025, the U.S. endured 23-billion-dollar weather events—nearly one every 16 days—compared to just one every 82 days in the 1980s. These disasters caused an estimated $184.8 billion in damage, with 80% covered by insurance. But
- [Four people charged in $659K Connecticut Medicaid fraud at Shelton clinic](https://insurancefraud.org/news_archives/four-people-charged-in-659k-connecticut-medicaid-fraud-at-shelton-clinic/) - Four people from a Shelton clinic were charged Wednesday in a Medicaid fraud scheme, according to the state Division of Criminal Justice. An investigation found that Advanced Pain and Regenerative Medical Solutions Corporation, or APRM Solutions, submitted 4,009 fraudulent claims to the Connecticut Medicaid Program for allergy immunotherapy services, the DCJ said. The agency noted
- [Home healthcare providers targeted amid fraud crackdown](https://insurancefraud.org/news_archives/home-healthcare-providers-targeted-amid-fraud-crackdown/) - The fraud allegations spurring new legislative action at the Ohio Statehouse are centered on Medicaid funds for home healthcare providers — something Gov. Mike DeWine (R-Ohio) said should remain in place, even as some of his fellow Republican leaders question the wisdom of the program. Since 1999, Ohio has operated a home healthcare waiver, meaning
- [Three Broward men sentenced to federal prison in multimillion-dollar Medicare fraud scheme](https://insurancefraud.org/news_archives/three-broward-men-sentenced-to-federal-prison-in-multimillion-dollar-medicare-fraud-scheme/) - Three Broward County men will serve federal prison terms for their involvement in a Medicare fraud and money laundering scheme. Marco Scamarone, 34, of Tamarac; Jose Mendez, 34, of Coral Springs; and Renee Vazquez, 33, of Tamarac, entered agreements in December and pled guilty to conspiracy to commit money laundering. Mendez was sentenced in April
- [RHOP Stars Wendy and Eddie Osefo’s Insurance Fraud Trial Set for 2027](https://insurancefraud.org/news_archives/rhop-stars-wendy-and-eddie-osefos-insurance-fraud-trial-set-for-2027/) - It was another busy day in court for Real Housewives of Potomac star Wendy Osefo. She and her husband, Eddie Osefo, officially have a trial date for their 34 fraud-related charges. After bouncing back and forth on whether to have their cases separated, they’ve changed course again, and a joint trial is now set for
- [Fighting insurance fraud is a team effort](https://insurancefraud.org/news_archives/fighting-insurance-fraud-is-a-team-effort/) - Insurance fraud continues to be a huge problem in the United States and North Carolina. I’ve assembled a great team to fight insurance fraud in North Carolina at the Department of Insurance. I’ve more than tripled the number of special agents fighting fraud since I first took office in January 2017. I’ve hired a legal
- [Maryland’s rising auto insurance costs](https://insurancefraud.org/news_archives/marylands-rising-auto-insurance-costs/) - The rising cost of vehicles, parts, and repairs, as well as the growing frequency and severity of accidents, have all played a role in driving up the cost of car insurance, nationwide. Combined with the higher costs of household essentials, affordability is a major concern. Many drivers face difficult financial decisions and choose to forgo
- [CMS ‘Crackdown on Fraud’ Continues with Nationwide Six-Month Moratoria on New Medicare Enrollments for Hospices and Home Health Agencies](https://insurancefraud.org/news_archives/cms-crackdown-on-fraud-continues-with-nationwide-six-month-moratoria-on-new-medicare-enrollments-for-hospices-and-home-health-agencies/) - On May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) imposed two nationwide, six‑month moratoria on new Medicare enrollments of hospice and home health agencies (HHAs). CMS states that the action, taken in coordination with Vice President JD Vance’s Anti-Fraud Task Force, “continues the Trump Administration’s crackdown on fraud, waste, and abuse in
- [How Medicaid fraud crackdown impacts the system](https://insurancefraud.org/news_archives/how-medicaid-fraud-crackdown-impacts-the-system/) - The Ohio Department of Medicaid (ODM) announced the addition of a new fraud detection and analytics tool to weed out bad actors. This follows Gov. Mike DeWine’s (R-Ohio) recent announcement of several initiatives to crack down on Medicaid fraud. But at the same time, those who are following the rules are worried that this shakedown
- [New York Business Owner Sentenced to Prison for Using Shell Companies to Launder Health Care Fraud Proceeds for Transnational Criminal Organization](https://insurancefraud.org/news_archives/new-york-business-owner-sentenced-to-prison-for-using-shell-companies-to-launder-health-care-fraud-proceeds-for-transnational-criminal-organization/) - A New York man was sentenced today to 37 months in prison for conspiring to launder nearly $1.5 million in illicit health care fraud proceeds through multiple domestic and global banks on behalf of a Transnational Criminal Organization (Organization). According to court documents, Elnar Zarbailov, 42, of Staten Island, New York, and dual citizen of
- [NICB Warns Americans Contractor Fraud Continues to Rise Nationwide](https://insurancefraud.org/news_archives/nicb-warns-americans-contractor-fraud-continues-to-rise-nationwide/) - The National Insurance Crime Bureau (NICB), the leading, established non-profit dedicated to identifying insurance fraud, is recognizing the sixth annual Contractor Fraud Awareness Week from May 18-22 by warning home and business owners about the growing threat of contractor fraud following natural disasters and severe weather events across the United States. As communities continue recovering
- [Blocking New Medicare Home Health And Hospice Firms Won’t Stop Fraud](https://insurancefraud.org/news_archives/blocking-new-medicare-home-health-and-hospice-firms-wont-stop-fraud/) - In its efforts to prevent alleged widespread fraud in Medicare, federal regulators have blocked for at least six months any new home health and hospice providers from participating in these federal programs. This strategy may succeed in grabbing headlines but it won’t stem corruption and may limit access to care for many who need it. In
- [Owner of California Medical Companies Pleads Guilty to Stealing More than $1 Million in Pandemic Relief Funds](https://insurancefraud.org/news_archives/owner-of-california-medical-companies-pleads-guilty-to-stealing-more-than-1-million-in-pandemic-relief-funds/) - The owner of two Southern California non-emergency ambulatory companies pleaded guilty today to wire fraud and money laundering. According to court documents and statements made in court, Mehrdad Tabrizi was the sole owner of Life Fleet Inc. and Resonante Group, two medical businesses based in Orange County. During the COVID-19 pandemic, Tabrizi used these two
- [Chief Financial Officer Blaise Ingoglia Announces Arrest of Five Suspects Following Staged Motor Vehicle Collision Scheme](https://insurancefraud.org/news_archives/chief-financial-officer-blaise-ingoglia-announces-arrest-of-five-suspects-following-staged-motor-vehicle-collision-scheme/) - Today, Chief Financial Officer Blaise Ingoglia announced the arrest of five suspects following an alleged staged motor vehicle collision scheme. The suspects arrested by the Department of Financial Services Criminal Investigations Division (CID) were Yumilka Melendez Pagan, Yancenia Diaz, Milaimi Gonzalez Acosta, Alfredo Ernesto Phinney Estrada and Vidal Jose Rojas Balbas, an illegal alien. Each
- [Hawaii’s fight against Medicaid fraud plagued for over a decade](https://insurancefraud.org/news_archives/hawaiis-fight-against-medicaid-fraud-plagued-for-over-a-decade/) - Behind the verbal sparring last week between federal and state officials over policing Medicaid fraud, data shows Hawaii's recent record on the subject is in some respects worst in the nation. In each of the last four years, Hawaii's Medicaid Fraud Control Unit has produced no indictments and no convictions for fraud - something no other state has done. The
- [Paul Caneiro gets life in prison for Colts Neck family murders](https://insurancefraud.org/news_archives/paul-caneiro-gets-life-in-prison-for-colts-neck-family-murders/) - A man convicted of killing his brother and his brother's family inside their Colts Neck home in 2018 was sentenced to life in prison without parole on Tuesday. The case was one of the most shocking murder cases in New Jersey in recent years. Paul Caneiro, 59, was sentenced to serve his sentence four times
- [Fake Nurse Faces Up to 100 Years in Prison, Indicted on 34 Counts](https://insurancefraud.org/news_archives/fake-nurse-faces-up-to-100-years-in-prison-indicted-on-34-counts/) - An alleged "fake nurse" accused of working at four New Mexico healthcare facilities without a license has been indicted on 34 counts by a grand jury in Doña Ana County, according to KRQE News. Margarita Gonzalez is charged with identity theft, nursing without a license, abuse of a resident, distribution of controlled substances to a
- [Lindberg seeks sentence that would limit additional prison time](https://insurancefraud.org/news_archives/lindberg-seeks-sentence-that-would-limit-additional-prison-time/) - Former top NC political donor Greg Lindberg is seeking to limit the amount of additional time he will have to spend behind bars in connection with a federal bribery conviction and a guilty plea in a separate insurance fraud case. The bribery case was tied to Lindberg’s attempt to influence state Insurance Commissioner Mike Causey
- [CMS Final Rule Lowers Costs, Cracks Down on Fraud, and Expands State Control](https://insurancefraud.org/news_archives/cms-final-rule-lowers-costs-cracks-down-on-fraud-and-expands-state-control/) - The Centers for Medicare & Medicaid Services (CMS) issued a sweeping rule to strengthen oversight of the Affordable Care Act (ACA) Exchanges for plan year 2027 by lowering user fees, tightening eligibility verification, and giving states greater authority over plan oversight. The final rule, “Notice of Benefit and Payment Parameters for 2027; Basic Health Program” (the
- [Emerging Growth Trends Driving Expansion in the Insurance Fraud Detection Market](https://insurancefraud.org/news_archives/emerging-growth-trends-driving-expansion-in-the-insurance-fraud-detection-market/) - The insurance fraud detection market is on track for remarkable growth in the coming years, driven by technological advancements and increasing demand for efficient fraud prevention methods. As insurers seek smarter tools to combat fraudulent activities, this sector is expected to evolve rapidly, offering new opportunities and innovations that will reshape how fraud is detected
- [Fraud Division Announces Massive Crackdown for Second Straight Week — Over $1 BILLION in Nationwide Fraud Enforcement Actions](https://insurancefraud.org/news_archives/fraud-division-announces-massive-crackdown-for-second-straight-week-over-1-billion-in-nationwide-fraud-enforcement-actions/) - The Justice Department’s National Fraud Enforcement Division announced numerous enforcement actions in the past week, as prosecutors across the country pursued the criminals stealing American taxpayer dollars. Notably, a jury in the Southern District of Florida found the founder and owner of HealthSplash guilty for his role in operating a platform that generated false doctors’ orders and
- [Attorney General Paxton Makes History by Securing a Land­mark Healthcare Fraud Settlement that Creates the Nation’s First-Ever Detransition Clinic and Secures $10 Million from Texas Children’s Hospital for ​“Transitioning” Kids](https://insurancefraud.org/news_archives/attorney-general-paxton-makes-history-by-securing-a-landmark-healthcare-fraud-settlement-that-creates-the-nations-first-ever-detransition-clinic-and-secures-10-million-from-texas-child/) - Attorney General Ken Paxton secured a historic settlement with Texas Children’s Hospital (“Texas Children’s”) that compels the creation of the country’s first-ever Detransition Clinic; requires the hospital to pay $10 million for billing Texas Medicaid for unallowable and illegal ‘gender-transition’ interventions, including by using false diagnosis codes; and compels the termination and revocation of privileges
- [Michigan Home Health Care Agency Owner Convicted of $1.6M Medicare Fraud Scheme and Kickback Conspiracy](https://insurancefraud.org/news_archives/michigan-home-health-care-agency-owner-convicted-of-1-6m-medicare-fraud-scheme-and-kickback-conspiracy/) - A federal jury in the Eastern District of Michigan convicted a Michigan nurse and home health care agency owner yesterday for operating a $1.6 million scheme to defraud Medicare. According to court documents and evidence presented at trial, Ruby Scott, 55, of Farmington Hills, Michigan, owned and operated Delta Home Health Care LLC (Delta). From
- [Sioux Falls attorney sentenced in $15,000 farm fraud case](https://insurancefraud.org/news_archives/sioux-falls-attorney-sentenced-in-15000-farm-fraud-case/) - A Sioux Falls attorney was sentenced Thursday in Douglas County to suspended prison time and jail after pleading no contest to felony grand theft by deception involving a farm family in a crop insurance case. Michael Henderson, formerly with the Swier Law Firm in Sioux Falls, received a five-year penitentiary sentence on a Class 4
- [Lincoln man set home on fire in attempt to defraud insurance company, police allege](https://insurancefraud.org/news_archives/lincoln-man-set-home-on-fire-in-attempt-to-defraud-insurance-company-police-allege/) - A Lincoln man was arrested Friday after being accused of setting his home on fire in an attempt to defraud his insurance company. On Nov. 2, 2025, Lincoln Fire and Recue was called to a two-alarm fire at a home near 25th and L streets around 1:47 p.m. According to court documents, the home was
- [Palmetto Man Charged with Arson and Insurance Fraud](https://insurancefraud.org/news_archives/palmetto-man-charged-with-arson-and-insurance-fraud/) - Deputies with the State Fire Marshal’s (SFM) Office have arrested 57-year-old Hertley James Andrus of Palmetto, Louisiana, in connection with an intentionally set vehicle fire earlier this year. He was taken into custody on April 27, 2026, on charges of Arson with Intent to Defraud and Automobile Insurance Policy Fraud. The charges stem from a
- [Dalton insurance agent charged with fraud, accused of taking payments without coverage](https://insurancefraud.org/news_archives/dalton-insurance-agent-charged-with-fraud-accused-of-taking-payments-without-coverage/) - A Dalton insurance agent is accused of taking thousands of dollars from customers who believed they had coverage. 33-year-old Lucy Margarita Suarez faces several felony charges, including five counts of insurance fraud and one count of forgery, according to the Georgia State Board of Workers’ Compensation. Investigators say Suarez owned and operated EliteOne Solutions on
- [Kuderer fines unauthorized insurer $80,000, issues two cease-and-desist orders](https://insurancefraud.org/news_archives/kuderer-fines-unauthorized-insurer-80000-issues-two-cease-and-desist-orders/) - A Yakima insurance agent and an unauthorized insurance company are barred from doing business in Washington after Insurance Commissioner Patty Kuderer issued cease-and-desist orders in April. Kuderer’s office investigated Carol E. Perez, the licensee for Perez Insurance Inc. in Yakima, for accepting premiums from a consumer but not forwarding those payments to an insurer for a policy.
- [Owner of Health Care Software Company Convicted of 1 Billion Dollar Medicare Fraud Conspiracy](https://insurancefraud.org/news_archives/owner-of-health-care-software-company-convicted-of-1-billion-dollar-medicare-fraud-conspiracy/) - A federal jury in the Southern District of Florida convicted the founder and owner of HealthSplash yesterday for his role in operating a platform that generated false doctors’ orders and prescriptions to defraud Medicare and other federal health care benefit programs out of more than $1 billion. “The Department of Justice crushed one of the
- [Arizona nurse practitioner sentenced for role in Medicaid fraud scheme](https://insurancefraud.org/news_archives/arizona-nurse-practitioner-sentenced-for-role-in-medicaid-fraud-scheme/) - A nurse practitioner will spend 3.5 years in prison for her role in a Medicaid fraud case tied to Arizona’s behavioral health care scandal. Rita Anagho was sentenced May 6 in Maricopa County Superior Court after pleading guilty in the case, according to Arizona Attorney General Kris Mayes. Mayes’ office said Anagho operated TUSA Integrated
- [Vance is Set to Speak in Maine About Fraud Investigations Ahead of Primary Election](https://insurancefraud.org/news_archives/vance-is-set-to-speak-in-maine-about-fraud-investigations-ahead-of-primary-election/) - Vice President JD Vance is slated to make an appearance in Maine on Thursday to highlight the Trump administration's efforts to combat fraud ahead of the state's primary elections for several high-profile races. Vance, who chairs the administration's anti-fraud task force, is scheduled to deliver remarks at Bangor International Airport, the White House and the
- [Travelers Urges Homeowners to Protect Against Contractor Fraud as Storm Season Approaches](https://insurancefraud.org/news_archives/travelers-urges-homeowners-to-protect-against-contractor-fraud-as-storm-season-approaches/) - Travelers Urges Homeowners to Protect Against Contractor Fraud as Storm Season Approaches In recognition of Contractor Fraud Awareness Week (May 18-22), The Travelers Companies, Inc. (NYSE: TRV) is providing guidance to help homeowners protect themselves from potential fraud when recovering from a storm. “In the aftermath of a storm, the desire to return to normalcy can
- [Adapting Claim Investigations for AI-Driven Fraud](https://insurancefraud.org/news_archives/adapting-claim-investigations-for-ai-driven-fraud/) - Insurance fraud is not a new problem. What has changed is the ease with which a fraudulent claim can be made to look legitimate. Tools that once required technical skill are now free and can be used by anyone in minutes. Artificial intelligence allows claimants and organized rings to now easily create and produce fraudulent
- [Man convicted of insurance fraud in Burleigh County trial](https://insurancefraud.org/news_archives/man-convicted-of-insurance-fraud-in-burleigh-county-trial/) - A man who was arrested for insurance fraud in North Dakota was found guilty this week. John Unruh was convicted in a trial in Burleigh County Court. Investigators say Unruh was trying to collect insurance money after his wife passed away. An investigator from the state’s insurance department fraud unit was looking closer at a
- [Children’s book author sentenced for husband’s poisoning death; judge calls her ‘too dangerous’](https://insurancefraud.org/news_archives/childrens-book-author-sentenced-for-husbands-poisoning-death-judge-calls-her-too-dangerous/) - A Utah children’s book author who once wrote about helping her young sons cope with grief was sentenced Wednesday to life in prison without the possibility of parole after being convicted of killing her husband with a fentanyl-laced drink. Kouri Richins was sentenced in a case that stunned observers with its mix of alleged greed,
- [HHS and CMS Announce First Meeting of Healthcare Advisory Committee](https://insurancefraud.org/news_archives/hhs-and-cms-announce-first-meeting-of-healthcare-advisory-committee/) - The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) is holding the first Healthcare Advisory Committee meeting on May 18 at 2 p.m. The public meeting will focus on introducing Committee members, outlining the vision of the Committee and establishing Committee bylaws. The Healthcare Advisory Committee,
- [Man accused of staging UTV theft to file insurance claim, KSP says](https://insurancefraud.org/news_archives/man-accused-of-staging-utv-theft-to-file-insurance-claim-ksp-says/) - A Martin County man is facing charges after Kentucky State Police say he falsely reported his UTV stolen as part of an attempted insurance fraud scheme. A Kentucky State Police uniform citation lists Larry A. Delong, of Tomahawk, charged with fraudulent insurance acts — $10,000 or more but less than $1,000,000 and false report of
- [New York Physical Therapist Admits Participating in Health Care Fraud Scheme Targeting Amtrak](https://insurancefraud.org/news_archives/new-york-physical-therapist-admits-participating-in-health-care-fraud-scheme-targeting-amtrak/) - A New York physical therapist today admitted participating in a health care fraud scheme to defraud Amtrak, U.S. Attorney Robert Frazer announced. Jaekwan Lee, 41, of Flushing, New York, pleaded guilty today before U.S. District Judge Madeline Cox Arleo in Newark federal court to an Indictment charging him with conspiracy to commit health care fraud.
- [Another Member of Notorious Philadelphia ‘10th and O Crew’ Sentenced to 60 Months for Opioid Drug Conspiracy](https://insurancefraud.org/news_archives/another-member-of-notorious-philadelphia-10th-and-o-crew-sentenced-to-60-months-for-opioid-drug-conspiracy/) - A Pennsylvania man was sentenced today in the District of New Jersey to 60 months in prison for conspiracy to distribute oxycodone, a highly addictive controlled substance. According to court documents, between July 2019 and July 2024, Michael Emma, 66, of Philadelphia, engaged in the unlawful sale of prescription oxycodone pills as a member of
- [Carpe Data urges industry-wide collaboration to stem AI-driven insurance fraud](https://insurancefraud.org/news_archives/carpe-data-urges-industry-wide-collaboration-to-stem-ai-driven-insurance-fraud/) - An American data and analytics firm is calling for industry-wide collaboration to find solutions for artificial intelligence-driven insurance fraud, which is becoming increasingly complex and widespread. “It’s always been this way. People have always wanted to try to commit fraud; they would submit either fake documents or altered receipts. But with AI, it not only
- [Nine Eastern Shore family members indicted in Medicaid fraud scheme](https://insurancefraud.org/news_archives/nine-eastern-shore-family-members-indicted-in-medicaid-fraud-scheme/) - Nine Eastern Shore family members were indicted by an Anne Arundel County Grand Jury for allegedly engaging in a scheme to defraud the Maryland Medicaid program, Attorney General Anthony Brown announced Tuesday. All of the defendants are related by either blood or marriage, officials said. “Medicaid is a lifeline for thousands of Marylanders with developmental
- [Utah Doctor and Two Nurses Charged with Health Care Fraud After Submitting False Claims to Medicare and Receiving Millions in Payout](https://insurancefraud.org/news_archives/utah-doctor-and-two-nurses-charged-with-health-care-fraud-after-submitting-false-claims-to-medicare-and-receiving-millions-in-payout/) - A federal grand jury in St. George returned an indictment today charging a Utah podiatrist and two nurses who worked for him with fraud after they allegedly submitted fraudulent claims to Medicare for skin substitute services, many of which were medically unnecessary, and resulted in Medicare paying $29 million dollars in claims. According to allegations
- [Dutchess County man revived fraud ploy in $400K con, prosecutors say](https://insurancefraud.org/news_archives/dutchess-county-man-revived-fraud-ploy-in-400k-con-prosecutors-say/) - A Dutchess County man is facing felony charges for allegedly defrauding trucking and insurance companies in a scheme federal prosecutors said was “virtually identical” to one that sent him to prison in 2012. Michael McMahon, 69, pleaded not guilty Tuesday to three counts of mail fraud in connection with what federal prosecutors described as a
- [Fresno transloading owner sentenced for $4.8 million canola theft, fraud](https://insurancefraud.org/news_archives/fresno-transloading-owner-sentenced-for-4-8-million-canola-theft-fraud/) - Richard Best, 72, of Fresno, California, was sentenced to three years in prison and ordered to pay $2 million in restitution for his role in a fraud scheme that stole millions of dollars’ worth of canola (used to make livestock feed) from international food processors, U.S. Attorney Eric Grant announced. “Richard Best treated the agricultural
- [AI Video Firm TruVideo Expands from Auto to Aviation and Insurance](https://insurancefraud.org/news_archives/ai-video-firm-truvideo-expands-from-auto-to-aviation-and-insurance/) - TruVideo, a company that built its reputation using AI-powered video technology in the automotive sector, is making a significant leap into two new high-stakes industries: aviation and insurance. The Wellesley-based firm announced the expansion of its video intelligence engine, aiming to solve critical operational bottlenecks and financial drains in aircraft maintenance and insurance underwriting and
- [Victorian chilli sauce fraudster caught running business while claiming compensation](https://insurancefraud.org/news_archives/victorian-chilli-sauce-fraudster-caught-running-business-while-claiming-compensation/) - A Victorian man who collected more than $117,000 in workers’ compensation payments while running a food business has been convicted of fraud, in a case that points to persistent vulnerabilities in how insurers and compensation schemes identify claimants who are working while receiving benefits. Conviction and sentenceGary Janson, 58, appeared before the Melbourne Magistrates’ Court
- [Maryland AG lands second insurance fraud conviction against same advisor](https://insurancefraud.org/news_archives/maryland-ag-lands-second-insurance-fraud-conviction-against-same-advisor/) - Maryland repeat offender has been convicted of insurance fraud twice in under a year, a Baltimore case laying bare how revoked agents keep selling while carriers fail to look past the name on an application. A Baltimore County jury has returned a guilty verdict against a Parkville financial advisor on multiple felony insurance fraud charges,
- [DoJ Targets Fraud in Medtech](https://insurancefraud.org/news_archives/doj-targets-fraud-in-medtech/) - The Department of Justice has released a new plan to crack down on fraud across the medical device industry. In April, Indiana-based legal firm Barnes & Thornburg released its annual Healthcare Enforcement and Compliance Annual Report, which found that False Claims Act recoveries for fiscal year 2025 totaled a record-setting $6.8 billion. The majority of
- [House OKs human services policy bill aimed at fraud-fighting, continuity of care](https://insurancefraud.org/news_archives/house-oks-human-services-policy-bill-aimed-at-fraud-fighting-continuity-of-care/) - Will the Senate agree to the House human services policy bill? Will a conference committee be needed to resolve differences? We’ll likely find out soon enough. There was no debate on the House Floor Monday before members passed HF729/SF476*, with a delete-all amendment to insert the House language. Following the 93-39 vote, the bill returns to
- [Cybersecurity Failures and Liability for Health Care Organizations: A New Enforcement Frontier](https://insurancefraud.org/news_archives/cybersecurity-failures-and-liability-for-health-care-organizations-a-new-enforcement-frontier/) - Healthcare organizations have long understood cybersecurity solely as a regulatory compliance obligation, or as a matter of HIPAA audits, breach notifications, and IT governance. No more. In 2025, cybersecurity-specific False Claims Act (FCA) settlements totaled over $50 million. Below, we survey the history of enforcement at the intersection of cybersecurity and healthcare, key regulatory developments,
- [Kia hamster actor charged with disability fraud](https://insurancefraud.org/news_archives/kia-hamster-actor-charged-with-disability-fraud/) - A man who played a dancing hamster in Kia car commercials and was a backup dancer for Madonna has been charged with California disability fraud. The California Department of Insurance says 27-year-old Leroy Barnes of Los Angeles collected $51,000 in workers compensation benefits in 2010 and 2011. Barnes claimed he was disabled when a piece
- [Former College Football Star Sentenced to 16 Years for $197M Scheme Targeting Seniors and Disabled Veterans](https://insurancefraud.org/news_archives/former-college-football-star-sentenced-to-16-years-for-197m-scheme-targeting-seniors-and-disabled-veterans/) - Former Mississippi college football star Joel Rufus French has been sentenced in his federal fraud case. French, 48, was sentenced to more than 16 years in prison for his $197 million Medicare fraud scheme that targeted seniors and disabled veterans, the U. S. Department of Justice announced in a statement on Friday, May 8. He
- [DOJ fraud crackdown targets $200M Medicaid autism payment errors](https://insurancefraud.org/news_archives/doj-fraud-crackdown-targets-200m-medicaid-autism-payment-errors/) - Audits reveal deep Medicaid oversight failures The HHS inspector general’s audit found $200 million in improper Medicaid payments for autism services between 2019 and 2024 in Maine, Indiana, Colorado, and Wisconsin, none of which had previously audited these payments. Examples included therapy sessions that were essentially movie-watching or video gaming, overlapping billing by therapists, and
- [Former healthcare CEO sentenced to 5 years in prison for role in $212M fraud conspiracy](https://insurancefraud.org/news_archives/former-healthcare-ceo-sentenced-to-5-years-in-prison-for-role-in-212m-fraud-conspiracy/) - The former CEO of a publicly traded healthcare company has been sentenced to five years in federal prison after he pleaded guilty to participating in a $212 million investment fraud scheme, the U.S. Department of Justice (DOJ) said. In an announcement, the agency confirmed that Parmjit “Paul” Parmar, 55, from New Jersey admitted to his
- [How East Texans can get free fraud alerts](https://insurancefraud.org/news_archives/how-east-texans-can-get-free-fraud-alerts/) - Titus County recently joined a growing list of East Texas counties that are offering property and identity fraud alerts to residents at no cost. In order to combat rising mortgage fraud and identity crime cases, Titus County has joined the Property Fraud Alert service that gives an early warning to residents by flagging any activities
- [LA County vocational nurse charged in alleged $1.5M Medi-Cal fraud scheme](https://insurancefraud.org/news_archives/la-county-vocational-nurse-charged-in-alleged-1-5m-medi-cal-fraud-scheme/) - A Los Angeles County-based vocational nurse was arrested last Friday on charges referred to as "white-collar crimes" by state prosecutors, after they say she stole more than $1.5 million from Medi-Cal. Mariafe Concepcion Garcia, 58, was arrested by the California Attorney General's Bureau of Medi-Cal Fraud on May 1, after a felony warrant was issued
- [DOJ bust exposes $10 BILLION medicare fraud scheme | Operation Gold Rush](https://insurancefraud.org/news_archives/doj-bust-exposes-10-billion-medicare-fraud-scheme-operation-gold-rush/) - Start your morning with The National News Desk as Jan Jeffcoat sits down with Open the Books' Rachel O'Brien to discuss a massive DOJ bust called Operation Gold Rush, which uncovered a global scheme that tried to rip off Medicare for more than $10 billion. Watch weekday mornings from 6 a.m. to 9 a.m. EST,
- [Colin Jackson Convicted of Participating in Scheme to Defraud Automobile Insurance Company](https://insurancefraud.org/news_archives/colin-jackson-convicted-of-participating-in-scheme-to-defraud-automobile-insurance-company/) - A federal jury convicted Colin Jackson of conspiracy to commit wire fraud, wire fraud, and money laundering on Wednesday, May 6, 2026. The jury’s verdict followed a seven-day trial before U.S. District Judge Trina L. Thompson. The jury found that Jackson conspired with others, including a previously convicted defendant, Kirill Afanasyev, to defraud an automobile
- [Medicaid fraud fears grow amid massive red state billing spike in sector that also plagued Minnesota](https://insurancefraud.org/news_archives/medicaid-fraud-fears-grow-amid-massive-red-state-billing-spike-in-sector-that-also-plagued-minnesota/) - As fraud concerns ramp up across the country, particularly involving Medicaid, North Carolina State Auditor Dave Boliek told Fox News Digital the problem is very real in his state, especially when it comes to autism therapy, an area that has been highly scrutinized in Minnesota. Boliek is sounding the alarm on potential waste, fraud and abuse within
- [The Fraud Division Announces Enforcement Actions from Across the Country Representing Nearly $1 Billion in Fraud](https://insurancefraud.org/news_archives/the-fraud-division-announces-enforcement-actions-from-across-the-country-representing-nearly-1-billion-in-fraud/) - The Justice Department’s National Fraud Enforcement Division continued to advance its mission to fight fraud and protect taxpayers. Just on Monday, two men were sentenced to 151 months and 36 months in prison, respectively, for their roles in submitting over $522 million in fraudulent claims for medically unnecessary genetic tests in a scheme to defraud Medicare, Medicaid,
- [AI is Making Digital Fraud Easier, Faster, and Harder to Stop](https://insurancefraud.org/news_archives/ai-is-making-digital-fraud-easier-faster-and-harder-to-stop/) - How to Protect Yourself From AI Identity Theft and Fraud
- [Spartanburg County woman accused of attempting to defraud GEICO of thousands](https://insurancefraud.org/news_archives/spartanburg-county-woman-accused-of-attempting-to-defraud-geico-of-thousands/) - The South Carolina Law Enforcement Division (SLED) charged a Spartanburg County woman with insurance fraud on Monday. Officials said that Erin Shaquaile Robbs Kilgore, 31, was charged with the following: Presenting a False Claim for Insurance Payment – Value $10,000 or More(2 counts) Forgery – Value Less Than $10,000Forgery – No Dollar Amount Involved The
- [Skilled Nursing Facilities Agreed to Pay $52,000 for Allegedly Violating the Civil Monetary Penalties Law by Employing Excluded Individuals](https://insurancefraud.org/news_archives/skilled-nursing-facilities-agreed-to-pay-52000-for-allegedly-violating-the-civil-monetary-penalties-law-by-employing-excluded-individuals/) - After they self-disclosed conduct to OIG, Country Hills Post Acute, Lakeport Post Acute, Oakwood Gardens Care Center, Primrose Post Acute, and St. Francis Healthcare Center (collectively, “the facilities”), with locations in California, entered into a $52,943 settlement agreement with OIG. The settlement agreement resolves allegations that the facilities employed individuals that they knew or should
- [Parent caregivers give perspective on proposed bill to combat future cuts to Medicaid](https://insurancefraud.org/news_archives/parent-caregivers-give-perspective-on-proposed-bill-to-combat-future-cuts-to-medicaid/) - Parent caregivers give perspective on proposed bill to combat future cuts to Medicaid
- [Masury man denied new trial in healthcare fraud case](https://insurancefraud.org/news_archives/masury-man-denied-new-trial-in-healthcare-fraud-case/) - A federal judge has denied a request for a new trial from a Masury man convicted for his part in defrauding a nonprofit healthcare network based in Sharon. U.S. District Judge Nicholas Ranjan issued the order late last month, rejecting a pair of post-trial motions filed by John O’Brien. The decision clears the way for
- [Advanced Urology Agrees to Pay $14 Million to Settle False Claims Act Allegations](https://insurancefraud.org/news_archives/advanced-urology-agrees-to-pay-14-million-to-settle-false-claims-act-allegations/) - On April 2, 2026, the U.S. Attorney from the Northern District of Georgia announced that Jitesh Patel, M.D., Advanced Urology, Inc., and affiliated companies (collectively “Advanced Urology”) agreed to pay $14 million to resolve allegations that they violated the False Claims Act and the Georgia False Medicaid Claims Act. The government alleged Advanced Urology violated both laws
- [After yearlong push, House passes inspector general bill aimed at combating fraud](https://insurancefraud.org/news_archives/after-yearlong-push-house-passes-inspector-general-bill-aimed-at-combating-fraud/) - One year ago Friday, the Senate overwhelmingly passed a bill concerning one of the highest-profile issues of this legislative biennium. But the House took no action in 2025. After months of stakeholder meetings — including representatives of all four legislative caucuses — to create an independent watchdog, the House finally passed a bill Thursday to
- [Man sentenced to life for $300,000 healthcare fraud after probation revoked in Smith County](https://insurancefraud.org/news_archives/man-sentenced-to-life-for-300000-healthcare-fraud-after-probation-revoked-in-smith-county/) - A man was sentenced to life in prison after his probation that he received for committing over $300,000 in healthcare fraud in Smith County was revoked on Friday. Benny Georges, 51, had been sentenced to 10 years' deferred adjudication probation on Dec. 4, 2025, in the 114th District Court after entering a guilty plea to
- [NJ State Comptroller Talks Fraud Awareness](https://insurancefraud.org/news_archives/nj-state-comptroller-talks-fraud-awareness/) - As New Jersey works to protect some of its most vulnerable residents, oversight and accountability in long-term care facilities remain a critical priority. The Office of the State Comptroller plays a key role in investigating fraud, ensuring transparency, and safeguarding taxpayer dollars, especially when it comes to Medicaid-funded services. Joining us now are Comptroller Shirley
- [Oklahoma Human Services Investigation Leads to Arrest for Program Fraud Scheme](https://insurancefraud.org/news_archives/oklahoma-human-services-investigation-leads-to-arrest-for-program-fraud-scheme/) - We can confirm the Office of Inspector General within Oklahoma Human Services initiated a coordinated investigation into potential criminal activity connected to one of our programs. Accountability matters, and this is exactly why our oversight and safeguards exist. Because this is an active investigation, there are limits to what can be discussed publicly, but it
- [Davidson Calls for Action After Investigation Reveals Massive Medicaid Fraud in Ohio](https://insurancefraud.org/news_archives/davidson-calls-for-action-after-investigation-reveals-massive-medicaid-fraud-in-ohio/) - Today, May 7, 2026, U.S. Representative Warren Davidson (OH-08) released the following statement after a Daily Wire investigation revealed widespread Medicaid fraud across Ohio. The investigation found that Ohio’s Medicaid program paid out roughly $1 billion in 2024 for “home health services,” often provided by people with no health care training and in many cases by relatives
- [7 South Florida men accused of taking part in huge insider-trading scheme](https://insurancefraud.org/news_archives/7-south-florida-men-accused-of-taking-part-in-huge-insider-trading-scheme/) - Seven South Florida men were among 30 brokers, lawyers and investors charged on Wednesday in an alleged decade-long insider-trading scheme that was fueled by confidential information stolen from law firms and netted tens of millions of dollars in illicit stock profits, federal prosecutors said. Prosecutors said the defendants used the confidential information on about 30
- [Michigan High Court Sides With Progressive in Policy Misrepresentation Case](https://insurancefraud.org/news_archives/michigan-high-court-sides-with-progressive-in-policy-misrepresentation-case/) - Progressive properly rescinded coverage to a Michigan driver who made misrepresentations on their insurance application, the state Supreme Court ruled. Plaintiff Janice Sherman sought personal protection insurance (PIP) benefits through Progressive after being involved in a July 2021 car accident. Progressive discovered that Sherman improperly disclosed where she garaged her vehicles and who she lived
- [6 arrests made in fraudulent insurance claims investigation in Ouachita Parish](https://insurancefraud.org/news_archives/6-arrests-made-in-fraudulent-insurance-claims-investigation-in-ouachita-parish/) - On March 18, 2026, the Louisiana Office of State Fire Marshal (OSFM) was contacted by the Louisiana Department of Insurance (LDI) about suspected fraudulent insurance claims in Ouachita Parish. After being contacted by LDI, OSFM fire investigators conducted a comprehensive review and requested additional documentation regarding numerous insurance claims spanning nearly a decade. Through multiple
- [Milwaukee woman charged for allegedly defrauding state’s Medicaid system of over $2M](https://insurancefraud.org/news_archives/milwaukee-woman-charged-for-allegedly-defrauding-states-medicaid-system-of-over-2m/) - A Milwaukee woman is facing felony charges for allegedly defrauding Wisconsin Medicaid of over $2 million. Debbie Long, 44, owned Pinnacle Home Health Care LLC, a company that offered “personal care services” to members of Medicaid, according to a criminal complaint filed Tuesday. In a statement Thursday, Long’s attorney said his client will fight the
- [Huntington Park Medical Practice and Doctor to Pay More Than $6.7 Million to Settle Allegations of Billing Medicare for Unnecessary Procedures](https://insurancefraud.org/news_archives/huntington-park-medical-practice-and-doctor-to-pay-more-than-6-7-million-to-settle-allegations-of-billing-medicare-for-unnecessary-procedures/) - A Huntington Park-based medical practice and its physician have agreed to pay more than $6.73 million to resolve allegations that they violated the False Claims Act by submitting false claims for medically unnecessary vascular interventional procedures on 20 Medicare beneficiaries. The United States alleged that, from 2016 to 2024, Dr. Feliciano Serrano of Serrano Kidney
- [Trump's Medicaid fraud crackdown may sound sensible, but it could harm Americans who require long-term care](https://insurancefraud.org/news_archives/trumps-medicaid-fraud-crackdown-may-sound-sensible-but-it-could-harm-americans-who-require-long-term-care/) - Mehmet Oz, the Centers for Medicare & Medicaid Services administrator, is ordering all states to step up their efforts to crack down on Medicaid fraud. His April 21, 2026, announcement expanded on the Trump administration's related enforcement actions, such as withholding Medicaid funds from Minnesota and threatening to do that for New York, Californiaand Maine.
- [Local leaders warn of growing concern over US hospice fraud](https://insurancefraud.org/news_archives/local-leaders-warn-of-growing-concern-over-us-hospice-fraud/) - Leaders at Hospice of Wichita Falls say hospice fraud is becoming a growing concern across the country, and while it may not be widespread here locally, they say it’s something families should be aware of. Leaders say in some cases, patients who are not terminally ill are being placed into hospice care, sometimes without fully
- [Big deal on Medicaid fraud: what we know about a major settlement](https://insurancefraud.org/news_archives/big-deal-on-medicaid-fraud-what-we-know-about-a-major-settlement/) - North Carolina and federal prosecuters have taken a big bite out of Medicaid fraud with a settlement announced Wednesday (May 6). In a press release, Attorney General Jeff Jackson and the United States Attorney’s Office for the Middle District of North Carolina say they have reached $584,143 settlement with Crossroads Treatment Center of Greensboro, P.C.
- [Allstate accuses Chicago surgery center of running fraud scheme](https://insurancefraud.org/news_archives/allstate-accuses-chicago-surgery-center-of-running-fraud-scheme/) - Allstate is taking aim at a Chicago surgery center and a wide cast of clinics, owners and a billing company, accusing them of running a coordinated insurance fraud scheme. In a civil racketeering suit filed May 5, 2026 in the US District Court for the Northern District of Illinois, the insurer alleges that Rogers Park One Day Surgery Center sat at the center of
- [New Boston Woman Sentenced for Embezzling More Than $2 Million from Employer](https://insurancefraud.org/news_archives/new-boston-woman-sentenced-for-embezzling-more-than-2-million-from-employer/) - Yesterday, Susan O’Hara, 56, of New Boston, was sentenced by Judge Darnella Williams-Claybourne of the 3rd Circuit Court in Wayne County to 30 months to 20 years’ incarceration for embezzling more than $2 million from her employer, General RV Center in Wixom, announced Michigan Attorney General Dana Nessel. O’Hara pled guilty in January to three
- [Woman charged after arson destroys Bloomsburg home](https://insurancefraud.org/news_archives/woman-charged-after-arson-destroys-bloomsburg-home/) - A woman is facing multiple felony charges after she set fire to a condemned property and caused significant damage to a nearby home earlier this year. The fire was reported March 2 at 1:30 a.m. at the corner of West Main and Barton streets, according to Bloomsburg Officer Tori Fitzwater. When officers arrived, a detached
- [Man accused of using victim’s identity to obtain insurance, arrested in North Bay Village](https://insurancefraud.org/news_archives/man-accused-of-using-victims-identity-to-obtain-insurance-arrested-in-north-bay-village/) - A man was arrested Monday in North Bay Village after police said he used a former friend’s personal information to obtain an insurance policy without permission, leaving the victim with an outstanding balance Bolton Ahimbisibwe, 24, was taken into custody May 4 following an investigation that began earlier this year, according to an arrest report.
- [Client Alert: Fourth Circuit Reverses Medicaid Fraud Convictions in U.S. v. Davis: A Reminder That Pattern Evidence Is Not a Substitute for Count-Specific Proof](https://insurancefraud.org/news_archives/client-alert-fourth-circuit-reverses-medicaid-fraud-convictions-in-u-s-v-davis-a-reminder-that-pattern-evidence-is-not-a-substitute-for-count-specific-proof/) - Case Summary In an unpublished opinion issued April 24, 2026, a divided Fourth Circuit panel reversed two convictions under 18 U.S.C. § 1347, holding that evidence of a generally questionable billing practice could not, on its own, establish that the specific claims charged in the indictment were false. Key Points Defendant: Former owner and clinical director
- [Waterbury Woman Sentenced for Medicaid Fraud](https://insurancefraud.org/news_archives/waterbury-woman-sentenced-for-medicaid-fraud/) - Chief State’s Attorney Patrick J. Griffin announced today that on May 4, 2026, the Honorable Frank A. Iannotti sentenced Carmen Berroa, age 61, of Waterbury, to 11 months in prison, execution suspended, with two years of conditional discharge for stealing from the Medicaid Program by submitting fraudulent claims for personal care assistance work she did
- [DOJ Announces New West Coast Health Care Fraud Strike Force](https://insurancefraud.org/news_archives/doj-announces-new-west-coast-health-care-fraud-strike-force/) - On April 30, 2026, the Department of Justice’s National Fraud Enforcement Division announced the creation of the West Coast Health Care Fraud Strike Force, a multi-district enforcement initiative focused on Arizona, Nevada, and the Northern District of California. The new Strike Force will partner prosecutors from the Fraud Division’s Health Care Fraud Section with the U.S.
- [U.S. Attorney’s Office Hosts Health Care Fraud Consortium Workshop with Federal Partners](https://insurancefraud.org/news_archives/u-s-attorneys-office-hosts-health-care-fraud-consortium-workshop-with-federal-partners/) - The United States Attorney’s Office for the District of Nevada and the Justice Department’s Health Care Fraud Unit on Monday held a Health Care Fraud Consortium Workshop with law enforcement partners to discuss health care fraud trends, emerging schemes, and the tools available to investigate and prosecute these offenses. The workshop brought together representatives from
- [Two Sentenced to Prison for $522M Genetic Testing Fraud and Illegal Kickback Scheme Targeting Medicare and Medicaid](https://insurancefraud.org/news_archives/two-sentenced-to-prison-for-522m-genetic-testing-fraud-and-illegal-kickback-scheme-targeting-medicare-and-medicaid/) - Two men were sentenced today for their roles in a scheme to defraud Medicare, Medicaid, and private health insurance companies by submitting over $522 million in fraudulent claims for medically unnecessary genetic tests that were obtained through the payment of illegal kickbacks and bribes.Reyad Salahaldeen, 57, of Buford, Georgia, was sentenced to 151 months in
- [Ord woman convicted of attempted insurance fraud](https://insurancefraud.org/news_archives/ord-woman-convicted-of-attempted-insurance-fraud/) - A 27-year-old Ord woman was found guilty Monday in Dawson County District Court of attempted violation of the Nebraska Insurance Fraud Act involving a loss between $500 and $1,500, a Class II misdemeanor. Makayla Ekross was originally charged with felony insurance fraud. During the hearing, Deputy Dawson County Attorney Corey Burns said the incident occurred
- [Tax preparer sentenced to 18 months for $44,000 insurance fraud scheme](https://insurancefraud.org/news_archives/tax-preparer-sentenced-to-18-months-for-44000-insurance-fraud-scheme/) - A Berkeley County tax preparer was sentenced to 18 months in federal prison for wire fraud after using clients’ personal information to open unauthorized insurance policies, federal officials announced. Amanda Gorham, 34, of Harpers Ferry, West Virginia, carried out the scheme while working simultaneously as a tax preparer in Martinsburg and an insurance agent at
- [Two Orlando Residents Sentenced for $148 Million Construction Payroll Scheme that Defrauded the IRS and Workers’ Compensation Insurers](https://insurancefraud.org/news_archives/two-orlando-residents-sentenced-for-148-million-construction-payroll-scheme-that-defrauded-the-irs-and-workers-compensation-insurers/) - Rene Mauricio Escobar (55) and Juana Nelida Escobar (36), residents of Orlando, have been sentenced by U.S. District Judge Wendy W. Berger for conspiracy to commit tax fraud and conspiracy to commit wire fraud. Rene Escobar was sentenced to four years and nine months in federal prison. Juana Escobar was sentenced to two years’ imprisonment.
- [Pennsylvania Auto Title Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-title-insurance-fraud-conviction-and-sentencing/) - On March 25, 2026, Pablo Correa pleaded Guilty to Unsworn Falsification, Forgery, Corrupt Organizations, Washing Vehicle Titles and several other charges and was sentenced to 23 months confinement followed by five years probation and ordered to pay $207,599.14 in restitution, $50 in fines and court costs of $1,187.75. On October 31, 2025, fugitives Anthony Troncoso
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-17/) - On March 24, 2026, Shaylyn Rosello of Washington, PA pleaded Guilty to Insurance Fraud and was sentenced to two months confinement and two years of probation and ordered to perform 50 hours of community service and to pay $2,937.50 in court costs. On July 17, 2025, Office of Attorney General special agents arrested Rosello and
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-16/) - On March 19, 2026, from a Negotiated Guilty plea to Insurance Fraud, Clarence C. Willis of Homestead, PA was sentenced to six months probation and ordered to pay $1,375.75 in court costs. On October 16, 2025, detectives of the PA State Police and Allegheny County District Attorney's Office arrested Willis and charged him with Insurance
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-15/) - On March 17, 2026, Stacy L. Parisella of Williamsport, PA pleaded Guilty to Insurance Fraud and was sentenced to two years probation and ordered to perform 25 hours of community service and to pay $2,065.50 in court costs. On January 21, 2026, Office of Attorney General special agents arrested Parisella and charged her with Insurance
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-14/) - On March 11, 2026, Tykeen S. Montouth of Mount Wolf, PA pleaded Guilty to Attempted Theft by Deception and was sentenced to 18 months probation and ordered to pay $2,089.25 in court costs. On August 6, 2025, detectives of the York County District Attorney's Office filed a criminal complaint charging Montouth with Insurance Fraud. According
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-13/) - On March 10, 2026, Wayne S. Fazzino of Butler, PA pleaded Guilty to Attempted Theft by Deception and was sentenced to 18 months probation and ordered to perform 50 hours of community service and to pay $1,479 in court costs. On October 27, 2025, Office of Attorney General special agents Fazzino and a codefendant and
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-12/) - On March 4, 2026, Jared K. Birch of Summerville, PA pleaded Guilty to Attempted Theft by Deception and was sentenced to two years probation and ordered to pay a $500 fine and $1,802.75 in court costs. On July 7, 2025, Office of Attorney General special agents arrested Birch and charged him with Insurance Fraud and
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-11/) - On March 2, 2026, Kevin Peterson of Philadelphia, PA was sentenced to three years probation and ordered to pay $3,185,50 in restitution and court costs of $2,739.50. On February 27, 2025, Office of Attorney General special agents arrested Breonna Peterson and Kevin Peterson. Breonna Peterson was charged with Insurance Fraud, Theft by Deception, Attempted Theft
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-10/) - On February 24, 2026, Jonathan Know of Aston, PA pleaded No Contest to Insurance Fraud and was sentenced to 12 months probation and ordered to pay $1,028.75 in court costs. On October 24, 2025, detectives of the Delaware County District Attorney's Office filed a criminal complaint charging Knox with Insurance Fraud. According to the complaint,
- [Pennsylvania Life and Accident Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-life-and-accident-insurance-fraud-conviction-and-sentencing/) - On February 23, 2026, from a Negotiated Guilty plea to Insurance Fraud and Attempted Theft by Deception, Walter A. Smith, Jr. was sentenced to five years probation and ordered to pay $6,878.29 in restitution and court costs of $571.50. On December 17, 2025, Office of Attorney General special agents arrested Smith and charged him with
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-9/) - On February 18, 2026, Frank A. Morales of Aston, PA pleaded No Contest to Insurance Fraud and was sentenced to 18 months probation and ordered to pay $2,268.75 in court costs. On August 18, 2025, detectives of the Delaware County District Attorney's Office arrested Morales and charged him with Insurance Fraud. According to the criminal
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-8/)
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-7/) - On February 10, 2026, from a Negotiated Guilty plea to Insurance Fraud, Michael E. McNeil of Philadelphia, PA was sentenced to three years probation and ordered to pay a $2,000 civil penalty to the Insurance Fraud Prevention Trust Fund and $712.75 in court costs. On September 23, 2025, detectives of the Philadelphia District Attorney's Insurance
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-6/) - On February 2, 2026, Naeem S. Toler pleaded Guilty to Attempted Theft by Deception and was sentenced to 12 months probation and ordered to pay $1,817 in court costs. On May 5, 2021, Office of Attorney General special agents arrested Toler and him with Insurance Fraud, Attempted Theft by Deception, Criminal Use of Communication Facility
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-5/) - On January 28, 2026, Christopher H. Rosa of Camden, NJ pleaded Guilty to two counts of Theft by Deception and was sentenced to two years probation and ordered to pay $1,750.82 in court costs. On March 2, 2025, the Bucks County District Attorney's Office received a case for prosecution regarding the arrest of Rosa who
- [Man admits to attempting to defraud insurance company through falsified claim after crash](https://insurancefraud.org/news_archives/man-admits-to-attempting-to-defraud-insurance-company-through-falsified-claim-after-crash/) - A Franconia Township man has been sentenced to three years of probation after admitting to attempting to defraud an insurance company and attempted theft in Montgomery County Common Pleas Court last week. Lamar Fisher, 35, of the 900 block of Camp Road, pleaded guilty to two misdemeanors; the court dismissed felony counts of insurance fraud
- [Pennsylvania Workers' Compensation Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-workers-compensation-insurance-fraud-conviction-and-sentencing/) - On January 21, 2026, Jeffrey L. Miller of Altoona, PA pleaded Guilty to Attempted Theft by Deception and was sentenced to four years probation and ordered to perform 50 hours of community service and to pay a $300 fine and $966.75 in court costs. On June 2, 2025, Office of Attorney General special agents arrested
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-4/) - On January 16, 2026, Sabo pleaded Guilty to Theft by Deception and was sentenced to 23 months confinement and ordered to perform 50 hours of community service, to pay $7,895.87 in restitution, a $300 fine and $2,293.69 in court costs. On January 16, 2025, Office of Attorney General special agents arrested 32 year old Ashley
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-3/) - On January 16, 2026, Brian Cattalo of Philadelphia, PA pleaded Guilty to Insurance Fraud and was sentenced to 12 months probation and ordered to pay $6,670.53 in court costs. On September 26, 2024, Office of Attorney General special agents arrested Cattalo and charged him with Insurance Fraud, Attempted Theft by Deception and Criminal Use of
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing-2/) - On January 9, 2026, from a Negotiated Guilty plea to Theft by Deception, Stephan Baggaley of Collingdale, PA was sentenced to 12 months probation and ordered to pay $1,066.25 in court costs. On February 10, 2025, detectives of the Delaware County District Attorney’s Office filed a criminal complaint charging Baggaley with Insurance Fraud and Criminal
- [Pennsylvania Auto Insurance Fraud Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-conviction-and-sentencing/) - On January 7, 2026, Ricardo M. Carter of Chester, PA pleaded Guilty to Insurance Fraud and was sentenced to three years probation and ordered to perform 100 hours of community service, to pay a $500 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs of $2,739.50. On April 28, 2025, Office of
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-100/) - On March 27, 2026, detectives of the Allegheny County Police Department filed a criminal complaint charging 36 year old Tanausha M. Wilson of Pittsburgh, PA with Insurance Fraud. According to the complaint, it is alleged that Wilson reinstated her auto insurance policy with Progressive Insurance after she had been involved in a collision. During the
- [Pa. public adjuster charged with insurance fraud, forgery](https://insurancefraud.org/news_archives/pa-public-adjuster-charged-with-insurance-fraud-forgery/) - The owner of a public adjusting company is accused of fraud after taking money from insurers intended for his clients, according to the Bucks County District Attorney's Office. Michael Joseph Breitenbach, 53, the owner of Patriot Public Adjusting, LLC, is accused of misappropriating over $82,000 in insurance claims and defrauding elderly homeowners in both Pennsylvania
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-99/) - On March 24, 2026, detectives of the Delaware County District Attorney's Office arrested 32 year old Jiavoni T. Collins of Sharon Hill, PA and charged her with Insurance Fraud. According to the criminal complaint, Collins filed a damage claim with GEICO Insurance on February 27, 2026, shortly after she purchased her GEICO policy. Collins reportedly
- [Pennsylvania Renter's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-renters-insurance-fraud-arrest-3/) - On March 23, 2026, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 35 year old Jillian D. Kaman of Nokomis, FL and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on July 6, 2025, Kaman obtained a renter’s insurance policy with Assurant Insurance for her property
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-98/) - On March 20, 2026, detectives of the Allegheny County Police Department filed a criminal complaint charging 20 year old Jacob Gasper of South Park, PA with Insurance Fraud. According to the complaint, it is alleged that Gasper purchased an auto insurance policy from Progressive Insurance after being involved in a collision. Gasper later filed a
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-97/) - On March 19, 2026, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 26 year old Cornelius Brown of Philadelphia, PA and charged him with Insurance Fraud and Theft by Deception. According to the criminal complaint, on October 31, 2023, at approximately 4:43 PM, Brown reinstated his auto policy for his 2016 Chrysler with
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-96/) - On March 17, 2026, detectives of the Delaware County District Attorney's Office arrested 52 year old Nathaniel Wood of Glenolden, PA and charged him with Insurance Fraud. According to the criminal complaint, On October 9, 2024, Wood submitted a renewal application for his Progressive Insurance auto policy omitting his son as a resident driver at
- [Pennsylvania Liability Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-liability-insurance-fraud-arrest/) - On March 17, 2026, detectives of the Delaware County District Attorney's Office arrested 59 year old Kimberly Singleton of Collingdale, PA and charged her with Insurance Fraud. According to the criminal complaint, Singleton claimed that she suffered serious injuries when a shelf fell on her at a Save A Lot store on June 3, 2023.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-95/) - On March 16, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 35 year old Jessica A. Elliot of York, PA with Insurance Fraud. According to the complaint, it is alleged that Elliot failed to disclose household members and other drivers who regularly used her vehicles, including her daughters and
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-94/) - On March 10, 2026, detectives of the Lehigh County District Attorney's Office filed a criminal complaint charging 35 year old Jose A. Fernandez of Brooklyn, NY with Insurance Fraud. According to the complaint, it is alleged that when Fernandez applied for an auto insurance policy with Progressive Insurance that he provided his garaging location was
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-93/) - On March 9, 2026, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging 33 year old Mairyn Rivera of Scranton, PA with Insurance Fraud. According to the complaint, it is alleged that Rivera was involved in an auto accident prior to obtaining a Progressive Insurance policy. An investigation was initiated
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-92/) - On March 2, 2026, detectives of the Allegheny County District Attorney's Office arrested 43 year old Kelley A. Nash of Pittsburgh, PA and charged her with Insurance Fraud. According to the criminal complaint, on September 2, 2025, Nash's husband caused a multi-vehicle accident and reportedly fled the scene. Nash's vehicle was impounded and later salvaged
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-91/) - On March 2, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 34 year old Justin P. Salter of Dillsburg, PA with Insurance Fraud. According to the complaint, Salter filed a claim with Sentry Insurance for a crash he was involved in when operating his vehicle. It is alleged that
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-90/) - On March 2, 2026, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 38 year old Whitney J. Blaylock of Malvern, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on September 9, 2025, at approximately 2:50 PM, Blaylock added her 2018 Range Rover to her
- [Pennsylvania Workers' Compensation Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-workers-compensation-insurance-fraud-arrest/) - On February 28, 2026, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 37 year old Desiree Morris of Philadelphia, PA and charged her with Insurance Fraud, Attempted Theft by Deception and Theft Unlawful Taking. According to the criminal complaint, Morris is a postal worker for the United States Postal Service. On March 26,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-89/) - On February 27, 2026, detectives of the Delaware County District Attorney's Office arrested 32 year old Tiara Carter of Brookhaven, PA and charged her with Insurance Fraud. According to the criminal complaint, Carter filed a claim with Liberty Mutual Insurance on January 26, 2026, for damage to her vehicle, claiming that it was hit while
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-88/) - On February 24, 2026, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 55 year old Keith D. Williams of Philadelphia, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, it is alleged that Williams filed a claim with Liberty Mutual Insurance for damage he stated
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-87/) - On February 19, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 70 year old Cheryl A. Spangler of York, PA with Insurance Fraud. According to the complaint, Spangler reported to Progressive Insurance that her grandchild's vehicle struck a deer, causing front-end damage. Spangler was informed that her Progressive policy
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-86/) - On February 19, 2026, detectives of the Delaware County District Attorney's Office arrested 53 year old Aminata Kabbah of Clifton Heights, PA and charged her with Insurance Fraud. According to the criminal complaint, on April 7, 2025, Kabbah's son was involved in a single-vehicle accident. Kabba's son was not a listed driver on the Progressive
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-85/) - On February 13, 2026, detectives of the Allegheny County Police Department filed a criminal complaint charging 25 year old Morgan A. Ellsworth of Pittsburgh, PA with Insurance Fraud. According to the complaint, on February 5, 2025, Ellsworth purchased an auto insurance policy from Progressive Insurance. On February 10, 2025, Ellsworth filed a claim stating her
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-84/) - On February 13, 2026, detectives of the Allegheny County Police Department filed a criminal complaint charging 29 year old Steven Castro of McKeesport, PA with Insurance Fraud. According to the complaint, on July 7, 2025, Castro purchased and auto insurance policy from Progressive Insurance at 2:25 PM. Later that day, at 6:50 PM, Castro filed
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-83/) - On February 12, 2026, detectives of the Delaware County District Attorney's Office arrested 44 year old Kimberly M. Horne of Sharon Hill, PA and charged her with Insurance Fraud. According to the criminal complaint, Horne was involved in a rear-end collision with another vehicle. Reportedly, after the accident, Horne provided expired insurance information to the
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-82/)
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-81/) - On February 12, 2026, detectives of the Delaware County District Attorney's Office arrested 38 year old Michael A. McNair of Clifton Heights, PA and charged him with Insurance Fraud and Criminal Use of Communication Facility. According to the criminal complaint, McNair filed a claim for an accident involving his vehicle on January 3, 2025, shortly
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-80/) - On February 10, 2026, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging 43 year old Kristy M. Cimilluca of Plymouth, PA with Insurance Fraud and Attempted Theft by Deception. According to the complaint, on November 1, 2025, the defendant initiated an online claim against Sentry Insurance. The defendant claimed
- [Pennsylvania Jewelry Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-jewelry-insurance-fraud-arrest/) - On February 10, 2026, detectives of the Lehigh County District Attorney's Office filed a criminal complaint charging 31 year old Juan D. Martinez Torres of Allentown, PA with Insurance Fraud. According to the complaint, Martinez Torres filed an insurance claim with USAA Insurance on June 6, 2025, for a stolen Rolex Date Just 41 mm
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-79/) - On February 9, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 31 year old Kimberly Moreno of York, PA with Insurance Fraud and Theft by Deception. According to the complaint, Moreno allegedly claimed that she added glass and comprehensive coverage to her Progressive Insurance auto policy before discovering damage
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-78/) - On February 3, 2026, detectives of the Delaware County District Attorney's Office arrested 40 year old Ronald A. Clay of Yeadon, PA and charged him with Insurance Fraud and Criminal Use of Communication Facility. According to the criminal complaint, Clay ordered a rideshare vehicle on May 19, 2025, for another individual and her infant son.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-77/) - On February 2, 2026, detectives of the Delaware County District Attorney's Office arrested 46 year old Willie Jacob of Philadelphia, PA and charged him with Insurance Fraud and Criminal Use of Communication Facility. According to the criminal complaint, Jacob reported to his insurer, Progressive Insurance, that a February 21, 2025, accident caused damage to his
- [Pennsylvania Pet Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-75/) - On January 30, 2026, detectives of the Delaware County District Attorney's Office arrested 47 year old Michell L. Richardson of Upper Darby, PA and charged her with Insurance Fraud and Criminal Use of Communication Facility. According to the criminal complaint, Richardson submitted a claim to Nationwide Insurance on September 29, 2025, for $795, citing veterinary
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-76/) - On January 30, 2026, detectives of the Lehigh County District Attorney's Office filed a criminal complaint charging 35 year old Ashleigh Tweedie of Coopersburg, PA with two counts of Insurance Fraud. According to the complaint, it is alleged that Tweedie filed a false auto accident claim with Permanent General Assurance Company during a lapse in
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-74/) - On January 30, 2026, Office of Attorney General special agents arrested 39 year old Ramon R. Coleman, II of Pittsburgh, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on December 21, 2024, at 11:33 PM, Coleman obtained a Progressive Insurance Company auto policy to cover his
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-73/) - On January 29, 2026, detectives of the Allegheny County Police Department filed a criminal complaint charging 37 year old Anton D. Mudd of Pittsburgh, PA with Insurance Fraud. According to the complaint, on November 13, 2025, Mudd purchased an auto policy from Progressive Insurance at 8:47 AM. Mudd, subsequently at 9:39 AM, filed a claim
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-72/) - On January 29, 2026, Office of Attorney General special agents arrested 39 year old Sarah J. Payne of Slippery Rock, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, in January 2024, Payne received a 2007 Toyota Corolla from her aunt that was covered under her USAA
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-71/) - On January 28, 2026, detectives of the Delaware County District Attorney's Office arrested 29 year old Jacob B. Ordonio of Wayne, PA and charged him with Insurance Fraud and Criminal Use of Communication Facility. According to the criminal complaint, Ordonio reinstated his lapsed Progressive Insurance auto policy on February 17, 2025. His policy had lapsed
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-70/) - On January 28, 2026, Office of Attorney General special agents arrested 32 year old Raquel J. Dovales of Reading, PA and charged her with two counts of Insurance Fraud and one count each of Attempted Theft by Deception and Criminal Use of Communication Facility. According to the criminal complaint, on September 13, 2023, Dovales’s automotive
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-69/) - On January 20, 2026, detectives of the Delaware County District Attorney's Office filed a criminal complaint charging 40 year old Michael A. Brown of Drexel Hill, PA with Insurance Fraud, Criminal Use of Communication Facility and Theft by Unlawful Taking. According to the complaint, it is alleged that Brown falsely claimed to GEICO Secure Insurance
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-68/) - On January 21, 2026, Office of Attorney General special agents arrested 32 year old Timothy DiFiore, Jr. of Philadelphia, PA and charged him with Insurance Fraud, Attempted Theft by Deception and Criminal Use of Communication Facility. According to the criminal complaint, on June 21, 2024, at 12:56 PM, DiFiore called the Progressive Insurance Company to
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-67/) - On January 21, 2026, Office of Attorney General special agents arrested 41 year old Stacy L. Parisella of Williamsport, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on April 24, 2025, at 3:42 PM, Parisella obtained an automobile insurance policy with the Progressive Insurance Company for
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-66/) - On January 20, 2026, Office of Attorney General special agents arrested 42 year old Aaron M. Iben of Kingston, PA and charged him with Insurance Fraud, Attempted Theft by Deception and False Reports. According to the criminal complaint, Iben secured an auto insurance policy with the Progressive Insurance Company on June 11, 2020. Iben added
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-65/) - On January 20, 2026, Office of Attorney General special agents arrested 24 year old Tayton A. Espinosa of Mount Joy, PA and charged him with two counts of Insurance Fraud. According to the criminal complaint, Espinosa had a Progressive Insurance Company automobile policy with effective dates of August 4, 2024, through February 4, 2025, for
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-64/) - On January 16, 2026, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging 29 year old David J. Vanderpool of Athens, PA with Insurance Fraud. According to the complaint, Vanderpool added comprehensive coverage to his GEICO Insurance policy with a $50 deductible as well as rental coverage to become effective
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-63/) - On January 15, 2026, detectives of the Delaware County District Attorney's Office arrested 53 year old Malinda Trotta of Newark, DE and charged her with Insurance Fraud. According to the criminal complaint, Trotta alleged to Erie Insurance that her 2013 Kia Optima was damaged in a hit-and-run incident in a supermarket parking lot in Lansdowne,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-62/) - On January 14, 2026, Office of Attorney General special agents arrested 63 year old James A. Stratton of Huntingdon Valley, PA and charged him with Insurance Fraud, Attempted Theft by Deception and Criminal Use of Communication Facility. According to the criminal complaint, Stratton’s automobile insurance policy with GEICO Insurance Company lapsed due to nonpayment. On
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-61/) - On January 13, 2026, detectives of the Allegheny County District Attorney's Office arrested 20 year old Tyrin J. Bowie of Pittsburgh, PA and charged him with Insurance Fraud. According to the criminal complaint, Bowie filed a claim for an accident and allegedly told Progressive Insurance the incident occurred on August 29, 2025. However, photo metadata
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-60/) - On January 13, 2026, Office of Attorney General special agents arrested 42 year old David W. Summerville of Pulaski, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on May 30, 2025, Summerville obtained a Permanent General Insurance (PGI) policy for his 2011 Toyota RAV 4, which
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-59/) - On January 13, 2026, detectives of the Allegheny County District Attorney's Office arrested 52 year old Jan D. Kim and 52 year old Yoon Sok Lim, each of Allison Park, PA and charged each with Insurance Fraud and Conspiracy. According to the criminal complaints, Lim was reportedly driving through a high school parking lot when
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-58/) - On January 12, 2026, detectives of the Delaware County District Attorney’s Criminal Investigation Division arrested 30 year old Stefanie Vaughn of Morton, PA and charged her with Insurance Fraud. According to the criminal complaint, Vaughn purchased a Progressive Insurance auto policy on September 30, 2025, at 8:08 AM and, at 3:48 PM, Vaughn purchased additional
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-57/) - On January 12, 2026, Office of Attorney General special agents arrested 45 year old Elarie M. Bentler of Erie, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on November 18, 2022, at 6:23 PM, Bentler and/or her boyfriend purchased a Progressive Insurance Company policy for his
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-56/) - On January 12, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 55 year old Roger Keister, Jr. of Dover, PA with Insurance Fraud. According to the complaint, Keister's Progressive Insurance auto policy was canceled on December 8, 2025. Keister was reportedly involved in an auto accident with his vehicle
- [Pennsylvania Life Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-life-insurance-fraud-arrest/) - On January 12, 2026, Office of Attorney General special agents arrested William J. Damato of Folcroft, PA and charged him with three counts of Insurance Fraud and two counts each of Identity Theft, Theft by Deception, Forgery and Attempted Theft by Deception. According to the criminal complaint, in August 2020, Damato obtained a $50,000 Globe
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-55/) - On January 9, 2026, Office of Attorney General special agents arrested 32 year old Branden S. Battle of Pitcairn, PA and charged him with two counts of Insurance Fraud and one count of Theft by Deception. According to the criminal complaint, on September 14, 2024, Battle’s Progressive Insurance Company auto policy for his 2011 Nissan
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-54/) - On January 9, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 20 year old Leslie Martinez-Salazar of York, PA with Insurance Fraud. According to the complaint, on October 1, 2025, at 8:25 AM, York County's 911 Center received a report of a crash. At approximately 8:26 AM, the defendant
- [Pennsylvania Renter's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-renters-insurance-fraud-arrest-2/) - On January 8, 2026, Office of Attorney General special agents arrested 32 year old Haven Wagner of Randallstown, MD and charged her with two counts of Insurance Fraud and one count each of Theft by Deception and Attempted Theft by Deception. According to the criminal complaint, on January 4, 2023, Wagner incepted a renter’s insurance
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-53/) - On January 7, 2026, detectives of the York County District Attorney's Office filed a criminal complaint charging 34 year old Cody W. Morgan of York Haven, PA with Insurance Fraud and Attempted Theft by Deception. According to the complaint, on July 16, 2025, Morgan began a claim for glass damage to his vehicle with his
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-28/) - On January 6, 2026, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 48 year old Tawanda Collier of Philadelphia, PA and charged her with Insurance Fraud, Forgery and Securing Execution. According to the criminal complaint, it is alleged that Collier registered her vehicle with a fake financial responsibility identification insurance card from Bristol
- [TrustLayer AI Analyzes 400,000 Monthly COIs to Detect Insurance Fraud](https://insurancefraud.org/news_archives/trustlayer-ai-analyzes-400000-monthly-cois-to-detect-insurance-fraud/) - Modern risk management is shifting away from legacy manual verification as TrustLayer continues to scale its AI-driven fraud detection capabilities. Processing more than 400,000 Certificates of Insurance (COIs) every month, the TrustLayer platform leverages a database of millions of compliance documents to identify sophisticated patterns of insurance fraud that often escape human detection. Verifying compliance documents has
- [AG: Southeastern Massachusetts full-time home caregiver accused of locking disabled elderly man now deceased in room smeared in feces, urine](https://insurancefraud.org/news_archives/ag-southeastern-massachusetts-full-time-home-caregiver-accused-of-locking-disabled-elderly-man-now-deceased-in-room-smeared-in-feces-urine/) - The Massachusetts Attorney General’s Office has announced in a release that a Plymouth woman has been indicted by a Plymouth County Grand Jury on three counts of Caretaker Neglect, one count of Kidnapping, and one count of Unemployment Fraud relating to her alleged significant mistreatment of an elderly and intellectually disabled man. According to the
- [Fighting Fraud in Massachusetts](https://insurancefraud.org/news_archives/fighting-fraud-in-massachusetts/) - A few years ago, Deb Bloomberg’s mother received an alarming call from someone claiming to be an attorney for her granddaughter. The man said the granddaughter was in jail for causing a near-fatal car accident and would have to spend the night there unless she sent $8,000. The only thing that saved Bloomberg’s mother, then
- [Regina Hicks' murder: Estranged husband convicted decades after body found in pond](https://insurancefraud.org/news_archives/regina-hicks-murder-estranged-husband-convicted-decades-after-body-found-in-pond/) - Regina first started dating Paul Hicks when they were in high school, eventually marrying. He filed for divorce the day after she went missing, according to court documents. In an exclusive new interview with "20/20," Regina's cousin Lisa Hersha said that their relationship was toxic. "Before Paul, she was loud, happy, and more vocal. Paul
- [Attorney General Ford Announces 69 Felony Charges in Alleged Scheme Involving Medicaid Fraud and Identity Theft of Seniors](https://insurancefraud.org/news_archives/attorney-general-ford-announces-69-felony-charges-in-alleged-scheme-involving-medicaid-fraud-and-identity-theft-of-seniors/) - Nevada Attorney General Aaron D. Ford announced that Lawrence Carter, 55, and Leasa Carter, 61, of Sun Valley, have been indicted by a grand jury on 69 Felony charges of Medicaid Fraud, Racketeering, Racketeering Conspiracy, Perjury, Theft, Identity Theft of Older Persons, and Identity Theft of 5 or More Persons. A 70-count indictment was returned
- [GEICO sues four New York suppliers over $2.6m no-fault fraud scheme](https://insurancefraud.org/news_archives/geico-sues-four-new-york-suppliers-over-2-6m-no-fault-fraud-scheme/) - GEICO has sued four New York medical suppliers, alleging a $2.6 million No-Fault fraud scheme run through paper owners and a hidden controller. The complaint, filed April 30, 2026 in federal court in the Eastern District of New York, names Go For Med Supply Corp., Snyder Med Supplies Corp., Tantemed Supply Corp., and 10 of 10
- [Oklahoma City Woman Sentenced to Federal Prison for $1.1 Million Health Care Fraud Scheme](https://insurancefraud.org/news_archives/oklahoma-city-woman-sentenced-to-federal-prison-for-1-1-million-health-care-fraud-scheme/) - NATASHA ALLMON, 49, of Oklahoma City, has been sentenced to serve 20 months in federal prison for health care fraud, announced U.S. Attorney Robert J. Troester. According to public records, from January 2021 through December 2023, Allmon had an agreement with Blue Cross Blue Shield (BCBS) to provide behavioral health counseling services. During that time,
- [Huntington Beach couple pleads guilty to insurance fraud](https://insurancefraud.org/news_archives/huntington-beach-couple-pleads-guilty-to-insurance-fraud/) - A Huntington Beach couple pleaded guilty Friday to ripping off an insurance company and were sentenced to four days in jail, or time already served behind bars. Hung Ta and his wife Tam Truong pleaded guilty to a felony count of money laundering derived from criminal activity. As part of their plea deal, they paid
- [Watchdog Paper Warns against Insurance Fraud for Child Gender Transition Procedures](https://insurancefraud.org/news_archives/watchdog-paper-warns-against-insurance-fraud-for-child-gender-transition-procedures/) - A paper published last month by medical watchdog group Do No Harm warns state officials and health insurance providers that “Healthcare Providers May Skirt Coding Rules to Get Paid for Child Sex Changes,” as the title puts it. The document identifies potential ways that medical providers can falsify insurance codes to ensure payment for gender transition procedures
- [Oswego County Resident Sentenced for Insurance Fraud After Concealing Work While Collecting Workers’ Compensation Benefits](https://insurancefraud.org/news_archives/oswego-county-resident-sentenced-for-insurance-fraud-after-concealing-work-while-collecting-workers-compensation-benefits/) - New York State Workers’ Compensation Fraud Inspector General Lucy Lang today announced the sentencing of an Oswego County man for fraudulently obtaining workers’ compensation benefits while concealing his return to work. Christopher Cronk, 58, of Central Square, NY, was sentenced on April 20, 2026, in Onondaga County Court before the Hon. Gordon Cuffy to five
- [The Fraud Division Launches West Coast Strike Force to Target Health Care Fraud Schemes Across Arizona, Nevada, and Northern California](https://insurancefraud.org/news_archives/the-fraud-division-launches-west-coast-strike-force-to-target-health-care-fraud-schemes-across-arizona-nevada-and-northern-california/) - The Justice Department’s National Fraud Enforcement Division (Fraud Division) today announced the formation of the West Coast Health Care Fraud Strike Force, a multi-district enforcement initiative uniting the Division’s Health Care Fraud Section with the U.S. Attorney’s Offices for the District of Arizona, District of Nevada, and Northern District of California. The Health Care Strike
- [Pharmacy Technician Pleads Guilty to $5.6M Health Care Fraud Scheme and Illegal Distribution of Oxycodone](https://insurancefraud.org/news_archives/pharmacy-technician-pleads-guilty-to-5-6m-health-care-fraud-scheme-and-illegal-distribution-of-oxycodone/) - A Michigan man pleaded guilty yesterday to defrauding health care benefit programs, including Medicare and Medicaid, by billing for prescription medications that he never dispensed and providing unlawful prescriptions of oxycodone to drug traffickers in exchange for cash. According to court documents, Ali Naserdean, 32, of Dearborn Heights, Michigan, was a pharmacy technician at three
- [Feds defer additional $91 million in Minnesota Medicaid funds; Gov. Walz calls it "campaign of retribution"](https://insurancefraud.org/news_archives/feds-defer-additional-91-million-in-minnesota-medicaid-funds-gov-walz-calls-it-campaign-of-retribution/) - Gov. Tim Walz says the Trump administration is exploiting the state's fraud crisis after Dr. Mehmet Oz, administrator for the Centers for Medicare & Medicaid Services, announced an additional $91 million in federal Medicaid funding is being deferred, citing ongoing concerns about fraud and program vulnerabilities. "This is a transparent effort to cut funding for
- [Man sentenced in Wyandotte County court for insurance fraud](https://insurancefraud.org/news_archives/man-sentenced-in-wyandotte-county-court-for-insurance-fraud/) - A Wyandotte County man was sentenced earlier this month for insurance fraud. Kansas Insurance Commissioner announced on Thursday that 33-year-old Christopher Dunn was sentenced on April 10 to 16 months in prison with 12 months of probation following his release. Dunn pleaded guilty on March 2 to one felony count of insurance Fraud. According to
- [Leader of insurance fraud and arson scheme sentenced to 15 years](https://insurancefraud.org/news_archives/leader-of-insurance-fraud-and-arson-scheme-sentenced-to-15-years/) - A district judge sentenced Evette “Betty” Osuegbu, 62, of Granite City, to 15 years in federal prison for her role in a string of arsons and insurance fraud stretching from 2014 to 2023. Following a five-day trial in December, a jury seated in East St. Louis found Osuegbu guilty of all 15 counts of an
- [Former St. Louis alderman sentenced for insurance fraud](https://insurancefraud.org/news_archives/former-st-louis-alderman-sentenced-for-insurance-fraud/) - A former St. Louis elected official has been sentenced in federal court after a jury found him guilty of fraud-related offenses tied to an insurance claim. U.S. District Judge Henry E. Autrey on Tuesday sentenced former St. Louis Alderman Brandon Bosley to 16 months in prison for insurance fraud and for making false statements to
- [St. Landry Parish Man Accused of Arson and Insurance Fraud](https://insurancefraud.org/news_archives/st-landry-parish-man-accused-of-arson-and-insurance-fraud/) - A St. Landry Parish man from the town of Palmetto is in trouble with the law after accusations have been leveled against him that he is responsible for setting his vehicle on fire and committing insurance fraud. According to officials with the State Fire Marshal's Office, they have been investigating the case of a vehicle
- [Spike in fake insurance cards](https://insurancefraud.org/news_archives/spike-in-fake-insurance-cards/) - Some consumers, looking for the best car insurance deal, may find out the hard way that the discount was too good to be true. Read on for why all drivers pay the price for fake insurance cards. 'THEY TRULY THOUGHT THEY WERE PURCHASING REAL INSURANCE' At Ann Nguyen’s office in Arlington, the State Farm Insurance
- [Opioid Manufacturer Purdue Pharma Sentenced for Fraud and Kickback Conspiracies](https://insurancefraud.org/news_archives/opioid-manufacturer-purdue-pharma-sentenced-for-fraud-and-kickback-conspiracies/) - Opioid manufacturer Purdue Pharma LP (Purdue) was sentenced today in federal court in Newark, New Jersey, and ordered to pay criminal penalties of over $5 billion for its role in fueling the opioid epidemic. “Purdue made billions by unlawfully marketing dangerous opioid products, and deceiving the DEA and the American people. Purdue profited by paying
- [Man Gets Just Over 2 Years Sentence for Committing $14M Medicare Fraud](https://insurancefraud.org/news_archives/man-gets-just-over-2-years-sentence-for-committing-14m-medicare-fraud/) - A Burbank man was sentenced Tuesday to two years, three months in federal prison for participating in a scheme to defraud Medicare out of at least $14 million via hospice and diagnostic testing services that were often never provided. Alex Alexsanian, 48, was also ordered to forfeit $3 million derived from the scheme. He pleaded
- [Superior Court lets U-Haul amend defence to allege brothers staged motor vehicle accident](https://insurancefraud.org/news_archives/superior-court-lets-u-haul-amend-defence-to-allege-brothers-staged-motor-vehicle-accident/) - The Ontario Superior Court has allowed U-Haul Co (Canada) Ltd to amend its defence against the plaintiff’s action and its proposed cross-claim against his brother to reflect evidence suggesting that the siblings deliberately staged a motor vehicle accident (MVA). In Parweez v. Manbauman, 2026 ONSC 2456, the plaintiff brought the MVA action against the defendants M. Manbauman
- [Sham hospice schemes are bilking Medicare — and harming California seniors](https://insurancefraud.org/news_archives/sham-hospice-schemes-are-bilking-medicare-and-harming-california-seniors/) - California has emerged as the epicenter of a sweeping hospice fraud crisis, one that is costing taxpayers hundreds of millions of dollars and putting vulnerable seniors at risk. Yet years after the state acknowledged the problem, key regulatory fixes remain in limbo while state and federal officials trade blame. Hospice care, an end of life
- [Bucks County Public Adjuster Charged with Stealing Over $140,000 in Insurance Payouts from Clients](https://insurancefraud.org/news_archives/bucks-county-public-adjuster-charged-with-stealing-over-140000-in-insurance-payouts-from-clients/) - The Bucks County District Attorney’s Office has announced criminal charges against the owner and operator of Advanced Public Adjusters following a four-month investigation into allegations of insurance fraud and theft. Greg A. Micucci, 61, of Bristol, is accused of misappropriating approximately $140,000 in insurance claim funds intended for nine victims and their contractors. The investigation,
- [Cherokee County man sentenced to probation for insurance fraud](https://insurancefraud.org/news_archives/cherokee-county-man-sentenced-to-probation-for-insurance-fraud/) - A judge sentenced a Cherokee County man to two years of probation for insurance fraud. According to the Kansas Department of Insurance, 43-year-old Chad Ashe pleaded guilty on January 21 to one count of insurance fraud. The department says Ashe added collision coverage to his policy following a car accident and filed a claim falsely
- [Queens Pharmacy Owner Sentenced to Over Five Years in Prison for Money Laundering Scheme](https://insurancefraud.org/news_archives/queens-pharmacy-owner-sentenced-to-over-five-years-in-prison-for-money-laundering-scheme/) - A New York man, Taesung “Terry” Kim, 61, of Harrison, New York, was sentenced today to 63 months in prison for conspiring to launder the proceeds of a $24.4 million pharmacy fraud scheme. “Mr. Kim’s scheme to pad his pockets with $24 million in taxpayer dollars by peddling unnecessary prescription drugs is despicable and dangerous,”
- [“Fraud Pays”: Congressional Hearing Exposes Deep Cracks in Medicare’s Defenses](https://insurancefraud.org/news_archives/fraud-pays-congressional-hearing-exposes-deep-cracks-in-medicares-defenses/) - A lengthy Ways and Means Committee hearing revealed extensive Medicare system exploitation and ignited partisan debates on fixing it. Witnesses before the House Ways and Means Committee delivered a stark assessment of Medicare fraud at a Congressional hearing stretching well beyond 4 hours.1 The system, as currently designed, rewards criminals and punishes honest providers, speakers said.
- [Analytics: Inside the New Fraud-Fighting Mindset](https://insurancefraud.org/news_archives/analytics-inside-the-new-fraud-fighting-mindset/) - Young insurance investigators and law enforcement officers often want to be in the field, inspecting losses, examining evidence, conducting face-to-face interviews, and catching the bad guy. I was once that law enforcement guy: at the ready, wanting to chase the villains instead of sitting behind a desk looking at spreadsheets and running data queries in
- [Pharmacist Sentenced to 30 months in Prison for Role in $2M Health Care Fraud Scheme](https://insurancefraud.org/news_archives/pharmacist-sentenced-to-30-months-in-prison-for-role-in-2m-health-care-fraud-scheme/) - Michael Shawn Boaz, 47, of Clinton, was sentenced this week to 30 months in prison and 3 years supervised release for one count of conspiracy to commit health care fraud and 13 counts of fraudulent prescriptions and ordered to pay restitution of $1,806,212.90. U.S. Attorney Kyle G. Bumgarner of the Western District of Kentucky, Special
- [Report: ‘Excessive fraud’ persists among correctional workers](https://insurancefraud.org/news_archives/report-excessive-fraud-persists-among-correctional-workers/) - Widespread misconduct, fraud and abuse among New York state correctional workers “continues to plague the system,” according to a 2025 annual report released by the Workers Compensation Fraud Inspector General. The report, released Tuesday, found that Department of Corrections and Community Supervision workers accounted for six of the 14 people arrested for alleged claimant fraud
- [Insurance customers are using AI images to make fake claims - these are the most shameless examples](https://insurancefraud.org/news_archives/insurance-customers-are-using-ai-images-to-make-fake-claims-these-are-the-most-shameless-examples/) - Images generated by artificial intelligence are fuelling a new wave of insurance fraud, as customers use them to make false claims for items that never existed. Insurance giant Admiral says it detected a 71 per cent rise in fraudulent insurance claims last year, amounting to £86.8million in motor, home and travel claims. This has been
- [Raleigh insurance agent accused of stealing $10,000 from elderly woman: Warrant](https://insurancefraud.org/news_archives/raleigh-insurance-agent-accused-of-stealing-10000-from-elderly-woman-warrant/) - A Raleigh insurance agent was arrested Friday after being accused of stealing $10,000 from an elderly woman more than six years ago, a warrant shows. According to a warrant filed by the North Carolina Department of Insurance Criminal Investigations Division, 68-year-old Gilbert Stanford Williams is an insurance agent and the owner of Senior Benefit Alliance,
- [Bombshell arrest: Stephenville insurance agent charged with theft, money laundering](https://insurancefraud.org/news_archives/bombshell-arrest-stephenville-insurance-agent-charged-with-theft-money-laundering/) - In a bombshell arrest following an investigation by the Texas Rangers, a well-known Stephenville businessman has been charged with two stunning crimes. Clayton Iley, owner of Texas Legacy Insurance Group, was taken into custody on Friday and charged with theft over $300,000, and money laundering, over $300,000, both first degree felonies. He is being held
- [House hearing highlights ‘systemic failure’ at heart of hospice, home health fraud](https://insurancefraud.org/news_archives/house-hearing-highlights-systemic-failure-at-heart-of-hospice-home-health-fraud/) - At a lengthy House Committee on Ways & Means hearing Tuesday, hospice and healthcare stakeholders testified about the harm caused by pervasive hospice and home health fraud in California and other states and laid out concrete ways to address the crisis. “Fraud exposes beneficiaries to exploitation and denies them access to appropriate care and undermines trust in
- [Calif. court upholds dismissal of worker’s fraud suit under comp exclusivity rule](https://insurancefraud.org/news_archives/calif-court-upholds-dismissal-of-workers-fraud-suit-under-comp-exclusivity-rule/) - A California appellate court on Monday affirmed the dismissal of a lawsuit brought by an emergency medical technician who alleged a claims administrator, adjuster and physician conspired to deny her workers compensation benefits, holding that the claims are barred by the state’s workers compensation exclusivity doctrine. In Davis v. CorVel Corp., the California Court of Appeal, Fourth
- [FTC moves to shut down health insurance fraud scheme](https://insurancefraud.org/news_archives/ftc-moves-to-shut-down-health-insurance-fraud-scheme/) - A federal court has temporarily halted a Florida-based operation that the Federal Trade Commission alleges collected more than $91 million by deceiving consumers into purchasing fake health insurance coverage. The FTC filed its complaint April 7 in the U.S. District Court for the Southern District of Florida, and a federal judge signed a temporary restraining
- [Perry Hall dental assistant and family members sentenced for illegal opioid distribution](https://insurancefraud.org/news_archives/perry-hall-dental-assistant-and-family-members-sentenced-for-illegal-opioid-distribution/) - A Baltimore County dental assistant and two of her family members have been sentenced for their roles in a scheme to illegally sell oxycodone to a licensed dentist who practiced while under the influence of the drugs, Maryland Attorney General Anthony G. Brown announced this week. Samantha Cook, a part-time assistant at Perry Hall Family
- [Healthcare Worker at Detention Facilities Pleads Guilty to Fraud](https://insurancefraud.org/news_archives/healthcare-worker-at-detention-facilities-pleads-guilty-to-fraud/) - Neery Velazquez admitted in federal court today that while he was a healthcare worker at U.S. Customs and Border Protection detention facilities in San Diego County, he submitted almost $250,000 in false travel claims for reimbursement. Velazquez, who worked for a government contractor, pleaded guilty to a single count of False Claim. He is scheduled
- [Baltimore County insurance agent charged with felony theft scheme, identity fraud, and insurance fraud](https://insurancefraud.org/news_archives/baltimore-county-insurance-agent-charged-with-felony-theft-scheme-identity-fraud-and-insurance-fraud/) - A Baltimore County insurance agent has been indicted on felony charges after allegedly stealing more than $100,000 through a sophisticated four-year scheme involving identity fraud and insurance fraud, Maryland Attorney General Anthony G. Brown announced Thursday. A Baltimore County grand jury returned a six-count indictment against 72-year-old Gregory A. Maslow, of Owings Mills. The charges
- [Malpractice insurer wins dispute over attorney’s alleged fraud scheme](https://insurancefraud.org/news_archives/malpractice-insurer-wins-dispute-over-attorneys-alleged-fraud-scheme/) - A professional liability insurer has no duty to defend an Atlanta attorney whose client defrauded FEMA by fabricating a contract to provide meals to hurricane survivors in Puerto Rico, a federal judge ruled Tuesday. In ALPS Property & Casualty Insurance Company v. Honoré, Chief Judge Leigh Martin May granted summary judgment to ALPS, a Missoula, Montana-based
- [$1.7 million in recovered funds, 22 arrests, headline Workers’ Compensation Fraud in 2025](https://insurancefraud.org/news_archives/1-7-million-in-recovered-funds-22-arrests-headline-workers-compensation-fraud-in-2025/) - The New York State Inspector General's annual Workers Compensation Fraud Report was released this week, with 22 arrests, and $1.9 million identified ($1.7 million recovered) in fraudulent activity in 2025. The 22 arrests are more than double the 2024 total, with six of the 22 coming from Department of Corrections and Community Supervision. While the
- [The MEDICARE FRAUD investigation that could shake healthcare](https://insurancefraud.org/news_archives/the-medicare-fraud-investigation-that-could-shake-healthcare/) - The MEDICARE FRAUD investigation that could shake healthcare
- [Lehigh County Man Sentenced to Prison for Posing as a Medical Professional](https://insurancefraud.org/news_archives/lehigh-county-man-sentenced-to-prison-for-posing-as-a-medical-professional/) - Attorney General Dave Sunday announced that a Lehigh County man with no medical training or licenses has been sentenced to state prison for posing as a medical professional in Carbon County to administer care to patients — for which Medicare, Medicaid, and private insurance companies paid out claims. Adam Herman was sentenced this week to
- [“F.R.A.U.D. is dope” podcaster sentenced to federal prison again](https://insurancefraud.org/news_archives/f-r-a-u-d-is-dope-podcaster-sentenced-to-federal-prison-again/) - Multi-convicted fraudster Jonathan Dupiton has been sentenced to seven years in federal prison for using stolen identities to obtain millions of dollars in unemployment insurance benefits. “During the pandemic, while citizens were struggling with job loss and trying to make ends meet, Dupiton stole unemployment benefits by submitting false applications using hundreds of stolen identities,”
- [Louisiana mayor arrested by attorney general, charged with Medicaid fraud](https://insurancefraud.org/news_archives/louisiana-mayor-arrested-by-attorney-general-charged-with-medicaid-fraud/) - Winnsboro Mayor Alice Wallace has been arrested and charged with Medicaid fraud by Louisiana Attorney General Liz Murrill. Murrill said Wallace, 50, Robinson Drive, was arrested on April 21 and booked into the East Baton Rouge Prison. No bond has been set. Wallace is charged with six counts of government benefits fraud in what Murrill
- [Man accused of falsifying details of insurance claim following crash in Charlotte County](https://insurancefraud.org/news_archives/man-accused-of-falsifying-details-of-insurance-claim-following-crash-in-charlotte-county/) - A man is accused of insurance fraud in Charlotte County after the Florida Department of Financial Services says he falsified the details of an insurance claim following a vehicle crash. According to court records, the investigation started with a complaint filed by the Florida Department of Financial Services Criminal Investigations Division stating that Richard Roy,
- [Former Geneva Co. insurance agent pleads guilty to fraud charges](https://insurancefraud.org/news_archives/former-geneva-co-insurance-agent-pleads-guilty-to-fraud-charges/) - Federal court records show a former Hartford, Alabama insurance agent has pleaded guilty to making false claims to a federal crop program. Prosecutors say Jonathan Lawrence Eubanks forged paperwork submitted to Great American Insurance Company to secure crop insurance for a farmer, including a document containing false information submitted well after the deadline for cotton
- [Former Pharmacy President Sentenced to 24 Months in Prison for Health Care Fraud and Kickback Scheme Involving Compounded Medications](https://insurancefraud.org/news_archives/former-pharmacy-president-sentenced-to-24-months-in-prison-for-health-care-fraud-and-kickback-scheme-involving-compounded-medications/) - On April 1, 2026 Adam Brosius, 61, of Delray Beach, Florida, was sentenced to 24 months in prison for his role in a $33 million health care fraud and kickback scheme, U.S. Attorney Robert Frazer announced. According to documents filed in this case and statements made in court: From 2014 through 2016, Brosius and others
- [Appleton clinic to pay $380k settlement over Medicare fraud allegations](https://insurancefraud.org/news_archives/appleton-clinic-to-pay-380k-settlement-over-medicare-fraud-allegations/) - Apple Medical Clinic and Dr. Michael Johnson agreed to pay $382,362.95 to the U.S. government over allegations they violated the False Claims Act (FCA). The alleged false claims to Medicare are for electrical muscle stimulation treatment, vitamin injections, and other related services not deemed medically reasonable or necessary. Apple Medical Clinic is based in Appleton.
- [National Fraud Enforcement Division uncovers $340 million in fraud schemes in its first week of operation](https://insurancefraud.org/news_archives/national-fraud-enforcement-division-uncovers-340-million-in-fraud-schemes-in-its-first-week-of-operation/) - The DOJ’s newly created National Fraud Enforcement Division announced Friday a wave of arrests, convictions and sentences in fraud schemes that targeted more than $340 million in taxpayer funds over just the past week. The actions, spanning April 10 through April 17, involved cases from across the country targeting fraud in federal programs including Medicare, Medicaid, COVID-19
- [Eagles Super Bowl champion Alshon Jeffery arrested for insurance fraud](https://insurancefraud.org/news_archives/eagles-super-bowl-champion-alshon-jeffery-arrested-for-insurance-fraud/) - Former Philadelphia Eagles wide receiver Alshon Jeffery was arrested for insurance fraud earlier this week, TMZ reports. Jeffery was also charged with conceal/fail to disclose insurance benefit or payment. He was booked Wednesday morning and has since been released. Jeffery, 36, spent four seasons in Philadelphia after being drafted by the Chicago Bears in the
- [California wildlife expert blew the lid off a bear suit luxury car insurance fraud scheme](https://insurancefraud.org/news_archives/california-wildlife-expert-blew-the-lid-off-a-bear-suit-luxury-car-insurance-fraud-scheme/) - Three Los Angeles-area residents were convicted of fraud for a scheme in which they used a bear suit to stage attacks on luxury cars to rake in insurance payouts. The California Department of Insurance said Thursday that Alfiya Zuckerman of Valley Village and Ruben Tamrazian and Vahe Muradkhanyan, both of Glendale, pleaded no contest to
- [2 of 5 sentenced in local $2M health care fraud scheme](https://insurancefraud.org/news_archives/2-of-5-sentenced-in-local-2m-health-care-fraud-scheme/) - Two of five men convicted in a $2 million health care fraud scheme in Sharon were sentenced this week in federal court. John Laeng, of West Middlesex, was sentenced to two years in prison and ordered to pay $1,980,904.46 in restitution. Christopher O’Brien, of Masury, was sentenced to three years of probation and ordered to
- [What’s worse than Medicaid fraud?](https://insurancefraud.org/news_archives/whats-worse-than-medicaid-fraud/) - Medicaid fraud drains public funds, undermines trust, and too often involves services for the frail elderly delivered on paper but not in reality. Yet fraud, for all its damage, is not the program’s most serious failing. Fraud is illegal, detectable, and, in principle, fixable with the right incentives and enforcement. The deeper problem is what
- [EO 14395 and the New Era of Healthcare Fraud Enforcement](https://insurancefraud.org/news_archives/eo-14395-and-the-new-era-of-healthcare-fraud-enforcement/) - Signed in March, Executive Order 14395, Establishing the Task Force to Eliminate Fraud, reflects a significant development in how the federal government approaches fraud in federally funded benefit programs.[1]. For healthcare providers who bill Medicaid, Medicare, or other federal programs, understanding the structure and implications of Executive Order 14395 (“EO 14395” or the “Order”) is
- [Michigan surgeon gets prison time for $7M Medicare fraud scheme](https://insurancefraud.org/news_archives/michigan-surgeon-gets-prison-time-for-7m-medicare-fraud-scheme/) - A West Bloomfield, Michigan, surgeon will spend a year in prison for his role in a $7 million Medicare fraud scheme, federal prosecutors said. Mustafa Hares, 79, was sentenced Thursday to one year in federal prison and ordered to pay $4.8 million in restitution. In addition, Hares will serve three years of supervised release once
- [Massachusetts woman fraudulently collected nearly $23K in workers' compensation, officials say](https://insurancefraud.org/news_archives/massachusetts-woman-fraudulently-collected-nearly-23k-in-workers-compensation-officials-say/) - A Massachusetts woman was arrested Wednesday for illegally collecting nearly $23,000 in worker’s compensation benefits while working at a storage facility in Putnam, state officials said. Mackenzie Coonan, 25, of Rutland, was charged with first-degree larceny and fraudulent claim or receipt of benefits, according to a news release Friday from the state Division of Criminal
- [FBI: Nearly $21B lost to cybercrime in 2025 as crypto scams dominate and AI scams rise](https://insurancefraud.org/news_archives/fbi-nearly-21b-lost-to-cybercrime-in-2025-as-crypto-scams-dominate-and-ai-scams-rise/) - The FBI's latest internet crime report shows Americans lost nearly $21 billion to cybercrime in 2025. Roughly half of those losses, about $11.4 billion, were tied to cryptocurrency-related complaints. The report underscores how scams are becoming more sophisticated and costly, with older Americans continuing to bear the heaviest burden. People 60 and older reported more than $7.7
- [N.Y. Judge Backs Insurer in Staged-Crash Scheme - TT](https://insurancefraud.org/news_archives/n-y-judge-backs-insurer-in-staged-crash-scheme-tt/) - A New York Supreme Court judge in Suffolk County recently sided with an insurance company refuting payouts after it proved a crime ring of Ecuadorians staged eight crashes with commercial vehicles. Judge Maureen T. Liccione in Riverhead granted summary judgment in its entirety to Integon National Insurance Co. after finding it proved the eight incidents
- [Annual report: Pa. tops nation in criminal convictions for Medicaid fraud | News | northcentralpa.com](https://insurancefraud.org/news_archives/annual-report-pa-tops-nation-in-criminal-convictions-for-medicaid-fraud-news-northcentralpa-com/) - The U.S. Department of Health and Human Services has released its Fiscal Year 2025 Medicaid Fraud Control Annual Report, with Pa. ranking first nationally in criminal convictions for Medicaid fraud. In addition, the Pa. Office of Attorney General ranked third overall in charges filed against those accused of stealing from Pa.’s Medicaid program. The Pa. Medicaid
- [Uber and Liberty Mutual sue alleged fraud ring over staged crashes](https://insurancefraud.org/news_archives/uber-and-liberty-mutual-sue-alleged-fraud-ring-over-staged-crashes/) - Uber and Liberty Mutual are suing 14 people and eight medical providers they say ran a staged-accident fraud ring targeting rideshare drivers in New York. The lawsuit, filed on April 14, 2026, in the US District Court for the Eastern District of New York, lays out what the plaintiffs describe as a methodical scheme spanning roughly 19
- [Milford Man Sentenced for Stealing from Medicaid](https://insurancefraud.org/news_archives/milford-man-sentenced-for-stealing-from-medicaid/) - Chief State’s Attorney Patrick J. Griffin announced that the Honorable Thomas V. O’Keefe, Jr. today sentenced Julian Cano, age 43, of Milford, to three years in prison, execution of that time suspended, with five years of conditional discharge for stealing from the Medicaid program by submitting fraudulent claims for work he did not perform and
- [2 people arrested in vehicle theft, fraud case](https://insurancefraud.org/news_archives/2-people-arrested-in-vehicle-theft-fraud-case/) - Two people were placed under arrest after the El Paso Police Department’s Auto Theft Task Force investigated a reported vehicle theft at a local body shop in Central El Paso. A victim reported paying thousands of dollars for repair and paint services on a vehicle at Junior Auto Collision, located at 4200 Dyer Street, according
- [Allstate unleashes RICO suit over alleged $7.9 million auto insurance fraud](https://insurancefraud.org/news_archives/allstate-unleashes-rico-suit-over-alleged-7-9-million-auto-insurance-fraud/) - Seven Allstate entities are taking on a Houston-area family and their network of healthcare businesses over an alleged multi-million-dollar auto insurance fraud scheme. In a federal court filing dated April 10, 2026, Allstate brought claims against four members of the Roopani family - Sohail Roopani, Anil Roopani, Rahil Roopani, M.D., and Barketali Roopani - along with at
- [Indictment outlines multimillion-dollar health care fraud case in Middle Georgia](https://insurancefraud.org/news_archives/indictment-outlines-multimillion-dollar-health-care-fraud-case-in-middle-georgia/) - Five people have been charged in a federal health care fraud case in Middle Georgia, according to an indictment filed in the U.S. District Court for the Middle District of Georgia. The indictment names Dawn James-Ellis, Lamonica Lakes, Tarshea Fudge-Riley, Angela Childs, and Adrian Harris as defendants. According to the indictment, the defendants are charged
- [Florida Nursing Assistant Sentenced to Nine Years in Prison for $11.4M Health Care Fraud Scheme Targeting Medicare Beneficiaries](https://insurancefraud.org/news_archives/florida-nursing-assistant-sentenced-to-nine-years-in-prison-for-11-4m-health-care-fraud-scheme-targeting-medicare-beneficiaries/) - A Florida nursing assistant was sentenced yesterday to nine years in prison and two years of supervised release for his role in an $11.4 million health care fraud and wire fraud conspiracy in which hundreds of Medicare beneficiaries were sent thousands of orthotic braces they did not need. Cruz was also ordered to pay $3,712,345.70
- [Behavioral therapist pleads guilty to health care fraud for submitting inflated insurance reimbursement claims](https://insurancefraud.org/news_archives/behavioral-therapist-pleads-guilty-to-health-care-fraud-for-submitting-inflated-insurance-reimbursement-claims/) - The owner of a McDuffie County behavioral therapy service faces up to 10 years in federal prison and substantial financial penalties after pleading guilty to submitting fraudulent insurance reimbursement claims. Mira Stallings, 41, of Thomson, Georgia, pled guilty in U.S. District Court to one count of Health Care Fraud, said Margaret E. “Meg” Heap, U.S.
- [Email hackers dupe nursing home out of $108K repair payment](https://insurancefraud.org/news_archives/email-hackers-dupe-nursing-home-out-of-108k-repair-payment/) - A nonprofit nursing home was bilked out of nearly $110,000 after suspects hacked their way into an email thread about legitimate heating system repairs and redirected payments to a bogus company. Police in Pennsylvania and Colorado are now on the case, having charged two men with theft by deception, conspiracy and dealing in proceeds of
- [Labor Pushes Crackdown on Construction Fraud](https://insurancefraud.org/news_archives/labor-pushes-crackdown-on-construction-fraud/) - Organized labor groups are pushing Missouri lawmakers to crack down on what they describe as widespread labor fraud in the construction industry, arguing the practice harms workers, undercuts legitimate businesses, and reduces state tax revenue. The Mid-America Carpenters Regional Council recently launched a campaign aimed at contractors who allegedly pay workers in cash and operate
- [Fake Nurse, 29, Who Treated Thousands of Patients Without a License at Florida Hospital Accepts Plea Deal](https://insurancefraud.org/news_archives/fake-nurse-29-who-treated-thousands-of-patients-without-a-license-at-florida-hospital-accepts-plea-deal/) - A woman who claimed to be a registered nurse in Florida and "treated" more than 4,000 patients without a license has been sentenced to probation and community service as part of a plea deal, RadarOnline.com can report. Autumn Bardisa, 29, must also serve 50 hours of community service and write an apology letter to the
- [Lawyers proposing house arrest for woman who helped scam Calgary seniors](https://insurancefraud.org/news_archives/lawyers-proposing-house-arrest-for-woman-who-helped-scam-calgary-seniors/) - The courier in a scam targeting vulnerable seniors — made to believe their grandchildren or a relative was in trouble with the law — should be spared jail time, court was told Friday. But Justice Michele Hollins expressed concern that a proposed two-year-less-a-day conditional sentence for Alana Love Duncan, including house arrest for the first
- [Recent FinCEN Advisory Highlights Rising Health Care Fraud Risk for Financial Institutions](https://insurancefraud.org/news_archives/recent-fincen-advisory-highlights-rising-health-care-fraud-risk-for-financial-institutions/) - As the federal government intensifies its “whole of government” approach to combat fraud, waste, and abuse, particularly in Federal Health Care Benefit Programs, financial institutions face growing exposure to health care fraud proceeds moving through domestic and cross‑border financial systems. Last week, FinCEN, in coordination with the FBI and HHS‑OIG, issued a new advisory urging heightened vigilance
- [Podiatrist and Pharmaceutical Sales Representative Sentenced in $3.2 Million Healthcare Fraud Conspiracy Involving Unlicensed Person Performing Skin Grafts](https://insurancefraud.org/news_archives/podiatrist-and-pharmaceutical-sales-representative-sentenced-in-3-2-million-healthcare-fraud-conspiracy-involving-unlicensed-person-performing-skin-grafts/) - U.S. District Judge Jennifer L. Thurston sentenced Felipe Ruiz, 52, of Fresno, and Jose Gabriel Aguirre, 53, of Clovis, to 63 months in prison for conspiracy to commit health care fraud, U.S. Attorney Eric Grant announced. Judge Thurston also ordered forfeiture of nine properties owned by Aguirre and Ruiz, as well as a $2.6 million
- [Minnesota spent $20 billion on Medicaid programs at high risk for fraud since 2018](https://insurancefraud.org/news_archives/minnesota-spent-20-billion-on-medicaid-programs-at-high-risk-for-fraud-since-2018/) - Last year, Minnesota paid $4.32 billion in Medicaid reimbursements to the 14 programs now identified as being a high risk for fraud — more than double what it paid in 2021. As more reimbursements have been finalized, a KARE 11 data practices request reveals the total since 2018 is $20 billion — even more than
- [But "We Don't Take Insurance": Why Cash-Pay Digital Health Companies Still Face Kickback and Fee-Splitting Risk](https://insurancefraud.org/news_archives/but-we-dont-take-insurance-why-cash-pay-digital-health-companies-still-face-kickback-and-fee-splitting-risk/) - Executive Summary Cash-pay healthcare models do not eliminate referral risk. Even when a company does not bill Medicare, Medicaid, or commercial insurers, federal, state, and “all-payor” fraud and abuse laws may still apply to compensation arrangements involving patient referrals. Certain arrangements carry heightened scrutiny. Percentage-based compensation, referral fees, physician equity, and marketing arrangements tied to patient volume
- [Lessons from the OIG: Common Billing Errors Texas Home Health Providers Need to Know](https://insurancefraud.org/news_archives/lessons-from-the-oig-common-billing-errors-texas-home-health-providers-need-to-know/) - The Texas Health and Human Services Office of Inspector General (HHSC-OIG) has a message for Texas providers and suppliers: Billing compliance matters, and the agency is watching. The Office of Inspector General (OIG) recently published its quarterly report for fiscal year 2026. Per the report, the HHSC-OIG recovered more than $95.7 million from December 1, 2025, to
- [Kansas arms insurance commissioner with new civil fraud powers](https://insurancefraud.org/news_archives/kansas-arms-insurance-commissioner-with-new-civil-fraud-powers/) - Kansas has handed its insurance commissioner a new weapon against fraud – and it is set to change how producers and adjusters get licensed. House Bill 2323, introduced during the 2025 legislative session by the Committee on Judiciary at the request of Steve Karrer on behalf of the Kansas Insurance Department, allows the commissioner of
- [Minnesota fraud suspect skips court, forfeits bond, throwing $11M Medicaid case into doubt](https://insurancefraud.org/news_archives/minnesota-fraud-suspect-skips-court-forfeits-bond-throwing-11m-medicaid-case-into-doubt/) - A man accused of orchestrating an $11 million Medicaid fraud scheme in Minnesota skipped a scheduled court appearance this week, prompting a warrant for his arrest, authorities said. Abdirashid Ismail Said, 50, failed to appear for a pretrial hearing in Hennepin County, forfeiting his bond, according Fox 9, citing the Minnesota Attorney General’s Office. Minnesota
- [Jury Finds New Orleans Attorneys Guilty in Staged Auto Accident Scheme](https://insurancefraud.org/news_archives/jury-finds-new-orleans-attorneys-guilty-in-staged-auto-accident-scheme/) - Two New Orleans personal injury attorneys were found guilty of running a scheme to defraud insurance companies by staging fraudulent accidents. The U.S. Attorney’s Office and the Criminal Division of the U.S. Department of Justice announced that Vanessa Motta and Jason Giles were found guilty of all charges pending against them, following a three-week jury
- [Slidell doctor sentenced for $6.6 million healthcare fraud](https://insurancefraud.org/news_archives/slidell-doctor-sentenced-for-6-6-million-healthcare-fraud/) - A Slidell doctor was sentenced on Thursday, April 9, for conspiracy to commit healthcare fraud. According to the Eastern District of Louisiana, 67-year-old Robert Tassin, from February to September of 2019, signed doctor’s orders for Cancer Genomic Testing, or CGx tests, for Medicare beneficiaries he never saw, spoke to or otherwise treated. He did this
- [Trump’s $39M nursing home fraudster pardon sparks outrage](https://insurancefraud.org/news_archives/trumps-39m-nursing-home-fraudster-pardon-sparks-outrage/) - A presidential pardon granted to a New Jersey businessman convicted of defrauding nursing home residents out of millions of dollars has ignited an unusually pointed backlash, with criticism arriving not just from political opponents but from within Trump’s own base of supporters. Joseph Schwartz, who once operated a nursing home empire, pleaded guilty to failing
- [Ohio cashier ordered to return $55K to Bureau of Workers Compensation after fraud conviction](https://insurancefraud.org/news_archives/ohio-cashier-ordered-to-return-55k-to-bureau-of-workers-compensation-after-fraud-conviction/)
- [Miramar insurance adjuster charged with stealing $610,000 from hurricane victims](https://insurancefraud.org/news_archives/miramar-insurance-adjuster-charged-with-stealing-610000-from-hurricane-victims/) - A Miramar public adjuster already facing prosecution in a similar case was arrested again last week, this time accused of diverting more than $610,000 in insurance settlement money meant for homeowners whose properties were damaged by Hurricane Ian. Following an investigation by the Florida Department of Financial Services, which reviewed complaints from several policyholders, police
- [Arson suspect in California warehouse fire allegedly compared himself to Luigi Mangione](https://insurancefraud.org/news_archives/arson-suspect-in-california-warehouse-fire-allegedly-compared-himself-to-luigi-mangione/) - The 29-year-old man charged in connection with fires that burned down a paper products warehouse in California was allegedly motivated by anti-capitalism sentiment and compared himself to Luigi Mangione, authorities said Friday. Chamel Abdulkarim, of Highland, California, was charged by federal authorities with arson of a building used in interstate and foreign commerce, Bill Essayli,
- [Hays County woman sentenced to 20 years for setting fire to Kyle home](https://insurancefraud.org/news_archives/hays-county-woman-sentenced-to-20-years-for-setting-fire-to-kyle-home/) - The Hays County District Attorney's Office announced Thursday that a woman has pleaded guilty in connection with a 2024 structure fire in a Kyle residential neighborhood. Lawanda Moreno pleaded guilty to Arson with Intent to Damage a Habitation, a first-degree felony. She was sentenced to 20 years in prison on March 17 by Judge
- [CMS revokes LA doctor’s Medicare access over $71M billing probe](https://insurancefraud.org/news_archives/cms-revokes-la-doctors-medicare-access-over-71m-billing-probe/) - The Centers for Medicare and Medicaid Services (CMS) has barred Los Angeles physician Dr. Rajiv Bhuva from participating in Medicare after linking him to $71 million in questionable hospice claims. The decision follows prior state audit warnings about suspicious hospice affiliations and is part of a wider federal anti-fraud initiative. Officials say the move sends
- [NW Iowa farmer sentenced to federal prison for fraud & other charges](https://insurancefraud.org/news_archives/nw-iowa-farmer-sentenced-to-federal-prison-for-fraud-other-charges/) - A Woodbury County farmer will spend the next 13 years in federal prison after admitting to theft of government funds, identity theft, crop insurance fraud and stalking. 33-year-old Tanner Seuntjens, of Danbury, entered those guilty pleas in federal court back in September. His criminal activity in this case dates back to 2020. Prosecutors say Seuntjens
- [Jax Contractor Nailed In Alleged $300K Workers’ Comp Scam, Could Get 30 Years](https://insurancefraud.org/news_archives/jax-contractor-nailed-in-alleged-300k-workers-comp-scam-could-get-30-years/) - A Jacksonville construction boss is in serious trouble after state investigators say he lowballed his company’s payroll to dodge roughly $300,000 in workers’ compensation premiums, leaving his crew and competitors holding the bag. According to Tampa Free Press, the defendant, Carlos Antonio Maradiaga Garcia, is accused of running a construction firm with a real payroll
- [LexisNexis: Synthetic Identity Fraud Rises Significantly in 2025](https://insurancefraud.org/news_archives/lexisnexis-synthetic-identity-fraud-rises-significantly-in-2025/) - A recent report by LexisNexis Risk Solutions found synthetic identity fraud is on the rise. According to its latest Cybercrime Report based on more than 100 billion online transactions in 2025, LexisNexis said 11% of frauds now involve a synthetic identity, representing an eight-fold global increase over 2024. “While organizations are strengthening defenses across channels,
- [Richland County coroner talks dangerous new opioid identified in SC](https://insurancefraud.org/news_archives/richland-county-coroner-talks-dangerous-new-opioid-identified-in-sc/) - WIS spoke with Richland County Coroner Nadia Rutherford amid new warnings from state officials about an opioid recently identified in South Carolina. According to the South Carolina Attorney General’s Office, cychlorphine has emerged as a new synthetic opioid in the state. Officials said it’s also considered to be multiple times more potent than fentanyl. “Most
- [DisplayRide Launches AIVA to Combat the Surging Commercial Auto Fraud Crisis](https://insurancefraud.org/news_archives/displayride-launches-aiva-to-combat-the-surging-commercial-auto-fraud-crisis/) - The moment a commercial vehicle incident occurs, a race begins. On one side: organized fraud networks — recruiting passengers, coordinating medical billing, and shaping a narrative designed to exploit the system. On the other: insurers, regulators, and the drivers themselves, who may not learn the full scope of what is being claimed against them for
- [St. Louis County Fossil Company Operator Accused of Disability Fraud](https://insurancefraud.org/news_archives/st-louis-county-fossil-company-operator-accused-of-disability-fraud/) - The following information was released by the U.S. Department of Justice: The owner of a fossil replica company was indicted Wednesday and accused of fraudulently seeking disability benefits. Scott A. Taylor, 50, is still on probation from a prior disability fraud case. The new indictment, on one count of making a false statement, accuses him
- [Stop the Scams: Governor Hochul Announces Partnership Between State Police and Department of Financial Services to Crack Down on Insurance Fraud](https://insurancefraud.org/news_archives/stop-the-scams-governor-hochul-announces-partnership-between-state-police-and-department-of-financial-services-to-crack-down-on-insurance-fraud/) - Stop the Scams: Governor Hochul Announces Partnership Between State Police and Department of Financial Services to Crack Down on Insurance Fraud State Police and DFS To Host Specialized Training For 250 Investigators, Troopers, and Personnel from Local Law Enforcement Agencies to Detect, Investigate and Prosecute Financial Crimes Part of Governor’s Efforts To Combat the High
- [Business Owner Convicted of $1.9M Medicare, Medicaid, and Private Insurer Fraud Scheme](https://insurancefraud.org/news_archives/business-owner-convicted-of-1-9m-medicare-medicaid-and-private-insurer-fraud-scheme/) - The following information was released by the U.S. Department of Justice: A business owner from Dearborn Heights pleaded guilty today to conspiring to commit health care fraud, which resulted in $1.9 million in loss to Medicare, Medicaid, and Blue Cross Blue Shield of Michigan, announced United States Attorney Jerome F. Gorgon, Jr. Gorgon was joined
- [Florida insurance brokers and parent company to pay over $135 Million for ACA fraud scheme](https://insurancefraud.org/news_archives/florida-insurance-brokers-and-parent-company-to-pay-over-135-million-for-aca-fraud-scheme/) - AP of South Florida, LLC (APSF), an insurance brokerage company located in Florida, has admitted to participating in a fraudulent scheme that took advantage of thousands of vulnerable consumers under the Affordable Care Act (ACA). The company is accused of illegally enrolling individuals into fully subsidized ACA plans, resulting in over $141 million in undeserved
- [Lee County woman charged with insurance fraud after crash claim](https://insurancefraud.org/news_archives/lee-county-woman-charged-with-insurance-fraud-after-crash-claim/) - A Lee County woman has been charged with insurance fraud following an investigation into a vehicle collision claim, according to the South Carolina Law Enforcement Division. Authorities said Zanajia Lachae’ Wilson-James, 29, was charged April 2, 2026, with Presenting a False Claim for an Insurance Payment, Value $10,000 or More. The investigation was requested by
- [NYC lawyer ran massive insurance fraud ring staging car accidents to drive up payouts: suit](https://insurancefraud.org/news_archives/nyc-lawyer-ran-massive-insurance-fraud-ring-staging-car-accidents-to-drive-up-payouts-suit/) - A Brooklyn-based personal injury attorney allegedly ran a massive scheme that used staged car accidents to drive up insurance payouts, according to a new, bombshell lawsuit — that comes as Gov. Kathy Hochul ramps up her campaign to crack down on such scams. FedEx filed the 92-page suit Tuesday accusing the Ikhilov Law Group and
- [L.A. County Supervisors move to combat Home Health, Hospice fraud amid nationwide crackdown](https://insurancefraud.org/news_archives/l-a-county-supervisors-move-to-combat-home-health-hospice-fraud-amid-nationwide-crackdown/) - The Los Angeles County Board of Supervisors voted Tuesday to strengthen oversight and enforcement against fraud in the home health and hospice industry, advancing a motion that calls for greater coordination between local, state and federal agencies as prosecutors describe Southern California as the epicenter of a national crisis in Medicare fraud. The motion, introduced
- [2 Arizonans sentenced for fake life insurance scheme targeting vulnerable people](https://insurancefraud.org/news_archives/2-arizonans-sentenced-for-fake-life-insurance-scheme-targeting-vulnerable-people/) - Two people are behind bars after investigators say they created a life insurance fraud scheme targeting those struggling with homelessness and substance abuse. Attorney General Kris Mayes announced that Shannon Lovell and Ryan Michell were sentenced for their roles in the intricate plot. Lovell was sentenced to 3.5 years in prison, and Michell will spend
- [Boulder dance studio owner staged robberies for insurance fraud, used money for cosmetic surgery, indictment alleges](https://insurancefraud.org/news_archives/boulder-dance-studio-owner-staged-robberies-for-insurance-fraud-used-money-for-cosmetic-surgery-indictment-alleges/) - A Thornton woman has been indicted on more than 20 counts of charges, including fraud, theft, and forgery. In a March 27, 2026, indictment by a grand jury, Cindy Burdine is accused of staging fake robberies of her Boulder dance studio, Kenesis Dance, and committing insurance fraud. Burdine is also accused of using at least
- [AG Rayfield Announces Medicaid Fraud Charges and Convictions in Three Separate Multnomah County Cases](https://insurancefraud.org/news_archives/ag-rayfield-announces-medicaid-fraud-charges-and-convictions-in-three-separate-multnomah-county-cases/) - Attorney General Dan Rayfield today announced charges against a Portland area behavioral health provider and his business for allegedly stealing hundreds of thousands of dollars from Oregon’s Medicaid program. The Oregon Department of Justice’s Medicaid Fraud Control Unit (MFCU) also secured convictions in two additional Multnomah County cases involving Medicaid fraud. “Medicaid exists to make
- [St. Louis County Man Admits $637,000 in Pandemic, Disability Fraud](https://insurancefraud.org/news_archives/st-louis-county-man-admits-637000-in-pandemic-disability-fraud/) - The following information was released by the U.S. Department of Justice: A man from St. Louis County on Monday admitted committing disability fraud and pandemic loan fraud totaling $637,000. Preston Randall, 62, pleaded guilty in U.S. District Court in St. Louis to five counts of wire fraud, two counts of theft of government property and
- [Fraud Prevention Month: Ohioans Urged to Protect Themselves from Insurance Fraud and Report Scams](https://insurancefraud.org/news_archives/fraud-prevention-month-ohioans-urged-to-protect-themselves-from-insurance-fraud-and-report-scams/) - Governor Mike DeWine has declared April as Fraud Prevention Month in Ohio and Department of Insurance Director Judith L. French is urging Ohioans to protect themselves from insurance fraud, one of the most prevalent crimes in the United States. Insurance fraud costs consumers and businesses billions of dollars each year. According to the Coalition Against
- [2 South Dakota farmers to pay $4 million in crop insurance fraud](https://insurancefraud.org/news_archives/2-south-dakota-farmers-to-pay-4-million-in-crop-insurance-fraud/) - Two South Dakota farmers have been ordered to pay over $4 million in civil judgment for crop insurance fraud that occurred in 2018 and 2019, according to a news release from the U.S. Department of Justice. James and Levi Garrett operated a family farm and ranch in Sully County. In 2018, the Garretts falsely told
- [South Florida man arrested for staging car crash to file fraudulent insurance claim](https://insurancefraud.org/news_archives/south-florida-man-arrested-for-staging-car-crash-to-file-fraudulent-insurance-claim/) - A South Florida man has been arrested after investigators say he intentionally caused a car crash and then tried to profit from it by filing a fraudulent insurance claim. According to authorities, the incident happened on Feb. 22, 2026, at the intersection of Woolbright Road and El Clair Ranch Road. What was initially reported as
- [Kansas farmer pleads guilty to crop insurance fraud](https://insurancefraud.org/news_archives/kansas-farmer-pleads-guilty-to-crop-insurance-fraud/) - The U.S. Attorney’s Office in Kansas announced Friday that a Kansas farmer pleaded guilty to charges that he defrauded the U.S. Department of Agriculture. David L. Mongeau, 54, of Holcomb, pleaded guilty to one count of making false statements and one count of bank fraud/attempted bank fraud. In 2019, Mongeau, owner of Mongeau Enterprises in
- [Macomb County Dentist Charged with Racketeering in Massive Alleged Medicaid Fraud Scheme](https://insurancefraud.org/news_archives/macomb-county-dentist-charged-with-racketeering-in-massive-alleged-medicaid-fraud-scheme/) - Faddi S. Salim, DDS, 37, of Troy, was arraigned in the 54B District Court in East Lansing on March 19 for allegedly conducting a massive Medicaid fraud scheme involving dental crowns, announced Michigan Attorney General Dana Nessel. Salim has been charged with one count of Conducting a Criminal Enterprise, a 20-year felony, and 131 counts
- [Former Intensive Care Nurse Indicted, Charged with Prescription Drug Fraud](https://insurancefraud.org/news_archives/former-intensive-care-nurse-indicted-charged-with-prescription-drug-fraud/) - An investigation by special agents with TBI’s Medicaid Fraud Control Division and Drug Investigation Division has resulted in the indictment of a former intensive care nurse. In July 2025, at the request of 2nd Judicial District Attorney General Barry Staubus, TBI agents began investigating allegations involving Joseph Juszak (DOB: 11/12/93). During the investigation, agents learned
- [Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft](https://insurancefraud.org/news_archives/former-medicaid-provider-sentenced-to-federal-prison-for-health-care-fraud-and-aggravated-identity-theft/) - Alabama Attorney General Steve Marshall, alongside the U.S. Attorney’s Office for the Middle District of Alabama and the Department of Health and Human Services Office of Inspector General (HHS-OIG), announced the sentencing of an Anniston man on charges of health care fraud and identity theft. On April 2, 2026, a federal judge sentenced 54-year-old Hasan
- [Florida Man Pleads Guilty In Health Care Fraud And Kickback Scheme Involving “Foot Baths”](https://insurancefraud.org/news_archives/florida-man-pleads-guilty-in-health-care-fraud-and-kickback-scheme-involving-foot-baths/) - The United States Attorney’s Office for the Middle District of Pennsylvania announced that Frank Suess (a.k.a., Franz P. Suess), age 79, of Wellington, Florida, pleaded guilty before Senior United States District Judge Malachy E. Mannion to conspiracy to commit health care fraud and conspiracy to violate the anti-kickback statute. Suess also agreed to forfeit a
- [Rockwell Man Faces Charges for Public Adjusting without a License and Insurance Fraud](https://insurancefraud.org/news_archives/rockwell-man-faces-charges-for-public-adjusting-without-a-license-and-insurance-fraud/) - Joseph Starr, 39, of Rockwell, was charged on March 24, 2026, with two counts of Acting as a Public Adjuster without a License and one count of Insurance Fraud—Presenting False Information (Class D Felony). The charges followed an investigation by the Iowa Insurance Division's Fraud Bureau. According to criminal complaints filed by the Iowa Insurance
- [Pfizer’s Lyme disease vaccine shows 70% efficacy; Texas man sentenced to 12.5 years in $61.5M Medicare telemarketing fraud scheme; Novo Nordisk launches Wegovy subscription model – Morning Medical Update](https://insurancefraud.org/news_archives/pfizers-lyme-disease-vaccine-shows-70-efficacy-texas-man-sentenced-to-12-5-years-in-61-5m-medicare-telemarketing-fraud-scheme-novo-nordisk-launches-wegovy-subscription-model-morn/) - Pfizer’s Lyme vaccine shows 70% efficacy The shot missed its statistical threshold for success. Pfizer and Valneva say their experimental Lyme disease vaccine reduced tick-borne infections by more than 70% in a late-stage trial of 9,400 people ages 5 and up, and the companies plan to submit the data to regulators despite the trial narrowly
- [Dental assistant gets light sentence for fraud](https://insurancefraud.org/news_archives/dental-assistant-gets-light-sentence-for-fraud/) - A dental assistant in Arkansas was sentenced to five years of probation after being convicted of fraudulently billing Medicaid for $18,000 in services that were never rendered to patients, according to the Arkansas Attorney General. Victoria Smith-Williams, 38, of Conway, AR, who was found guilty of one count of Medicaid fraud, was ordered to pay
- [8 Arrested in Health Care Fraud Takedown, Including Owners of Hospices that Billed Taxpayers Millions of Dollars to Serve the ‘Dying’](https://insurancefraud.org/news_archives/8-arrested-in-health-care-fraud-takedown-including-owners-of-hospices-that-billed-taxpayers-millions-of-dollars-to-serve-the-dying/) - In coordination with the Vice President’s Task Force to Eliminate Fraud, eight defendants, including three nurses, a chiropractor, and a purported psychologist, have been arrested on federal charges that they schemed to defraud the nation’s health care system out of more than $50 million – including by running sham hospice care facilities that bilked Medicare
- [Close associate of former Mayor Eric Adams indicted on fraud charges](https://insurancefraud.org/news_archives/close-associate-of-former-mayor-eric-adams-indicted-on-fraud-charges/) - A close associate of former New York City Mayor Eric Adams has been indicted on insurance fraud charges, according to prosecutors. Zhan Petrosyants was accused of obtaining millions of dollars from no-fault auto insurance claims from 2018 to 2023, said U.S. Attorney for the Southern District of New York Jay Clayton. In the indictment, Petrosyants'
- [Lexington Man Convicted of Conspiracies to Commit Healthcare Fraud and Violate the Anti-Kickback Statute at Sober Homes](https://insurancefraud.org/news_archives/lexington-man-convicted-of-conspiracies-to-commit-healthcare-fraud-and-violate-the-anti-kickback-statute-at-sober-homes/) - A Lexington man, Dashawn Dawkins, 34, was convicted on Wednesday by a federal grand jury in Lexington for conspiracy to commit healthcare fraud and conspiracy to receive kickbacks. Dawkins was convicted of the charges following a 3-day trial. Dawkins was a peer support specialist at Serenity Keeper’s, LLC (“Serenity Keepers”), a sober home company based
- [Insurance company owner arrested on insurance fraud, theft charges in Graves County](https://insurancefraud.org/news_archives/insurance-company-owner-arrested-on-insurance-fraud-theft-charges-in-graves-county/) - A Murray, Kentucky, insurance company owner is facing charges in connection with insurance fraud and theft. According to the Graves County Sheriff’s Office, an investigation revealed that a Graves County church was defrauded of over $10,000 for insurance coverage. Investigators said the insurance agent never purchased the policies for property and liability coverage. The suspect
- [Jonah Slatky of Somis charged with six felony counts of worker’s compensation insurance fraud](https://insurancefraud.org/news_archives/jonah-slatky-of-somis-charged-with-six-felony-counts-of-workers-compensation-insurance-fraud/) - Jonah Slatky, the owner of a framing and rough carpentry company in Somis, was charged with six felony counts of worker's compensation insurance fraud with an alleged loss of $519,000 in state revenue. Slatky was arraigned on March 27, 2026, where he pled not guilty to all charged counts before he was released on his
- [Doctors, nurses arrested in SoCal health care fraud investigation](https://insurancefraud.org/news_archives/doctors-nurses-arrested-in-socal-health-care-fraud-investigation/) - The U.S. Department of Justice on Thursday announced what they called a major health care fraud takedown throughout Southern California, which included the arrest of doctors and nurses. First Assistant U.S. Attorney Bill Essayli was joined during a press conference by several law enforcement agencies including the FBI, and Dr. Mehmet Oz, head of the
- [Balance Needed to Fight Fraud, Waste in Medicare, Other Health Programs, AARP Says](https://insurancefraud.org/news_archives/balance-needed-to-fight-fraud-waste-in-medicare-other-health-programs-aarp-says/) - AARP gave federal health officials a list of proposals Monday designed to cut fraud and improve accountability, oversight and savings. The seven-page letter highlights AARP’s support for efforts to root out fiscal malfeasance and waste in Medicare, Medicaid and the health insurance marketplace, including responsibly using artificial intelligence (AI) to identify and thwart fraudulent billing,
- [Limiting Medicaid Waste, Fraud, and Abuse: A Checklist for States to Protect Medicaid for the Vulnerable and the Taxpayers Who Finance It](https://insurancefraud.org/news_archives/limiting-medicaid-waste-fraud-and-abuse-a-checklist-for-states-to-protect-medicaid-for-the-vulnerable-and-the-taxpayers-who-finance-it/) - Medicaid waste, fraud, and abuse arise from several primary sources: legalized money laundering schemes and resulting corporate welfare; ineligible enrollees in the program; eligibility errors that allow ineligible individuals to enroll and remain enrolled; vulnerable service categories with weak oversight that create opportunities for fraud; and limited transparency, particularly in managed care. The following is
- [Surveillance video shows alleged staged crash in Sunny Isles Beach insurance fraud case, cops say](https://insurancefraud.org/news_archives/surveillance-video-shows-alleged-staged-crash-in-sunny-isles-beach-insurance-fraud-case-cops-say/) - Local 10 News obtained surveillance video on Tuesday that authorities say shows a staged crash tied to an alleged insurance fraud scheme involving two South Florida men. Hector Cordero Jr., 33, of Hallandale Beach, and Jerry Detres Jr., 42, of Miami, were arrested in connection with the Feb. 25 incident at a Shell gas station
- [Broward insurance adjuster accused of stealing over $611K from Hurricane Ian victims](https://insurancefraud.org/news_archives/broward-insurance-adjuster-accused-of-stealing-over-611k-from-hurricane-ian-victims/) - A South Florida insurance adjuster exploited Hurricane Ian victims by withholding more than $600,000 in insurance settlement money, according to arrest documents obtained by Local 10 News on Tuesday. Jail records show Francisco Javier Chaparro Araus, 45, of Miramar, is facing multiple charges following an investigation by the Florida Department of Financial Services. Investigators said
- [AHCA/NCAL Submits Comments on Fraud Prevention Request for Information](https://insurancefraud.org/news_archives/ahca-ncal-submits-comments-on-fraud-prevention-request-for-information/) - AHCA/NCAL submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a Request for Information (RFI) on the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative [RIN 0938-AV97]. The CRUSH RFI seeks stakeholder feedback on potential policy approaches to strengthen detection, prevention, and enforcement of fraud-waste, and abuse (FWA) across federal
- [Omaha healthcare company files for bankruptcy amid lawsuits over alleged fraud](https://insurancefraud.org/news_archives/omaha-healthcare-company-files-for-bankruptcy-amid-lawsuits-over-alleged-fraud/) - Lawsuits over tens of millions of dollars between an Omaha healthcare provider and its investors has forced one company to file for bankruptcy. Banyan Medical Systems with its headquarters at 87th and F Streets in Omaha filed for bankruptcy last week. The company, founded 20 years ago, provides virtual nursing services and healthcare technology. In
- [Fifth Circuit examines whether workers’ comp is a health care benefit in pharmacy fraud appeal](https://insurancefraud.org/news_archives/fifth-circuit-examines-whether-workers-comp-is-a-health-care-benefit-in-pharmacy-fraud-appeal/) - A Fifth Circuit panel grappled Tuesday with a question of first impression in a $145 million health care fraud appeal: Is the federal workers’ compensation program for government employees a “health care benefit program” under the statute that criminalizes defrauding such programs? The question was raised in the appeal of former Texas pharmacy managers Dehshid
- [Ohio couple sentenced for arson in $2M insurance fraud scheme](https://insurancefraud.org/news_archives/ohio-couple-sentenced-for-arson-in-2m-insurance-fraud-scheme/) - An Ohio couple have been sentenced for devising a scheme to collect more than $2 million dollars in insurance money by conspiring to set insured houses on fire, the U.S. Attorney’s Office, Northern District of Ohio announced. Lonnie White, 48, from Willoughby Hills, Ohio, was sentenced to 53 months in prison by Chief U.S. District
- [Texas Man Jailed in Rome for Insurance Fraud](https://insurancefraud.org/news_archives/texas-man-jailed-in-rome-for-insurance-fraud/) - A Houston man is facing a felony insurance‑fraud charge after authorities in Floyd County issued a warrant detailing what investigators describe as an elaborate scheme involving falsified insurance documents. Bradford Lee McWhorter II, 43, was arrested in Rome after state insurance investigators linked him to a fraudulent Certificate of Liability Insurance allegedly used in an
- [GEICO sues 12 companies over alleged $2.9 million no-fault fraud scheme](https://insurancefraud.org/news_archives/geico-sues-12-companies-over-alleged-2-9-million-no-fault-fraud-scheme/) - GEICO is going after an alleged $2.9 million no-fault fraud operation run through 12 DME companies and 10 individuals in New York. In a civil action filed on March 27, 2026, in the US District Court for the Eastern District of New York, the insurer alleges a coordinated network of durable medical equipment providers systematically submitted
- [Treasury Targets Fraud Schemes Exploiting Government Health Care Benefits](https://insurancefraud.org/news_archives/treasury-targets-fraud-schemes-exploiting-government-health-care-benefits/) - Today, in support of President Trump’s pledge to combat fraud, the U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) issued an Advisory urging financial institutions to be vigilant about fraud schemes targeting government health care benefit programs such as Medicare and Medicaid. This follows Secretary of the Treasury Scott Bessent’s trip to Minnesota
- [What Veterinary Practice Owners Need To Know About Liability Insurance](https://insurancefraud.org/news_archives/what-veterinary-practice-owners-need-to-know-about-liability-insurance/) - One session I found particularly interesting during the VetPartners annual meeting in January was a discussion on legal issues facing veterinarians and their practices. The panelists were outstanding attorneys in the animal health space, with many years of experience. What grabbed my attention was the conversation about professional liability insurance coverage, state veterinary boards, and
- [Central Washington Doctor gets 1 year, 1 day in federal prison for fraud](https://insurancefraud.org/news_archives/central-washington-doctor-gets-1-year-1-day-in-federal-prison-for-fraud/) - A central Washington physician was sentenced Wednesday to just over a year in federal prison for altering recalled breathing devices and billing Medicaid for them as new, federal prosecutors said. Dr. Eric Edward Haeger, 57, of Brewster, was sentenced March 25 by U.S. District Judge Rebecca L. Pennell to one year and one day in
- [Treasury Launches Whistleblower Rewards to Crush Health Care Fraud Schemes](https://insurancefraud.org/news_archives/treasury-launches-whistleblower-rewards-to-crush-health-care-fraud-schemes/) - Treasury Secretary Scott Bessent is launching a new program on Monday that will reward tipsters with up to 30% of fines imposed on criminals who are trying to bleed Medicare and Medicaid dry. The move comes after a sprawling web of scams by Somali immigrants in Minnesota, who allegedly ripped off government welfare programs to
- [Statewide Grand Jury Indicts Insurance Broker for Fraud and Theft](https://insurancefraud.org/news_archives/statewide-grand-jury-indicts-insurance-broker-for-fraud-and-theft/) - The following information was released by the office of the Colorado Attorney General: The statewide grand jury indicted George Gonzalez, 55, of Denver on 14 counts for allegedly diverting thousands of dollars in insurance premium payments instead of sending them to insurance companies as required by law, Attorney General Phil Weiser announced today. "When a
- [Texas Report Highlights Dental Marketing Risks as Medicaid Oversight Expands](https://insurancefraud.org/news_archives/texas-report-highlights-dental-marketing-risks-as-medicaid-oversight-expands/) - The latest Joint Annual Interagency Coordination Report from the Texas Health and Human Services Office of Inspector General and the Texas Office of the Attorney General, which was published this month, offers a useful reminder for Medicaid dentists about where enforcement attention is currently focused. Dental marketing practices under review Among the ongoing cases listed in
- [South Carolina woman charged with insurance fraud and financial identity theft](https://insurancefraud.org/news_archives/south-carolina-woman-charged-with-insurance-fraud-and-financial-identity-theft/) - A Spartanburg County, South Carolina, woman was charged with insurance fraud and financial identity fraud on Tuesday, March 24. According to an arrest warrant, on July 21, 2025, Miranda Jeanette Fuller knowingly submitted a false claim for insurance payment to Progressive. Fuller contacted Progressive to file an automobile claim on behalf of another person and
- [Synthetic identity fraud: the growing threat in 2026](https://insurancefraud.org/news_archives/synthetic-identity-fraud-the-growing-threat-in-2026/) - Synthetic identity fraud is fast becoming one of the most complex threats facing financial institutions and regulated businesses today. According to SmartSearch, unlike conventional fraud, where criminals steal a real person’s identity wholesale, synthetic identity fraud blends genuine and fabricated information to construct entirely new identities that can pass standard verification checks. For compliance teams,
- [Six Sentenced in Healthcare Fraud Conspiracy that Stole $10 Million from Medicaid Over Six-Year Period](https://insurancefraud.org/news_archives/six-sentenced-in-healthcare-fraud-conspiracy-that-stole-10-million-from-medicaid-over-six-year-period/) - Six defendants, who stole upwards of $10 million from the Virginia Medicaid system over a six-year period by submitting false claims on behalf of 1st Adult N Pediatric Healthcare Services for services that were never provided, were sentenced today in U.S. District Court in Lynchburg. The three owners of 1st Adult N Pediatric, Carolyn Bryant-Taylor,
- [Telemedicine Company Owner Pleads Guilty to $46M Medicare Fraud Scheme](https://insurancefraud.org/news_archives/telemedicine-company-owner-pleads-guilty-to-46m-medicare-fraud-scheme/) - The owner of a telemedicine company pleaded guilty today to organizing and leading a $46.2 million Medicare fraud conspiracy that spanned more than six years. According to court documents, Christopher Harwood, 43, of Fort Lauderdale, Florida, admitted that he owned and operated a telemedicine company called TelevisitMD. Harwood and his co-conspirators targeted Medicare patients through
- [Victims of Ghost Broking Fraud Are Seeing Their IDs Used Again](https://insurancefraud.org/news_archives/victims-of-ghost-broking-fraud-are-seeing-their-ids-used-again/) - Victims of motor insurance ‘ghost broking’ scams – where criminals posing as legitimate brokers sell fake or invalid motor insurance policies – have surged 93%, with two-thirds of victims’ identities reused in further fraud. Analysis from the National SIRA shared risk intelligence consortium found that 66% of identities linked to ghost broking appear in additional
- [Pa. attorney general charges York man with insurance fraud](https://insurancefraud.org/news_archives/pa-attorney-general-charges-york-man-with-insurance-fraud/) - Pennsylvania Attorney General Dave Sunday charged a York County man who, investigators say, committed insurance fraud, getting thousands of dollars in payouts. Taofiq Salami, 30, of York Haven, faces numerous charges, including: Insurance fraudIdentity theftForgeryTitle washing Investigators say Salami used fake and stolen identities, as well as those of other people, to buy and insure
- [Woman filed insurance claims for undamaged home she doesn't own, charges say](https://insurancefraud.org/news_archives/woman-filed-insurance-claims-for-undamaged-home-she-doesnt-own-charges-say/) - A Syracuse woman allegedly filed three home insurance claims in a week last year. The problem, according to prosecutors, is that the woman does not own the house, and nothing actually happened to the residence. Katherine Ann Davis, 37, was charged Friday with insurance fraud and identity fraud, second-degree felonies, and four counts of forgery,
- [New Haven woman charged with making $65,000 by defrauding CT Medicaid](https://insurancefraud.org/news_archives/new-haven-woman-charged-with-making-65000-by-defrauding-ct-medicaid/) - A New Haven woman was arrested last Wednesday after allegedly orchestrating a scheme that defrauded nearly $65,000 from the Connecticut Medicaid program. Vartaysha Reed, 26, appeared in New Haven Superior Court this week, according to a report from the state Division of Criminal Justice on Thursday. She is charged with one count of health insurance
- [The White House Task Force to Eliminate Fraud: What’s at Stake for Medicaid](https://insurancefraud.org/news_archives/the-white-house-task-force-to-eliminate-fraud-whats-at-stake-for-medicaid/) - On March 19, President Trump issued an Executive Order Establishing the Task Force to Eliminate Fraud. The stated purpose of the Task Force, which is chaired by Vice President J.D. Vance, is to “coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointely with State,
- [Oklahoma House passes insurance bill to tighten claims oversight](https://insurancefraud.org/news_archives/oklahoma-house-passes-insurance-bill-to-tighten-claims-oversight/) - The Oklahoma House of Representatives has passed House Bill 2933, a broad property insurance measure authored by Representative Mark Tedford, a Republican from Jenks, aimed at increasing transparency in the state’s insurance market and tightening protections for policyholders during the claims process. HB 2933 would require insurers to file detailed quarterly reports with the Oklahoma
- [Texas Fugitive Apprehended and Sentenced to Over 12 Years in Prison for $61M Telemarketing Fraud Scheme Targeting Medicare Beneficiaries](https://insurancefraud.org/news_archives/texas-fugitive-apprehended-and-sentenced-to-over-12-years-in-prison-for-61m-telemarketing-fraud-scheme-targeting-medicare-beneficiaries/) - A Texas man was sentenced Wednesday to 150 months in prison and two years of supervised release for organizing and leading a $61.5 million health care fraud and wire fraud conspiracy in which thousands of Medicare beneficiaries who were the victims of deceptive telemarketing were sent thousands of orthotic braces, foot baths, and genetic tests
- [Attorney General Schwalb Secures Over $302,000 for Construction Workers & DC](https://insurancefraud.org/news_archives/attorney-general-schwalb-secures-over-302000-for-construction-workers-dc/) - Attorney General Brian L. Schwalb today announced that two drywall installation companies operating in the District – DR Construction and Consulting, Inc. (DRCC) and Pedro & Pablo’s Construction Company, Inc. (Pedro & Pablo) – will together pay more than $302,000 to workers and the District to resolve allegations of worker misclassification, which deprived more than
- [Orlando Man Pleads Guilty to His Role in Years-Long Off-the-Books Payroll Scheme](https://insurancefraud.org/news_archives/orlando-man-pleads-guilty-to-his-role-in-years-long-off-the-books-payroll-scheme/) - A Honduran national pleaded guilty today to conspiring with others as part of a years-long off-the-books payroll scheme that caused more than $38 million in losses to the U.S. government. According to court documents and statements made in court, Mario Lisandro Flores Moradel operated an illegal, off-the-books cash payroll system for construction workers to avoid
- [Healthcare billing fraud: 10 recent cases](https://insurancefraud.org/news_archives/healthcare-billing-fraud-10-recent-cases-3/) - From the owner of a California medical center charged in an alleged $11 million scheme to an Alabama physician sentenced in a telemedicine fraud case, here are 10 healthcare billing fraud cases Becker’s has reported since March 6: 1. An Alabama physician was sentenced to 16 months in prison for a $2.7 million telemedicine fraud scheme involving medically unnecessary
- [New Bedford Couple Pleads Guilty to Defrauding Clients of Over $750,000 in Connection with Their Insurance Business](https://insurancefraud.org/news_archives/new-bedford-couple-pleads-guilty-to-defrauding-clients-of-over-750000-in-connection-with-their-insurance-business/) - A married couple from New Bedford pleaded guilty yesterday in federal court in Boston to a scheme to defraud individuals seeking insurance coverage through the couple’s business, BL Insurance Brokerage, LLC. Brendan Lawler, 58, and Lisa Lawler, 46, pleaded guilty to conspiracy to commit wire fraud. U.S. District Court Judge Myong J. Joun scheduled sentencing
- [Trump admin again pursuing James over alleged home fraud](https://insurancefraud.org/news_archives/trump-admin-again-pursuing-james-over-alleged-home-fraud/) - Agency director Bill Pulte on Wednesday made two criminal referrals against New York state attorney general Letitia James over alleged insurance fraud at two Virginia properties tied to the A.G., reports MS NOW. The referrals were made to U.S. attorneys in Illinois and Florida, where the insurance companies Allstate and Universal Property Insurance are based,
- [CCIIO chief: ‘Still a lot of fraud’ in the ACA marketplace](https://insurancefraud.org/news_archives/cciio-chief-still-a-lot-of-fraud-in-the-aca-marketplace/) - Crushing fraud is one of the main priorities for Medicaid and the Affordable Care Act marketplace, according to the deputy administrator and director of the Center for Consumer Information and Insurance Oversight. Peter J. Nelson discussed his agency’s efforts to prevent fraud, waste and abuse in health care during the AHIP Medicare, Medicaid, Duals and
- [Arlington man charged with theft in $80K workers’ comp fraud case](https://insurancefraud.org/news_archives/arlington-man-charged-with-theft-in-80k-workers-comp-fraud-case/) - An Arlington resident is facing a charge of first-degree theft after the Washington Department of Labor & Industries (L&I) conducted a workers’ compensation fraud investigation. Jon Paul Traff, 49, allegedly received more than $80,000 in workers’ compensation benefits after claiming he was too injured to work. “After getting hurt at one job, and getting time-loss
- [Pa. officials search for more victims after public adjuster charged with fraud](https://insurancefraud.org/news_archives/pa-officials-search-for-more-victims-after-public-adjuster-charged-with-fraud/) - The owner of a public adjusting company is accused of fraud after taking money from insurers intended for his clients, according to the Bucks County District Attorney's Office. Michael Joseph Breitenbach, 53, the owner of Patriot Public Adjusting, LLC, is accused of misappropriating over $82,000 in insurance claims and defrauding elderly homeowners in both Pennsylvania
- [Synthetic Identities And Agentic Bots Drive 8 Per Cent Global Rise In Fraud Attacks](https://insurancefraud.org/news_archives/synthetic-identities-and-agentic-bots-drive-8-per-cent-global-rise-in-fraud-attacks/) - Cybercriminals are scaling automation, deploying bots that convincingly mimic human behaviour and building fake identities from stolen data fragments, according to the latest annual cybercrime report from LexisNexis Risk Solutions. The report, released today, draws on analysis of more than 116 billion online transactions processed through the LexisNexis Digital Identity Network during 2025. It found
- [Hush Launches $5M Identity Theft Insurance as AI-Driven Fraud Targets Wealthy Individuals](https://insurancefraud.org/news_archives/hush-launches-5m-identity-theft-insurance-as-ai-driven-fraud-targets-wealthy-individuals/) - Cybercriminals are increasingly targeting wealthy individuals for multi-million-dollar payouts and Hush is betting identity protection needs to catch up. The digital privacy and executive protection platform today launched up to $5 million in identity theft insurance, among the highest coverage levels available, as fraud shifts from broad, low-value attacks to highly targeted campaigns enabled by
- [As Insurance Fraud Exceeds $40 Billion Annually, Consumers Face More Sophisticated, Harder-to-Detect Scams](https://insurancefraud.org/news_archives/as-insurance-fraud-exceeds-40-billion-annually-consumers-face-more-sophisticated-harder-to-detect-scams/) - Insurance fraud is no longer limited to staged accidents or exaggerated claims—it's becoming faster, more sophisticated, and increasingly digital. As fraud schemes evolve, Mercury Insurance (NYSE/NYSE Texas: MCY) is helping consumers understand how these scams work, how they can unknowingly get caught up in them, and what steps to take to protect themselves. Insurance fraud costs Americans billions each year. According to the Federal
- [New Data Shows Fraud Impact in Montana — AARP Responds with free shred days, fraud workshops and real protection strategies this April](https://insurancefraud.org/news_archives/new-data-shows-fraud-impact-in-montana-aarp-responds-with-free-shred-days-fraud-workshops-and-real-protection-strategies-this-april/) - Fraud Prevention Month Comes to Montana Fraud continues to threaten families across the country — and here in Montana, the impact is real. According to the Federal Trade Commission, consumers in Montana reported $23.2 million stolen by fraud in 2024 – the most recent year for which we have complete data. The most common scams
- [Owner of Klamath Falls lab charged with defrauding Medicare for $46 million](https://insurancefraud.org/news_archives/owner-of-klamath-falls-lab-charged-with-defrauding-medicare-for-46-million/) - Federal prosecutors have charged the owner of a Klamath Falls medical lab with health care fraud, alleging the man submitted $46 million in fake claims to Medicare Advantage plans over a six-month period. Authorities allege Jahangeer Ali used his business, Oregon Clinical Laboratory, to collect more than $28 million from fraudulent payments. According to court
- [U.S. Attorney's Office Entered Settlements Exceeding $900 Million and Collected Over $70 Million in Civil and Criminal Actions in Fiscal Year 2025](https://insurancefraud.org/news_archives/u-s-attorneys-office-entered-settlements-exceeding-900-million-and-collected-over-70-million-in-civil-and-criminal-actions-in-fiscal-year-2025/) - United States Attorney Leah B. Foley announced today that the District of Massachusetts entered settlements with defendants for more than $900 million and collected more than $70 million in criminal and civil actions in Fiscal Year 2025. Of this amount, $30.5 million was collected in criminal actions and $39.6 million was collected in civil actions.
- [Nurse killed friend who lied about having cancer for years, hoped to steal life insurance](https://insurancefraud.org/news_archives/nurse-killed-friend-who-lied-about-having-cancer-for-years-hoped-to-steal-life-insurance/) - A nurse was found guilty of murdering her friend who lied about having cancer for years. She believed she could cash in a $1.5 million life insurance policy by killing the victim, but soon learned the policy never existed. According to court reporting from People, authorities responded to the home of 38-year-old Kacee Lyn Terry
- [Yonkers Man Admits Guilt in Insurance Fraud Scheme](https://insurancefraud.org/news_archives/yonkers-man-admits-guilt-in-insurance-fraud-scheme/) - A Yonkers man named Majid Haddad has pleaded guilty to conspiracy, arson, and insurance fraud charges after admitting to hiring someone to burn down his home on Odell Avenue in 2021 in order to collect over $1 million in insurance payouts. Why it mattersThis case highlights the serious consequences of insurance fraud, which can put
- [Trump administration escalates Medicaid fraud claims against Maine and other states • Maine Morning Star](https://insurancefraud.org/news_archives/trump-administration-escalates-medicaid-fraud-claims-against-maine-and-other-states-maine-morning-star/) - The Trump administration has signaled a willingness to halt billions of dollars in federal health payments to multiple states, mirroring moves they made against Minnesota. The specific target is Medicaid, the public health insurance program that pairs state and federal money. Federal officials have announced unprecedented actions in Minnesota this year, declaring they could withhold over
- [Using AI and Advanced Analytics to Prevent Insurance Fraud: From Red Flags to Real Action](https://insurancefraud.org/news_archives/using-ai-and-advanced-analytics-to-prevent-insurance-fraud-from-red-flags-to-real-action/) - How can insurers use artificial intelligence, advanced analytics, and forensic approaches to connect prevention, detection, and investigation into a comprehensive and effective anti‑fraud system? Insurance fraud is becoming increasingly complex and often involves third parties such as suppliers, agents, brokers, and other business partners. While preventive controls remain essential, insurers are increasingly faced with the question of how to act effectively
- [A South Philly man was convicted in a prolific arsenic-murder ring on this week in Philly history](https://insurancefraud.org/news_archives/a-south-philly-man-was-convicted-in-a-prolific-arsenic-murder-ring-on-this-week-in-philly-history/) - Exploiting the financial stress that followed the Great Depression, two cousins from South Philadelphia initiated a murder-for-hire scheme preying on Italian immigrants that resulted in one of the most notorious crime sprees in city history. Not all of their victims were even accounted for, but it was estimated that 50 to 100 people died. Facing
- [TDI investigation helps stop $400 million Medicare fraud scheme, suspect faces up to 20 years](https://insurancefraud.org/news_archives/tdi-investigation-helps-stop-400-million-medicare-fraud-scheme-suspect-faces-up-to-20-years/) - A Texas Department of Insurance (TDI) investigator and crime analyst played a key role in stopping a Russian national who filed $400 million in fake Medicare claims. Nikolai Buzolin was living in Houston in 2025 when he created a durable medical equipment company and stole patients’ and doctors’ identities to submit fake claims to health
- [Larchmont Woman Sentenced to Nearly 3 Years in Federal Prison for Her Role in Hospice and Diagnostic Testing Fraud that Conned Medicare](https://insurancefraud.org/news_archives/larchmont-woman-sentenced-to-nearly-3-years-in-federal-prison-for-her-role-in-hospice-and-diagnostic-testing-fraud-that-conned-medicare/) - A woman from the Larchmont area of Los Angeles was sentenced today to 35 months in federal prison for defrauding Medicare out of more than $14 million by submitting fraudulent claims for hospice care and diagnostic testing services that were either unnecessary or not provided at all. Sophia Shaklian, 38, was sentenced by United States
- [Former St. Louis Area Pediatrician Sentenced to 20 Years in Prison for Exchanging Prescriptions for Sex Acts](https://insurancefraud.org/news_archives/former-st-louis-area-pediatrician-sentenced-to-20-years-in-prison-for-exchanging-prescriptions-for-sex-acts/) - U.S. District Judge John A. Ross on Tuersday sentenced a former St. Louis County, Missouri pediatrician to 20 years in prison for prescribing pain pills and other controlled substances in exchange for sex acts, nude photos or cash. From at least 2014 through May of 2023, Craig A. Spiegel, now 70, exploited his position to
- [Former Northeast Kingdom Human Services employee sues agency over alleged Medicaid fraud](https://insurancefraud.org/news_archives/former-northeast-kingdom-human-services-employee-sues-agency-over-alleged-medicaid-fraud/) - Tesla Hubbard alleges she lost her job after raising the alarm, both internally and then with the state, on potential Medicaid fraud at the social services organization Northeast Kingdom Human Services, according to a civil suit Hubbard and her lawyers filed on March 11. The suit alleges Northeast Kingdom Human Service enacted a “fraudulent billing
- [Owner of Now-Closed Milwaukee Prenatal Care Coordination Company Sentenced to 60 Months’ Imprisonment for Healthcare Fraud Scheme](https://insurancefraud.org/news_archives/owner-of-now-closed-milwaukee-prenatal-care-coordination-company-sentenced-to-60-months-imprisonment-for-healthcare-fraud-scheme/) - Brad D. Schimel, First Assistant U.S. Attorney for the Eastern District of Wisconsin, announced that on March 19, 2026, Lakia Jackson (age 36) was sentenced to 60 months’ incarceration for committing a healthcare fraud scheme through which she stole $2,655,463.63 from a Medicaid benefit meant to help at-risk pregnant women and women with young children.
- [Florida Doctor Pleads Guilty to Making False Statements in Connection with Multi-Million-Dollar Health Care Fraud Scheme](https://insurancefraud.org/news_archives/florida-doctor-pleads-guilty-to-making-false-statements-in-connection-with-multi-million-dollar-health-care-fraud-scheme/) - A Florida-based doctor has pleaded guilty in federal court in Boston to making false statements in connection with a multi-million-dollar health care fraud scheme involving medically unnecessary genetic testing and durable medical equipment (DME). Simon Grinshteyn, 52, pleaded guilty to one count of making false statements relating to health care matters. U.S. District Court Judge
- ['This happens all the time': Nashville couple hit not once but twice by medical fraud — what to know about 'rampant' Medicare scams targeting retirees](https://insurancefraud.org/news_archives/this-happens-all-the-time-nashville-couple-hit-not-once-but-twice-by-medical-fraud-what-to-know-about-rampant-medicare-scams-targeting-retirees/) - Doug Leins thought something was off when he opened his Explanation of Benefits (EOB). The west Nashville retiree and his wife had been billed through their Medicare supplemental insurance for genetic testing that neither of them had requested, nor had their doctor. "We knew for a fact that we had never requested that and that
- [Couple sentenced after pleading to insurance fraud over $100,000](https://insurancefraud.org/news_archives/couple-sentenced-after-pleading-to-insurance-fraud-over-100000/) - Thomas Alexander George, 49, and Tamika Hampton, 43, have been sentenced after entering pleas of nolo contendere to making a fraudulent insurance claim over $100,000. According to an affidavit filed by the Florida Department of Financial Services, George was involved in a crash on June 7, 2019 and filed an insurance claim. George and Hampton
- [Former Tennessee Insurance Agent Charged With Keeping Premium Payments](https://insurancefraud.org/news_archives/former-tennessee-insurance-agent-charged-with-keeping-premium-payments/) - Richard Darrel Wolfe, 67, of Hendersonville, was indicted by a Sumner County grand jury in late February. He was charged with 14 counts of theft and three forgery counts, dating to 2023 and 2024, court records show. Investigators began looking into Wolfe’s alleged actions in November, after several local businesses alleged that the man had
- [St. Louis County woman admits to $174K home healthcare fraud scheme](https://insurancefraud.org/news_archives/st-louis-county-woman-admits-to-174k-home-healthcare-fraud-scheme/) - A St. Louis County woman has admitted to filing false claims in a $174,000 home healthcare fraud scheme. On Thursday, Camille S. Childress, 41, pleaded guilty in federal court to one felony count of health care fraud. Investigators say Childress submitted fraudulent documents to enroll her home health care company, Inspiring Angels LLC, with Missouri
- [AARP Report Warns Digital Fraud Crimes Are Harming Georgians at Alarming Rates](https://insurancefraud.org/news_archives/aarp-report-warns-digital-fraud-crimes-are-harming-georgians-at-alarming-rates/) - Digital scams are becoming more sophisticated, and Georgians are increasingly being targeted. The March/April 2026 issue of AARP Bulletin examines how fast‑moving fraud schemes threaten financial security nationwide, with a sharp focus on states like Georgia, where losses continue to climb. Georgia is now a hotspot for cryptocurrency kiosk–related scams. The state has more than
- [Louisiana Legal Giants Convicted in Massive 18-Wheeler Crash Scam](https://insurancefraud.org/news_archives/louisiana-legal-giants-convicted-in-massive-18-wheeler-crash-scam/) - A federal jury in New Orleans has convicted two prominent local attorneys, Vanessa Motta and Jason F. Giles, along with their law firms, of orchestrating a sophisticated criminal enterprise that staged collisions with 18-wheelers to defraud insurance companies out of millions of dollars over a 10-year period. The scheme involved 'slammers' who intentionally caused the
- [Haskell County insurance producer fined, license revoked following investigation](https://insurancefraud.org/news_archives/haskell-county-insurance-producer-fined-license-revoked-following-investigation/) - The Oklahoma Insurance Department announced it has fined and revoked the license of Leslie Clark, a resident insurance producer from Stigler, following an investigation led by its Anti-Fraud Unit. On Feb. 11, a show-cause hearing was held at OID's offices before an independent examiner, at which Clark failed to appear. Clark was found to have
- [Helping Dual Eligibles: How State Medicaid Agencies and State Health Insurance Programs Collaborate](https://insurancefraud.org/news_archives/helping-dual-eligibles-how-state-medicaid-agencies-and-state-health-insurance-programs-collaborate/) - As states work to better support individuals who are eligible for both Medicare and Medicaid, understanding how agencies collaborate is critical. To shed light on these partnerships, ADvancing States and the SHIP Technical Assistance (TA) Center, both in partnership with NCOA, launched a two‑part national survey effort in May 2025. The resulting report provides a
- [Foreign National Charged with Orchestrating Health Care Fraud Scheme Targeting Medicare Advantage Programs](https://insurancefraud.org/news_archives/foreign-national-charged-with-orchestrating-health-care-fraud-scheme-targeting-medicare-advantage-programs/) - United States Attorney Craig H. Missakian announced criminal charges against an individual for perpetrating a large-scale fraud targeting federal health care funds distributed through the Medicare Advantage program. Anar Rustamov, a national of Azerbaijan who appears to have entered the United States illegally, was indicted yesterday by a federal grand jury and charged with health
- [Younger Consumers More Willing to Alter Insurance Claim Photos, Raising Red Flags for Carriers](https://insurancefraud.org/news_archives/younger-consumers-more-willing-to-alter-insurance-claim-photos-raising-red-flags-for-carriers/) - A generational divide over digital insurance fraud is stark: 55% of Gen Z consumers and 49% of millennials say they are at least somewhat likely to make a small, rule-bending edit to a claim photo or document, compared with just 12% of baby boomers, according to Verisk’s 2026 State of Insurance Fraud study. The findings,
- [Ex insurance agent accused of fraud facing dozens of charges](https://insurancefraud.org/news_archives/ex-insurance-agent-accused-of-fraud-facing-dozens-of-charges/) - A Huber Heights man and former insurance agent who reportedly fraudulently sold life insurance and annuities and stole thousands from clients is facing 74 charges. A grand jury indicted Ryan O. Tarjanyi, 52, on 28 counts of forgery, 21 counts of money laundering, 16 counts of telecommunications fraud, three counts of theft, four counts of
- [11 arrested in $17M scheme targeting elderly L.A. homeowners](https://insurancefraud.org/news_archives/11-arrested-in-17m-scheme-targeting-elderly-l-a-homeowners/) - Federal agents fanned out across Southern California Thursday morning, serving 11 arrest warrants in a sweeping organized crime and fraud investigation, according to the FBI. The case, dubbed “Operation Hard Money,” centers on allegations that the suspects stole victims’ identities and used them to secure fraudulent real estate loans backed by the victims’ properties, according
- [Martin County man charged with insurance fraud, forgery, officials say](https://insurancefraud.org/news_archives/martin-county-man-charged-with-insurance-fraud-forgery-officials-say/) - A Martin County man is facing multiple felony charges after state investigators say he filed a fraudulent insurance claim. North Carolina Insurance Commissioner Mike Causey announced the arrest of James Daryl Williams, 34, of Robersonville, who is charged with: Insurance fraudAttempting to obtain property by false pretenseForgeryUttering According to the North Carolina Department of Insurance,
- [Healthcare fraud, waste and abuse awareness and prevention](https://insurancefraud.org/news_archives/healthcare-fraud-waste-and-abuse-awareness-and-prevention/) - Like you, we’re committed to maintaining the highest ethical standards and protecting the integrity of the care our members receive. A critical part of this commitment is our shared responsibility to prevent, detect and report healthcare fraud, waste and abuse (FWA). Geisinger Health Plan has zero tolerance for any form of FWA. Because we must
- [Attorney General’s Medicaid Fraud and Vulnerable Victims Unit Secures a $250,000 Settlement and Corporate Oversight of Dennett Rehab Center](https://insurancefraud.org/news_archives/attorney-generals-medicaid-fraud-and-vulnerable-victims-unit-secures-a-250000-settlement-and-corporate-oversight-of-dennett-rehab-center/) - Attorney General Anthony G. Brown today announced a $250,000 settlement with the owners of the Dennett Rehab Center nursing home in Oakland, Maryland, resolving allegations that the owners violated the Maryland False Health Claims Act by providing substandard care to hundreds of residents at the facility. The settlement involves both the current owners, Dennett Rehab, and the previous owners,
- [D.A. cracks down on workers’ compensation fraud](https://insurancefraud.org/news_archives/d-a-cracks-down-on-workers-compensation-fraud/) - Los Angeles County District Attorney Nathan Hochman announced the launch of a countywide Metro bus advertisement campaign warning the public that lying or misrepresenting facts to obtain workers’ compensation benefits is a felony. “Knowingly making a false statement to collect workers’ compensation benefits is textbook fraud, and we are filing charges against anyone who engages
- [WSJ Opinion: Welcome to Medicaid's Biggest Fraud](https://insurancefraud.org/news_archives/wsj-opinion-welcome-to-medicaids-biggest-fraud/) - Welcome to Medicaid's Biggest Fraud
- [Philadelphia man arrested in alleged title-washing scheme involving $3.8M in stolen luxury vehicles](https://insurancefraud.org/news_archives/philadelphia-man-arrested-in-alleged-title-washing-scheme-involving-3-8m-in-stolen-luxury-vehicles/) - Pennsylvania's attorney general announced the arrest of a North Philadelphia man accused of running a multi-million dollar vehicle title-washing scheme. According to the AG's office, 40-year-old Adam Richardson operated a business called Richardson Family Enterprises LLC, which appeared to be a legitimate vehicle title company. Richardson worked as an authorized issuing agent with the Pennsylvania
- [AI Editing Tools Are Fueling a New Era of Insurance Fraud, According to New Research from Verisk](https://insurancefraud.org/news_archives/ai-editing-tools-are-fueling-a-new-era-of-insurance-fraud-according-to-new-research-from-verisk/) - From adjusting the lighting in a photo to repairing a blurry image, AI‑powered image editing tools have become part of everyday life – and increasingly, part of the insurance claims process. New data from the Verisk State of Insurance Fraud study reveals that more than one third of consumers (36 percent) would consider digitally altering a claim image
- [Connecticut recovers $43 million in Medicaid fraud payments](https://insurancefraud.org/news_archives/connecticut-recovers-43-million-in-medicaid-fraud-payments/) - At least $43.4 million in fraudulent Medicaid payments were made in Connecticut between fiscal years 2021 and 2025, the state Division of Criminal Justice recently reported to a legislative committee. The Division of Criminal Justice informed the Appropriations Committee in a follow-up report to its budget presentation for the upcoming 2027 fiscal year that the
- [Trump administration widens Medicaid fraud crackdown to Florida, calling it 'hotspot'](https://insurancefraud.org/news_archives/trump-administration-widens-medicaid-fraud-crackdown-to-florida-calling-it-hotspot/) - The Trump administration on Tuesday widened its efforts to stamp out Medicaid fraud, at least in its fifth state this year, calling on Florida officials to share information on how they identify, prevent, and address bad actors in their state program. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz had previously sent similar
- [Anchorage doctor sentenced to prison in multi-million-dollar health care, tax fraud schemes](https://insurancefraud.org/news_archives/anchorage-doctor-sentenced-to-prison-in-multi-million-dollar-health-care-tax-fraud-schemes/) - An Anchorage doctor was sentenced today to six and a half years in prison for executing a $12.5 million health care fraud scheme and evading over $4 million in taxes on the profits of their 15-year scheme. Her husband and co-defendant was sentenced to three years’ probation, with two years to be served in home
- [Decision in whistleblower case could put False Claims Act’s fate in Supreme Court’s hands](https://insurancefraud.org/news_archives/decision-in-whistleblower-case-could-put-false-claims-acts-fate-in-supreme-courts-hands/) - A legal ruling expected any day could lead to permanent changes in how the government handles the kind of False Claim Act cases that have long dogged skilled nursing operations. In a late 2024 decision in United States ex rel. Zafirov v. Florida Medical Associates, the District Court found that relators, or whistleblowers, who use the False
- [Warner, Sánchez Introduce Bicameral Bill to Strengthen Hospice Care for Patients, Protect Against Fraud](https://insurancefraud.org/news_archives/warner-sanchez-introduce-bicameral-bill-to-strengthen-hospice-care-for-patients-protect-against-fraud/) - U.S. Sen. Mark R. Warner (D-VA) and U.S. Rep. Linda T. Sánchez (D-Calif.) today introduced the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act to modernize the Medicare hospice benefit, protect patients and taxpayers from fraud, and expand access to essential services and caregiver support. Medicare’s hospice benefit has remained largely unchanged since its inception in 1982. However,
- [Greenspring Hosts 10th “Slam The Scam” Fraud Prevention and Awareness Expo](https://insurancefraud.org/news_archives/greenspring-hosts-10th-slam-the-scam-fraud-prevention-and-awareness-expo/) - Greenspring, an Erickson Senior Living community in Springfield, Va., hosted its 10th annual “Slam The Scam” Fraud Prevention and Awareness Expo on March 13. The educational event was held in conjunction with National Consumer Protection Week, March 1 to 7, 2026, and National Slam The Scam Day on March 5, 2026. The March Madness themed
- [CMS’ New Approach to Federal Medicaid Spending in Cases of Potential Fraud](https://insurancefraud.org/news_archives/cms-new-approach-to-federal-medicaid-spending-in-cases-of-potential-fraud/) - The current administration is placing a new emphasis on potential fraud in Medicaid. The Centers for Medicare and Medicaid Services (CMS’) current efforts are focused on Minnesota and four other states (three with Democratic governors – California, Maine, and New York and one with a Republican governor – Florida). The House Committee on Energy and Commerce
- [GEICO sues three Florida clinics over $3.7 million PIP fraud scheme](https://insurancefraud.org/news_archives/geico-sues-three-florida-clinics-over-3-7-million-pip-fraud-scheme/) - GEICO is taking aim at three Florida clinics it says operated a coordinated PIP fraud scheme worth more than $3.7 million. The insurer filed suit on March 13 in the US District Court for the Middle District of Florida, naming ten defendants across three Tampa-area clinics - Relief and Rehab, Inc. f/k/a Del Sol Care
- [DA, FBI, and U.S. Department of Health& Human Services, Office of theInspector General, Shut Down MedicalCenter Committing Healthcare Fraud](https://insurancefraud.org/news_archives/da-fbi-and-u-s-department-of-health-human-services-office-of-theinspector-general-shut-down-medicalcenter-committing-healthcare-fraud/) - San Diego County District Attorney Summer Stephan announced criminal charges today againstKim Huynh, 51, who was bilking Medicare and insurance companies through phony billingpractices, money laundering and practicing medicine without a license. In all, the defendantbilled more than $11 million for tests and treatment not covered under insurance plans.Huynh directed the medical billers in her
- [Monday’s Headlines: Beware of ‘Fraud’ Fraud Edition](https://insurancefraud.org/news_archives/mondays-headlines-beware-of-fraud-fraud-edition/) - The news on Friday before we closed up shop for the weekend was a press conference held by Gov. Hochul in support of her increasingly desperate push to lower car insurance rates. Readers of Streetsblog know that we've thrown virtually all of our limited resources to challenge the governor's basic premise that owning a car
- [Unfounded Fraud Allegations Threaten Vital Medicaid Home And Community-Based Services](https://insurancefraud.org/news_archives/unfounded-fraud-allegations-threaten-vital-medicaid-home-and-community-based-services/) - The Centers for Medicare & Medicaid Services (CMS) has just announced a major crackdown on Medicaid fraud, including the deferral of more than $250 million in federal Medicaid funds owed to Minnesota as well as an intent to withhold future funds exceeding $500 million per quarter. CMS has opened investigations into several other states’ Medicaid
- [Owners and CEO of Wholesale Pharmaceutical Company Sentenced for Distributing More Than $92M of Black-Market HIV Drugs](https://insurancefraud.org/news_archives/owners-and-ceo-of-wholesale-pharmaceutical-company-sentenced-for-distributing-more-than-92m-of-black-market-hiv-drugs/) - Two owners of a pharmaceutical wholesale company were sentenced Friday to a total of 38 years in prison for orchestrating a complex, nationwide drug diversion scheme that harmed vulnerable HIV-positive patients, placed countless others at risk, and corrupted the supply chain for prescription drugs in the United States. “Patrick and Charles Boyd did not just
- [Utah children’s book author Kouri Richins convicted in husband’s murder](https://insurancefraud.org/news_archives/utah-childrens-book-author-kouri-richins-convicted-in-husbands-murder/) - Kouri Richins, the Utah children’s book author accused of poisoning her husband with a fentanyl-laced drink before publishing a book about grief for their children, was found guilty in his 2022 death. Prosecutors alleged the mother of three murdered her husband, Eric Richins, in a calculated scheme to collect millions of dollars in life insurance
- [Chief Financial Officer Blaise Ingoglia Announces Arrest Made Following $1 Million Workers' Compensation Fraud Scheme](https://insurancefraud.org/news_archives/chief-financial-officer-blaise-ingoglia-announces-arrest-made-following-1-million-workers-compensation-fraud-scheme/) - Today, Chief Financial Officer Blaise Ingoglia announced the arrest of Jacques G. Denomme following a $1 million workers’ compensation fraud scheme. The arrest was made by the Department of Financial Services Criminal Investigations Division (CID) after Denomme allegedly tried to avoid paying higher workers’ compensation premiums by hiding payroll information. Chief Financial Officer Blaise Ingoglia
- [Former Oklahoma Farmers Agent Accused of Sharing Confidential Data in Lawsuit](https://insurancefraud.org/news_archives/former-oklahoma-farmers-agent-accused-of-sharing-confidential-data-in-lawsuit/) - Farmers Insurance alleges in a lawsuit that a former agent in Oklahoma conspired to move Farmers’ insureds to other insurance companies, including an agency where his wife works. Farmers alleges that Bradley McKinney broke his Agent Appointment Agreement with Farmers by selling insurance policies for other carriers out of his Farmers Agency Office. Before McKinney
- [Pa. authorities: Reading repair shop owner staged crashes with wife and others for insurance payouts](https://insurancefraud.org/news_archives/pa-authorities-reading-repair-shop-owner-staged-crashes-with-wife-and-others-for-insurance-payouts/) - In January 2023, Fatima V. Valenzuela of Reading filed an auto insurance claim alleging her husband’s flatbed tow truck had been rear-ended by an SUV three months earlier on Route 222 near Kutztown. But an investigation by Three Insurance Co. revealed an identical claim involving the same vehicles and crash details had been filed just
- [AI deepfake detection tool targets surge in synthetic medical claims fraud](https://insurancefraud.org/news_archives/ai-deepfake-detection-tool-targets-surge-in-synthetic-medical-claims-fraud/) - US health plans are adopting new AI tools to detect manipulated medical records and diagnostic evidence as generative AI increases the scale and sophistication of healthcare fraudCodoxo has launched a new artificial intelligence (AI)-powered deepfake detection tool designed to help US health plans identify fraudulent medical documentation before claims are paid. The solution, called Deepfake
- [Aetna to pay $117.7M to settle Medicare Advantage fraud allegations](https://insurancefraud.org/news_archives/aetna-to-pay-117-7m-to-settle-medicare-advantage-fraud-allegations/) - Aetna has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate and untruthful diagnosis codes for its Medicare Advantage Plan enrollees to increase its payments from Medicare. The U.S. Department of Justice announced the settlement this week. "The government pays private insurers
- [Milwaukee fraudster sentenced to 11 years in federal prison](https://insurancefraud.org/news_archives/milwaukee-fraudster-sentenced-to-11-years-in-federal-prison/) - Brad D. Schimel, United States Attorney for the Eastern District of Wisconsin, announced that on March 10, 2026, Lenard R. Monroe received a total sentence of 132 months in federal prison for Medicaid fraud, violations of the antikickback statute, wire fraud, and money laundering. The sentence, imposed by Chief United States District Judge Pamela Pepper,
- [10 Medicaid Providers Facing Fraud Charges](https://insurancefraud.org/news_archives/10-medicaid-providers-facing-fraud-charges/) - Indictments filed this month by the office of Ohio Attorney General Dave Yost accuse 10 Medicaid providers of stealing a combined $578,000 from the government health-care program for the needy. “In the spirit of St. Patrick, we’re driving out the snakes who prey on Medicaid,” Yost said. “We have zero tolerance for billing shenanigans that
- [Doctor denies knowing about rampant LA-area Medicare fraud using his provider number](https://insurancefraud.org/news_archives/doctor-denies-knowing-about-rampant-la-area-medicare-fraud-using-his-provider-number/) - On a busy, gritty street in suburban Los Angeles, the white one-story stucco building looked like any other. Among the apartments, offices, sidewalk bodegas, the only defining feature was the building's door – a thick, solid slab of dark oak with a small, security grill about six inches square. "Is Dr. Faustina here," I asked.
- [AI in Insurance Claims Processing: Emerging Trends and Applications](https://insurancefraud.org/news_archives/ai-in-insurance-claims-processing-emerging-trends-and-applications/) - If you have ever filed an insurance claim, you know how it feels: calls on hold, forms to fill, days, sometimes weeks, of waiting. That experience is changing fast. In 2026, artificial intelligence has moved from the lab to the core of insurance operations, reshaping how claims are submitted, reviewed, and paid out. This article
- [Former NBA player Glen Davis released from prison after 17 months for involvement in healthcare fraud scheme](https://insurancefraud.org/news_archives/former-nba-player-glen-davis-released-from-prison-after-17-months-for-involvement-in-healthcare-fraud-scheme/) - Former NBA player Glen Davis was released from prison Thursday after serving 17 months of a 40-month sentence following a November 2023 conviction for his involvement in a scheme to defraud the league’s healthcare plan. Davis and fellow NBA player Will Bynum were convicted by a Manhattan jury in 2023 for filing false reimbursement claims
- [Federal Jury Convicts Three Women For Conspiracy To Commit Wire Fraud Related To Rocky Hill Pharmacy](https://insurancefraud.org/news_archives/federal-jury-convicts-three-women-for-conspiracy-to-commit-wire-fraud-related-to-rocky-hill-pharmacy/) - On March 13, 2026, following a 15-day trial, a jury convicted Tiffany Haney, 43, Anne Warren, 45, and Tina Roper, 40, all of Knoxville, of conspiracy to commit wire fraud in violation of 18 U.S.C. § 1349. The jury also convicted Haney and Warren of committing specific acts of wire fraud in violation of 18
- [Winter Storm Season Is Prime Time for Home Repair Scams: Here's How to Spot One](https://insurancefraud.org/news_archives/winter-storm-season-is-prime-time-for-home-repair-scams-heres-how-to-spot-one/) - When a storm rolls through your neighborhood, the damage to your home might only be the beginning of your problems. Within hours, door-to-door contractors appear, offering quick fixes at prices that seem almost too good to be true — and they often are. Home repair scams are a persistent problem year-round. The FTC received 81,925
- [Minnesota woman accused of using $600K in Medicaid funds for flights, food, rides](https://insurancefraud.org/news_archives/minnesota-woman-accused-of-using-600k-in-medicaid-funds-for-flights-food-rides/) - This week, Minnesota Attorney General Keith Ellison's Medicaid Fraud Control Unit charged Gertrue Kemunto Mongare with multiple counts of felony theft by false representation. Investigators say Mongare is the owner of B&G Caring Angels LLC, a Medicaid-enrolled home health care agency. She's accused of submitting more than 3,000 claims totaling more than $600,000 over four
- [New York judge brings the hammer down on alleged staged car accident, insurance fraud ring](https://insurancefraud.org/news_archives/new-york-judge-brings-the-hammer-down-on-alleged-staged-car-accident-insurance-fraud-ring/) - An alleged insurance fraud ring in New York State has been shut down in its attempts to receive money from insurers after a New York Supreme Court judge issued a summary judgement last month against a group of defendants who reportedly organized staged car crashes throughout the Empire State. New York Supreme Court Justice Maureen
- [Connecticut business owner charged with not providing workers’ comp insurance](https://insurancefraud.org/news_archives/connecticut-business-owner-charged-with-not-providing-workers-comp-insurance/) - An Enfield business owner will appear in New London Superior Court on Monday to face allegations from state prosecutors that he failed to provide his employees with required workers’ compensation insurance coverage. Edgar Villacis Pinto, 54, owns VIP Janitorial Services, Inc., according to a report released Friday by the Connecticut Division of Criminal Justice. He
- [Camden County Man Sentenced to Three Years in Prison for Filing False Insurance Claim in Connection with House Fire](https://insurancefraud.org/news_archives/camden-county-man-sentenced-to-three-years-in-prison-for-filing-false-insurance-claim-in-connection-with-house-fire/) - Attorney General Jennifer Davenport, the Division of Criminal Justice (DCJ), and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that a Camden County, New Jersey, man was sentenced to three years in prison for insurance fraud in connection with a fire that destroyed his house. Richard Orlandini, 65, of Cherry Hill, New Jersey,
- [$12.7M Medicaid fraud scheme exposes wider program concerns](https://insurancefraud.org/news_archives/12-7m-medicaid-fraud-scheme-exposes-wider-program-concerns/) - Last week, a federal judge sentenced four people tied to fake substance-abuse treatment facilities in Kinston and Goldsboro to 14 year prison sentences. Prosecutors say they were orchestrating a $12.7 million Medicaid billing scheme that used illegal kickbacks to lure patients into unnecessary services. The operation billed Medicaid for fraudulent claims between 2018 and 2023.
- [CMS imposes equipment supplier moratorium; 3 sentenced to prison in fraud cases](https://insurancefraud.org/news_archives/cms-imposes-equipment-supplier-moratorium-3-sentenced-to-prison-in-fraud-cases/) - Since CMS implemented a six-month nationwide moratorium on new Medicare enrollment for certain durable medical equipment suppliers, the Justice Department has announced at least four settlements and sentences tied to DME fraud schemes. CMS said it stopped more than $1.5 billion in suspected fraudulent durable medical equipment, prosthetics and orthotics suppliers billing last year. According to a
- [War on Fraud Comes to New York, Addressing Medicare’s Skin Substitute Abuse, Important FDA Reform, and More](https://insurancefraud.org/news_archives/war-on-fraud-comes-to-new-york-addressing-medicares-skin-substitute-abuse-important-fda-reform-and-more/) - This week’s newsletter highlights several important developments in the fight to restore integrity to federal health programs. First, the Centers for Medicare and Medicaid Services (CMS) has begun scrutinizing the most expensive and corrupt Medicaid program in the country—New York’s. I also discuss an amicus brief that I joined supporting CMS’s rule to shut down an
- [Ag supplier says farmers are delaying crop decisions](https://insurancefraud.org/news_archives/ag-supplier-says-farmers-are-delaying-crop-decisions/) - An ag input supplier says 2026 has been unusually quiet so far. Matt Oehmichen with Short Lane Ag Supply in Wisconsin tells Brownfield, “There still is a significant amount of growers that haven’t called in to get all of their acres finalized yet.” Oehmichen says poor commodity prices with corn under five dollars a bushel,
- [Owners of one of the largest towing businesses in Southern California arrested in nearly 6 million dollar fraud scheme](https://insurancefraud.org/news_archives/owners-of-one-of-the-largest-towing-businesses-in-southern-california-arrested-in-nearly-6-million-dollar-fraud-scheme/) - Brothers and tow company owners, Mark Hassan, 46, of Corona Del Mar, and Ahmed Hassan, 35 of Walnut, were arrested today on multiple counts of felony insurance fraud after allegedly underreporting employee payroll and paying portions of employees’ wages in cash to defraud workers’ compensation insurance companies out of nearly 6 million dollars of insurance
- [How a Fee To Fight Insurance Fraud Became a Cash Cow for Police](https://insurancefraud.org/news_archives/how-a-fee-to-fight-insurance-fraud-became-a-cash-cow-for-police/) - Critics say the $10 annual fees state drivers pay to fight car insurance theft and fraud aren’t being used as intended. More than three decades ago, New York passed a law aimed at bringing down New Yorkers’ auto insurance bills — by raising them. It tacked an extra fee onto auto insurance bills to help the
- [CEO of Montgomery County Home Care Agency Sentenced to Incarceration, Ordered to Pay for $1.7 Million Medicaid Fraud Scheme](https://insurancefraud.org/news_archives/ceo-of-montgomery-county-home-care-agency-sentenced-to-incarceration-ordered-to-pay-for-1-7-million-medicaid-fraud-scheme/) - Attorney General Dave Sunday announced that Naya Campbell has been sentenced to prison for her role in a multi-million dollar Medicaid fraud scheme involving a Montgomery County home care agency where she served as CEO. Campbell, of Audubon, previously pleaded guilty to felony counts of corrupt organizations, theft by deception, and Medicaid Fraud for submitting
- [We visited “ground zero” for hospice fraud: Los Angeles, California](https://insurancefraud.org/news_archives/we-visited-ground-zero-for-hospice-fraud-los-angeles-california/) - At age 69, Lynn Ianni is a pickleball whiz, zipping from dinks to drives energetically. When she suffered an injury on the court two years ago, she sought physical therapy, and was surprised to learn her Medicare insurance wouldn’t cover it. She was, according to Medicare records, dying and in hospice. “They said, ‘you're in
- [$11B NY Medicaid contractor accused of ‘fiscal and operational failures’ in other states](https://insurancefraud.org/news_archives/11b-ny-medicaid-contractor-accused-of-fiscal-and-operational-failures-in-other-states/) - The company awarded a controversial Medicaid contract managing $11 billion in New York was accused of “egregious fiscal and operational failures” in other states, The Post can reveal. Public Partnerships LLC (PPL) was brought in to replace hundreds of middlemen in the Consumer Directed Personal Assistance Program (CDPAP) as a cost saving measure in 2024.
- [IFIG Working With Verisk on Anti-Fraud Intelligence Platform](https://insurancefraud.org/news_archives/ifig-working-with-verisk-on-anti-fraud-intelligence-platform/) - his new partnership aims to share data which will help insurers spot potential fraud issues, here’s the word; The Insurance Fraud Investigators Group (IFIG), working with Verisk, has launched a new intelligence-sharing platform designed to help insurers and fraud investigators identify fraudulent activity across multiple lines of business. The platform provides a secure environment for
- [‘That’s the smoking gun’: Inside the hunt for insurance fraudsters amid a national surge](https://insurancefraud.org/news_archives/thats-the-smoking-gun-inside-the-hunt-for-insurance-fraudsters-amid-a-national-surge/) - The dashcam video shows a car going too slowly for Toronto’s Highway 407. Suddenly, it veers off the highway and slams into a guardrail. The front end had caved in – the car was a write-off. The story from the sheepish driver to his insurance company was that he swerved to avoid another car. But
- [Walz shares plan to ‘transform’ largest Minnesota state agency, combat fraud](https://insurancefraud.org/news_archives/walz-shares-plan-to-transform-largest-minnesota-state-agency-combat-fraud/) - Gov. Tim Walz says he has a plan to “transform” the largest state agency and combat fraud. The plan would be a major structural overhaul for the Minnesota Department of Human Services (DHS), which has been riddled with fraud allegations impacting numerous programs it administers. The department employs over 7,000 people and manages billions of
- [Herkimer business owner arrested on numerous charges following fraud investigation](https://insurancefraud.org/news_archives/herkimer-business-owner-arrested-on-numerous-charges-following-fraud-investigation/) - A Herkimer business owner was arrested in March on numerous charges after he turned himself in to police, according to information from the Otsego County District Attorney’s Office. Steven Vitalo, 32, the owner and operator of Central Plumbing & Drains in Herkimer, was arrested on the following: Insurance fraud.Grand larceny.Attempted grand larceny.Scheme to defraud. The
- [What you need to know about AI scams](https://insurancefraud.org/news_archives/what-you-need-to-know-about-ai-scams/) - You've probably heard about the amazing things artificial intelligence (AI) can do, from quickly creating written content and images to making videos that appear real, even when they're fake. Unfortunately, this easily accessible technology is also used by fraudsters to fool people into sharing personal information, investing in fake schemes, or giving scammers their money.
- [Owner of Durable Medical Equipment Company Sentenced for $59M Medicare Fraud](https://insurancefraud.org/news_archives/owner-of-durable-medical-equipment-company-sentenced-for-59m-medicare-fraud/) - A Texas man was sentenced Friday to 90 months in prison for his role in a $59.9 million conspiracy to pay kickbacks and submit claims for medically unnecessary durable medical equipment (DME) to Medicare. According to court documents, Patrick Cassells, 65, of Fulshear, Texas, owned and operated three DME companies and concealed his role in
- [Chiropractor Sentenced to 43 Months in Prison for $14.9 Million Health Care Fraud and Kickback Scheme Related to Durable Medical Equipment and Cancer Genetic Testing](https://insurancefraud.org/news_archives/chiropractor-sentenced-to-43-months-in-prison-for-14-9-million-health-care-fraud-and-kickback-scheme-related-to-durable-medical-equipment-and-cancer-genetic-testing/) - A Georgia chiropractor was sentenced to 43 months in prison for her role in a $14.9 million health care fraud and illegal kickback conspiracy, Senior Counsel Philip Lamparello announced. “This defendant built a business model around fraud—using kickbacks, sham arrangements, and medically unnecessary equipment to siphon millions from Medicare. Health care programs exist to serve
- [CMS Announces Wide-Ranging Fraud Crackdown](https://insurancefraud.org/news_archives/cms-announces-wide-ranging-fraud-crackdown/) - Key Takeaways:Centers for Medicare & Medicaid Services (CMS) deferred $259.5 million in federal Medicaid funds to Minnesota over program integrity concerns.CMS will impose a six-month nationwide moratorium on new enrollments for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers.CMS issued a Request for Information seeking stakeholder feedback under its CRUSH initiative to strengthen
- [Insurance Fraud Bill Unanimously Passes Washington Senate](https://insurancefraud.org/news_archives/insurance-fraud-bill-unanimously-passes-washington-senate/) - A bill intended to combat insurance fraud by updating a 20-year-old law passed the Washington state senate in late February. Senate Bill 6031 defines insurance fraud as its own crime, a Class B felony. The bill passed on a unanimous vote. SB 6031 was pushed for by Washington Insurance Commissioner Patty Kuderer. State law established
- [Carriers Report Higher Claims Severity as Medical Inflation, Litigation Trends and AI Fraud Increase Complexity](https://insurancefraud.org/news_archives/carriers-report-higher-claims-severity-as-medical-inflation-litigation-trends-and-ai-fraud-increase-complexity/) - A new industry report indicates that insurance carriers across North America are facing higher claims complexity and rising costs. Medical inflation, litigation behavior, and the growth of AI-enabled fraud are contributing to increased severity in claims handling. According to Gallagher Bassett’s 2026 Carrier Report, 64% of North American carriers say claims complexity increased during the
- [Pennsylvania Brothers Convicted of Decades Long Racketeering Conspiracy](https://insurancefraud.org/news_archives/pennsylvania-brothers-convicted-of-decades-long-racketeering-conspiracy/) - Three individuals were convicted today at trial in connection with a racketeering conspiracy encompassing multiple fraud schemes, including visa fraud to employ foreign workers unlawfully, soliciting salary kickbacks from the employed workers, and health care fraud billing schemes resulting in over $32 million in losses to Pennsylvania Medicaid. As proven at trial, Bhaskar and Arun
- [Kansas Doctor Sentenced to 3 Years in Prison for $8 Million Medicare Fraud](https://insurancefraud.org/news_archives/kansas-doctor-sentenced-to-3-years-in-prison-for-8-million-medicare-fraud/) - U.S. District Judge Catherine D. Perry on Friday sentenced a Kansas anesthesiologist to three years in prison for accepting hundreds of thousands of dollars in kickbacks to order medically unnecessary health care for thousands of patients. She also ordered Dr. Scott Taggart Roethle, 48, to pay restitution of $8.3 million. From 2017 to 2020, Dr.
- [Federal Appeals Court Denies Workers’ Compensation Claim for Cannabis Edibles](https://insurancefraud.org/news_archives/federal-appeals-court-denies-workers-compensation-claim-for-cannabis-edibles/) - A construction worker who was permanently disabled on the job has been denied workers’ compensation coverage for cannabis-infused edibles prescribed by his doctor. The Second Circuit Court of Appeals has upheld the denial on the grounds that marijuana’s classification as a Schedule I substance under the Controlled Substances Act (CSA) means that the edibles have
- [How a successful Colorado startup turned into a nearly $1 billion health care fraud scheme](https://insurancefraud.org/news_archives/how-a-successful-colorado-startup-turned-into-a-nearly-1-billion-health-care-fraud-scheme/) - Marian Houk was rehabbing from a major spinal surgery in 2022 when her physical therapist at UCHealth in Aurora, Colorado, recommended she try electrical stimulation to manage the pain. Like many providers around the country, UCHealth sent Houk to Zynex Inc., an Englewood, Colorado-based medical device company that manufactures and sells instruments used for pain management
- [Missouri AG charges St. Peters insurance agent with fraud](https://insurancefraud.org/news_archives/missouri-ag-charges-st-peters-insurance-agent-with-fraud/) - Missouri Attorney General Catherine Hanaway announced Monday that her office has filed felony charges against a St. Peters insurance agent. This lawsuit follows an investigation into deceptive practices of Pamela Walsh, of J. Walsh Insurance, a now-closed agency owned by her husband. According to the Attorney General’s Office, from Aug. 2022 through Nov. 2024, Walsh
- [Catching Fake Insurance Claims: Why Image Verification Has Become Essential](https://insurancefraud.org/news_archives/catching-fake-insurance-claims-why-image-verification-has-become-essential/) - We've been working with reverse image search technology for years now, and one thing that keeps surprising us is how many industries are quietly dealing with the same problem: people submitting fake or recycled images to make money. Insurance is probably the worst hit. We're not talking about small potatoes here — Forbes Advisor puts the annual
- [Batavia Township man found guilty of burning down home for insurance money](https://insurancefraud.org/news_archives/batavia-township-man-found-guilty-of-burning-down-home-for-insurance-money/) - A Batavia Township man has been found guilty of several charges after investigators said he burned down his home to receive insurance money. According to prosecutors, Asa and Kaitlyn Dawson increased their policy totals for their home about one month before the fire happened. Prosecutors also said that investigators found accelerants at the scene. The
- [Local mayor appears in court on felony charge for insurance fraud](https://insurancefraud.org/news_archives/local-mayor-appears-in-court-on-felony-charge-for-insurance-fraud/) - A local mayor appeared in court Friday afternoon after being charged with a felony for allegedly lying to insurance agents about what he paid to purchase a boat. David Dwayne Price, 62, appeared in front of Magistrate Judge Michael Kirkham at the Bonneville County Courthouse for a felony charge of insurance fraud. Price’s attorney, Ronald
- [House committee requests Vermont Medicaid fraud data](https://insurancefraud.org/news_archives/house-committee-requests-vermont-medicaid-fraud-data/) - A Congressional committee has requested documentation from Vermont on possible fraud, waste, and abuse in the state’s Medicaid program. It comes as the Trump administration last week announced a “war on fraud” in the program that provides public health insurance for low-income people. The U.S. House Committee on Energy and Commerce wants Vermont to provide
- [Comfort Keepers of Portage, MI, Shares Information on Long-Term Care Insurance Coverage for In-Home Senior Care in Kalamazoo](https://insurancefraud.org/news_archives/comfort-keepers-of-portage-mi-shares-information-on-long-term-care-insurance-coverage-for-in-home-senior-care-in-kalamazoo/) - Comfort Keepers of Portage, MI, is providing information to families in Kalamazoo who are asking an important planning question: Does long-term care insurance pay for in-home senior care? As more older adults choose to remain at home, understanding available financial resources has become a central part of care conversations. Long-term care insurance policies are designed
- [Alabama dentist gets prison for torching practice for insurance money amid mounting debt](https://insurancefraud.org/news_archives/alabama-dentist-gets-prison-for-torching-practice-for-insurance-money-amid-mounting-debt/) - An Alabama dentist has been sentenced to prison after he burned down his own dental office to collect insurance money amid mounting debt. Conecuh County Circuit Judge Jack B. Weaver sentenced Douglas Patrick O’Connor to 15 years in prison with three years to serve, Alabama Attorney General Steve Marshall announced Friday. O’Connor, a dentist in
- [Former Strawberry Point Firefighter Pleads Guilty to Insurance Fraud](https://insurancefraud.org/news_archives/former-strawberry-point-firefighter-pleads-guilty-to-insurance-fraud/) - A Strawberry Point man accused of faking a truck burglary, arson and a home invasion among other things pleaded guilty in Clayton County District Court to a charge of insurance fraud - presenting false information. This is just one in a string of insurance fraud cases spanning Buchanan, Clayton and Delaware Counties. This guilty plea
- [State authorities looking for Clayton County insurance fraud suspects](https://insurancefraud.org/news_archives/state-authorities-looking-for-clayton-county-insurance-fraud-suspects-2/) - State Investigators asked for the public’s help Wednesday to find a Jonesboro man and woman wanted in an insurance fraud investigation. Special agents with the Criminal Investigations Division of the Insurance and Safety Fire Commissioner’s Office want to know the whereabouts of 30-year-old Olamide Olanipekun and 48-year-old Ramona Denise Gilmore, both of Jonesboro. Olanipekun is
- [After wait, physical therapy fraud case advances in Erie federal court. Here's what's next:](https://insurancefraud.org/news_archives/after-wait-physical-therapy-fraud-case-advances-in-erie-federal-court-heres-whats-next/) - After months of inactivity, the docket is coming to life again in the $22 million federal fraud case against the Erie-based Hertel & Brown physical therapy practice. A judge has scheduled a long-awaited evidentiary hearing in the case, which started with an indictment in November 2021 against Hertel & Brown Physical & Aquatic Therapy as
- [SC lawmakers target insurance fraud as fake crashes, claims surge](https://insurancefraud.org/news_archives/sc-lawmakers-target-insurance-fraud-as-fake-crashes-claims-surge/) - Insurance fraud is happening every day across South Carolina. State law enforcement and insurance companies have noticed that criminals are now staging fake medical claims and phony car crashes. Organized fraud rings are faking car accidents by deliberately crashing into innocent drivers and filing false injury claims. “We’re looking for people who are trying to
- [Insurance fraud worldwide estimated to exceed $80b annually in 2025](https://insurancefraud.org/news_archives/insurance-fraud-worldwide-estimated-to-exceed-80b-annually-in-2025-2/) - Asia-Pacific reported a 22% year-on-year increase in fraudulent claims in 2023. Insurance fraud worldwide is estimated to surpass $80b yearly, according to CoinLaw’s “Insurance Fraud Statistics 2025: Massive Losses Revealed” report. “Whilst some sectors report fraud rates approaching 10%, industry-wide suspicious insurance payouts are generally estimated to be closer to 2% to 10%, depending on
- [United States Obtains More Than $1.4 Million Judgment Against Family Medical Practitioner for Fraudulent Billing](https://insurancefraud.org/news_archives/united-states-obtains-more-than-1-4-million-judgment-against-family-medical-practitioner-for-fraudulent-billing/) - The U.S. Attorney’s Office for the District of Maryland (USAO-MD) announced that it obtained a judgment of $1,407,493.23 against Dr. Richard Akoto, M.D., a family medical doctor, and his practice, Richard O. Akoto, M.D. PC, located in Takoma Park, Maryland. The U.S. District Court for the District of Maryland found that Akoto submitted, or caused the submission
- [Two children digging in LA residential yard hit something bizarre and it turned out to be a buried Ferrari](https://insurancefraud.org/news_archives/two-children-digging-in-la-residential-yard-hit-something-bizarre-and-it-turned-out-to-be-a-buried-ferrari/) - Two kids playing outside their Los Angeles home found a buried Ferrari Dino 246 GTS in their backyard. The kids were pretending to dig up buried treasure when they ended up doing exactly that. It was some innocent fun that turned into an incredibly exciting discovery for the kids. Unfortunately, the story behind the buried
- [California Behavioral Medicine Provider Agrees To Pay $2.75 Million To Resolve Alleged False Claims For Psychotherapy Services](https://insurancefraud.org/news_archives/california-behavioral-medicine-provider-agrees-to-pay-2-75-million-to-resolve-alleged-false-claims-for-psychotherapy-services/) - American Psychiatric Centers, Inc., doing business under the name Comprehensive Psychiatric Services (CPS), has agreed to pay $2.75 million to resolve allegations that CPS violated the False Claims Act by submitting false claims to government healthcare payors for certain psychotherapy services. CPS, which is headquartered in Walnut Creek, Calif., provides behavioral medicine services for individuals
- [Health Insurance Irving Highlights Fight Against Fraud to Protect Policyholders](https://insurancefraud.org/news_archives/health-insurance-irving-highlights-fight-against-fraud-to-protect-policyholders-2/) - The illegal activities involving deceptive billing practices and false claims harm not only the providers but also disrupt the services offered to honest policyholders. Rising cases of fraudulent claims can result in skyrocketing insurance rates and increased scrutiny for genuine claims, causing unnecessary stress for individuals who rely on their policies. This has a ripple
- [Police say $3.4m Diamond "Theft" was Insurance Fraud](https://insurancefraud.org/news_archives/police-say-3-4m-diamond-theft-was-insurance-fraud/) - Police in Surat, India, say the reported theft of diamonds worth at least Rs 25 crore (USD 3.4m) was an insurance fraud. They were called to DK & Sons Diamond Company on Monday morning (18 August), after an extended closure for the Janmashtami festival, and found the safe had been opened with gas cutting equipment.
- [Iowa Department of Insurance and Financial Services Warns Iowans of Storm-Related Scams](https://insurancefraud.org/news_archives/iowa-department-of-insurance-and-financial-services-warns-iowans-of-storm-related-scams/) - In the wake of recent severe storms and flooding in Chickasaw, Winnebago, and Winneshiek Counties, the Iowa Department of Insurance and Financial Services urges Iowans to be on the lookout for scams and contractors looking to exploit storm relief efforts. Following disasters, scammers often take advantage of communities during times of need, utilizing deceptive tactics
- [America’s biggest pharmacy chain slapped with massive penalty over fraud](https://insurancefraud.org/news_archives/americas-biggest-pharmacy-chain-slapped-with-massive-penalty-over-fraud/) - A federal judge has ordered CVS Health’s pharmacy benefit manager, Caremark, to pay nearly $290 million after a whistleblower accused the business of overcharging Medicare on prescription drugs more than a decade ago. Sarah Behnke, a former Aetna actuary, alleged Caremark defrauded Medicare Part D by causing false drug cost reports to be submitted in
- [Verisk Unveils New ClaimSearch Tools to Detect Digital Commerce and Locate Assets in Insurance Investigations](https://insurancefraud.org/news_archives/verisk-unveils-new-claimsearch-tools-to-detect-digital-commerce-and-locate-assets-in-insurance-investigations/) - Verisk (Nasdaq: VRSK), a leading global data analytics and technology provider, announced a strategic alliance with Legentic, a fraud and financial crime detection and prevention company, to launch two advanced fraud detection and asset location tools into its ClaimSearch® platform. Now available for the first time in the U.S., Digital Commerce Detector can help insurers
- [Protect Yourself Against Medicare Scams](https://insurancefraud.org/news_archives/protect-yourself-against-medicare-scams/) - The arrests of 11 individuals in connection with an alleged $10 billion Medicare fraud case serves as an important reminder to review your insurance statements and guard your personal information. This case is not an isolated incident – healthcare fraud costs the U.S. billions every year. Capital Blue Cross has seen an uptick in fraudulent
- [Former Insurance employee faces multiple felonies for fraud and forgery](https://insurancefraud.org/news_archives/former-insurance-employee-faces-multiple-felonies-for-fraud-and-forgery/) - A former employee of Salvione Insurance Agency, Inc. is facing multiple felony charges following an investigation by the Gloversville Police Department. 42-year-old Georgianne Blakeslee of Johnstown, is accused of accepting money from customers intended for insurance premiums and instead stealing the funds while providing fraudulent receipts, police said. Authorities say that Blakeslee altered business records
- [DOJ and HHS collaborate to enhance False Claims Act prosecution](https://insurancefraud.org/news_archives/doj-and-hhs-collaborate-to-enhance-false-claims-act-prosecution/) - On July 2, 2025, the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) announced the creation of the DOJ-HHS False Claims Act Working Group to combat healthcare fraud. In a recent article for Westlaw Today, Managing Directors Jenelle Beavers and Donald Lochabay explore the U.S. government’s new collaboration
- [US Attorney creates new section to prosecute criminal healthcare fraud](https://insurancefraud.org/news_archives/us-attorney-creates-new-section-to-prosecute-criminal-healthcare-fraud/) - A US Attorney’s Office in Illinois has created a first-of-its-kind section to target criminal prosecution of healthcare fraud, adding to enforcement pressures for skilled nursing operators. Andrew S. Boutros, US Attorney for the Northern District of Illinois, announced Friday that he has formed a group of six prosecutors experienced in healthcare criminal enforcement. He said
- [DoJ expands probe into UnitedHealth's prescription management services, Bloomberg News reports](https://insurancefraud.org/news_archives/doj-expands-probe-into-unitedhealths-prescription-management-services-bloomberg-news-reports/) - The U.S. Justice Department's criminal division is digging into business practices at UnitedHealth Group's (UNH.N), opens new tab pharmacy benefit manager, Optum Rx, Bloomberg News reported on Tuesday, citing people familiar with the matter. Under an ongoing probe into the company's operations, the investigators are looking into its prescription management services and how it reimburses
- ['How Legal Is This?:' Man Considers Lying To His Car Insurance Company To Save Money. But Does This Loophole Work?](https://insurancefraud.org/news_archives/how-legal-is-this-man-considers-lying-to-his-car-insurance-company-to-save-money-but-does-this-loophole-work/) - A TikTok user went viral after posing a risky hypothetical: What happens if you lie to your car insurance company to score a cheaper rate? Andrew (@andrews_garage), who jokes about making “bad financial decisions” on his page, raised the question in a recent clip. “How legal is this?” he asked in the caption. In the
- [Dr. Oz addresses Tylenol use during pregnancy, Medicaid and Medicare fraud](https://insurancefraud.org/news_archives/dr-oz-addresses-tylenol-use-during-pregnancy-medicaid-and-medicare-fraud/) - Centers for Medicare and Medicaid Services administrator Dr. Mehmet Oz joins "The Takeout" to discuss Tylenol use during pregnancy, the Trump administration's "MAHA" agenda and other health issues. Dr. Oz addresses Tylenol use during pregnancy, Medicaid and Medicare fraud
- [Video captures Florida man staging traffic crash for insurance fraud](https://insurancefraud.org/news_archives/video-captures-florida-man-staging-traffic-crash-for-insurance-fraud/) - Watch: Video captures Florida man staging traffic crash for insurance fraud Watch: Video captures Florida man staging traffic crash for insurance fraud
- [NICB Projects 49% Rise in Insurance Fraud Linked to Identity Theft in 2025](https://insurancefraud.org/news_archives/nicb-projects-49-rise-in-insurance-fraud-linked-to-identity-theft-in-2025/) - Use of identity theft in insurance crime is expected to rise 49% by the end of 2025, according to the National Insurance Crime Bureau (NICB), the nation's leading non-profit association dedicated to preventing insurance fraud and crime. An analysis of thousands of questionable insurance claims that were submitted by policyholders to their insurance companies from
- [3 to stand trial in Eaton Co. for identity theft, fraud](https://insurancefraud.org/news_archives/3-to-stand-trial-in-eaton-co-for-identity-theft-fraud/) - Three people have been ordered to stand trial for their alleged roles in an identity theft and fraud scheme, state officials said. Averill Dintaman, 46, of Mount Pleasant, Dwayne Johnson, 59, of Saint Louis, and Daniel Nolan, 51, also of Mount Pleasant, were bound over for trial in Eaton County Circuit Court, Michigan Attorney General
- [UGA study looks at gap in generational attitudes on committing insurance fraud](https://insurancefraud.org/news_archives/uga-study-looks-at-gap-in-generational-attitudes-on-committing-insurance-fraud/) - A new study from the University of Georgia reveals that younger generations are more inclined to commit insurance fraud, with two out of five young adults unfazed by such actions. The research, which focused on data from the Coalition Against Insurance Fraud, surveyed nearly 1,500 adults about their attitudes about insurance claims. The findings indicated
- [Review Finds Local Governments’ Health Insurance Funds Have Conflicts of Interest and Public Contracting Violations](https://insurancefraud.org/news_archives/review-finds-local-governments-health-insurance-funds-have-conflicts-of-interest-and-public-contracting-violations/) - Health insurance funds that serve hundreds of local governments and school boards have been effectively taken over by a private, for-profit company, in violation of conflict-of-interest rules and public contracting laws designed to prevent corruption and safeguard funds, according to an Office of the State Comptroller report, released today. Since the 1990s, New Jersey municipalities
- [National Disability Insurance Scheme introduces tighter identity checks to protect against fraud](https://insurancefraud.org/news_archives/national-disability-insurance-scheme-introduces-tighter-identity-checks-to-protect-against-fraud/) - The National Disability Insurance Scheme (NDIS) is securing its systems and services against fraud. Identity checks will be tightened to ensure NDIS recipients and their nominated representatives are the only ones who can access NDIS funds, account information and plan details. “We’ll be checking that your account information is up to date and matches the
- [Doctor and Urgent Care Clinic Settle Allegations Over Medicaid Fraud](https://insurancefraud.org/news_archives/doctor-and-urgent-care-clinic-settle-allegations-over-medicaid-fraud/) - AG Rayfield: “It is a betrayal of public trust when any business or individual exploits their position for profit.”Oregon Attorney General Dan Rayfield today announced a significant civil settlement reached by the Oregon Department of Justice’s Medicaid Fraud Unit (MFU) with Family Choice Urgent Care, LLC. Family Choice agreed to pay $489,280 to resolve allegations
- [Got a package you didn’t order? It could be Medicare fraud](https://insurancefraud.org/news_archives/got-a-package-you-didnt-order-it-could-be-medicare-fraud/) - The package arrived at the home of Patrick Niehaus, a retired firefighter in Arizona, like a puzzle in a box. He hadn’t ordered it, but he had to sign for the delivery. Inside was a strange medical device, possibly some kind of brace, with no instructions to explain what it was or how to use
- [Insurance fraud hits everyone in the wallet](https://insurancefraud.org/news_archives/insurance-fraud-hits-everyone-in-the-wallet-2/) - We all pay for insurance fraud. A 2022 study conducted for the Coalition Against Insurance Fraud concluded that insurance fraud costs Americans $308.6 billion every year. That’s $932.63 for every person in America. For a family of four, that adds up to nearly $3,800. I want to discuss things you should know about insurance fraud.
- [Identity thieves are coming for your insurance](https://insurancefraud.org/news_archives/identity-thieves-are-coming-for-your-insurance/) - I was shocked by this stat the other day. The National Insurance Crime Bureau says identity theft–driven insurance fraud is projected to spike 49% by the end of 2025. Really, insurance fraud? You see, identity theft isn’t just about someone opening a store credit card or taking a car loan out in your name anymore.
- [New plan to curb insurance frauds](https://insurancefraud.org/news_archives/new-plan-to-curb-insurance-frauds/) - Created by the Association of Fleet Professionals (AFP)’s Risk and Compliance Committee, the guidance provides a plan that could help to lower insurance premiums in the future. Martin Evans, chair of the committee, said: “For 2023, the most recent year for which figures are available, fraudulent insurance claims topped £500 million – up 8% on
- [Cracking the clone: A new era of auto fraud](https://insurancefraud.org/news_archives/cracking-the-clone-a-new-era-of-auto-fraud/) - As auto insurance fraud in Canada becomes more complex, a new threat has emerged: stolen vehicles with cloned VINs are now staying within Canadian borders. In the past, stolen vehicles were often quickly exported through shipping ports; however, as the Canada Border Services Agency (CBSA) enhances its scrutiny at these exit points, fraudsters are adapting
- [New Haven Man, 48, Charged In Medicaid Fraud Scheme, Faces Up To 20 Years: Chief State's Attorney](https://insurancefraud.org/news_archives/new-haven-man-48-charged-in-medicaid-fraud-scheme-faces-up-to-20-years-chief-states-attorney-2/) - A New Haven man who worked as an individual day support provider for people with disabilities was arrested and charged with billing Medicaid for personal care services he did not provide, according to the Office of the Chief State's Attorney. Gordon Skinner, 48, of New Haven, was arrested Sept. 9 by Medicaid Fraud Control Unit
- [Calling Time on Luxury Watch Fraud: A Digital Counter-Revolution](https://insurancefraud.org/news_archives/calling-time-on-luxury-watch-fraud-a-digital-counter-revolution/) - Luxury watches have long attracted crime. These small, high-value, portable goods are easier to steal than fine art, and easier to transport than drugs or arms. Press coverage as early as the 1990s was calling attention to how Rolex watches were becoming prime targets in London street robberies. The Watch Register database holds records of
- [AG Yost sues two home remodeling contractors](https://insurancefraud.org/news_archives/ag-yost-sues-two-home-remodeling-contractors/) - Lawsuits have been filed against two contractors who tried to fleece consumers, Ohio Attorney General Dave Yost announced today. The lawsuits accuse business owners Joseph Schlosser and Daniel Sechriest of violating the Consumer Sales Practices Act. Schlosser, through his company Building with Faith Construction offered general contracting and home remodeling services in northwest Ohio. Six
- [Toledo woman among 16 Medicaid providers indicted for theft, fraud](https://insurancefraud.org/news_archives/toledo-woman-among-16-medicaid-providers-indicted-for-theft-fraud/) - A Toledo woman is among 16 Medicaid providers who the Ohio attorney general's office says were indicted on theft and fraud charges for allegedly stealing $1.7 million from the healthcare program.Jameshia Harkness, 33, "allegedly billed for 49 dates of service for which she did not provide care, representing a $8,391 loss to Medicaid," according to
- [Ohio Attorney General Dave Yost: 16 Medicaid providers statewide indicted for stealing a combined $1.7 million](https://insurancefraud.org/news_archives/ohio-attorney-general-dave-yost-16-medicaid-providers-statewide-indicted-for-stealing-a-combined-1-7-million/) - Ohio Attorney General Dave Yost has announced a new round of indictments against multiple Medicaid providers statewide, including several from Greater Cleveland, on felony charges of fraud and theft. According to a release from Yost's office, the cases include "two people who, because of felony convictions, were prohibited from providing services to Medicaid recipients yet
- [Gwinnett man allegedly posing as insurance agent indicted for fraud](https://insurancefraud.org/news_archives/gwinnett-man-allegedly-posing-as-insurance-agent-indicted-for-fraud/) - A Gwinnett County man has been indicted for insurance fraud after allegedly misrepresenting himself as an insurance agent and issuing fraudulent certificates of insurance. Fernando Jose Cuellar Membreno, 54, was arrested following an investigation by the Georgia State Board of Workers’ Compensation’s Enforcement Division. The investigation revealed that Membreno operated under several business names, including
- [Illinois man indicted in $17.3M healthcare fraud scheme, feds say](https://insurancefraud.org/news_archives/illinois-man-indicted-in-17-3m-healthcare-fraud-scheme-feds-say/) - A Grayslake man is facing federal charges after prosecutors say he submitted more than $17.3 million in false healthcare claims. What we know:Shawn Bashir allegedly created two entities—Success for Kids and Growing Kids Therapy—that claimed to provide early intervention services for children. According to an indictment unsealed Friday in Chicago, Bashir submitted or caused to
- [Will GOP act on $124B in Medicare insurance fraud?](https://insurancefraud.org/news_archives/will-gop-act-on-124b-in-medicare-insurance-fraud/) - Earlier this year, UnitedHealthcare acknowledged it is under federal investigation over accusations is defrauded Medicare Advantage through multiple billions of dollars in alleged illegal upcoding, which makes their patients look sicker than they are to get higher payments from the Medicare program. As Congress debates the upcoming federal budget, healthcare costs are at the center
- [Fraud trial for former Orleans Parish 911 director begins Monday](https://insurancefraud.org/news_archives/fraud-trial-for-former-orleans-parish-911-director-begins-monday-2/) - It’s been more than a year since the former head of the Orleans Parish 911 center was indicted by a grand jury for crashing a city vehicle on his birthday and allegedly trying to cover it up in an insurance fraud scheme. Jury selection in the trial of Tyrell Morris is set to begin Monday
- [Fresno County Podiatrist and Sales Representative Plead Guilty to Conspiracy to Submit False Claims Related to Skin Grafts](https://insurancefraud.org/news_archives/fresno-county-podiatrist-and-sales-representative-plead-guilty-to-conspiracy-to-submit-false-claims-related-to-skin-grafts/) - Felipe Ruiz, 51, of Fresno, and Jose Gabriel Aguirre, 52, of Clovis, pleaded guilty today to conspiracy to commit health care fraud, U.S. Attorney Eric Grant announced. According to court documents, Ruiz was a podiatrist at West Coast Podiatry Inc. (WCP), a podiatric medical practice with locations in Fresno, Madera, and Stanislaus Counties. Aguirre was
- [Gilead Sciences, Inc. to Pay $202 Million to Resolve Kickback Allegations on HIV/AIDs Drugs](https://insurancefraud.org/news_archives/gilead-sciences-inc-to-pay-202-million-to-resolve-kickback-allegations-on-hiv-aids-drugs/) - The State of Alaska has joined with other states and the federal government to reach an agreement with Gilead Sciences, Inc. (“Gilead”) to settle allegations that the company paid kickbacks to providers to improperly promote its HIV drugs: Stribild®, Genvoya®, Complera®, Odefsey®, Descovy®, and Biktarvy® (the “Gilead HIV Drugs”). “Kickback schemes drain Medicaid dollars and
- [Another Florida ex-Merrill Lynch advisor, guilty of Medicare fraud, draws scrutiny](https://insurancefraud.org/news_archives/another-florida-ex-merrill-lynch-advisor-guilty-of-medicare-fraud-draws-scrutiny/) - Merrill Lynch is facing legal fallout from a second Florida financial advisor in recent months for engaging in criminal activity. InvestmentNews reported during the summer that a former Merrill Lynch financial advisor, Isaiah T. Williams, was arrested in June for his alleged involvement in the theft of almost $2.6 million from Reshad Jones, a one-time
- [N.J. man took over dead sister’s counseling office and stole $3.4M from Medicaid, prosecutors say](https://insurancefraud.org/news_archives/n-j-man-took-over-dead-sisters-counseling-office-and-stole-3-4m-from-medicaid-prosecutors-say/) - An Essex County man is facing health care and tax fraud charges after federal investigators said he took over his dead sister’s counseling practice and filed false Medicaid claims totaling more than $3.4 million. Vincente Lopez, 63, of East Orange, was indicted for health-care claims fraud and theft by deception, both second-degree crimes. Attorney General
- [GEICO pursues $2.2 million fraud claims in New York lawsuit](https://insurancefraud.org/news_archives/geico-pursues-2-2-million-fraud-claims-in-new-york-lawsuit/) - A leading auto insurer is suing to recover nearly $800,000, alleging a sweeping fraud scheme involving no-fault insurance claims and medical equipment in New York. GEICO and its affiliated companies filed a complaint in the United States District Court for the Eastern District of New York on September 19, 2025, naming Live Again Medical Supply
- [Most Costly Insurance Fraud Cases: Fraud, Fallout & Future Risks](https://insurancefraud.org/news_archives/most-costly-insurance-fraud-cases-fraud-fallout-future-risks/) - Insurance fraud remains one of the most damaging financial crimes globally, draining billions from industries and consumers alike. From corporate healthcare scandals to nationwide scams, fraud schemes expose deep weaknesses in insurance systems and regulators. The impact stretches far beyond finances, premiums rise, trust erodes, and in extreme cases, fraud escalates into violence. These top
- [Department of Justice lawsuit claims Inland Empire Health Plan committed Medi-Cal fraud](https://insurancefraud.org/news_archives/department-of-justice-lawsuit-claims-inland-empire-health-plan-committed-medi-cal-fraud/) - Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for The Inland Empire newsletter to receive a weekly look at how people in the I.E. are living, learning and working. The Inland Empire Health Plan kept $320 million that it should have given back to the
- [Oregon lawmaker calls for investigation into potential Medicaid fraud he says is linked to attempted murder](https://insurancefraud.org/news_archives/oregon-lawmaker-calls-for-investigation-into-potential-medicaid-fraud-he-says-is-linked-to-attempted-murder/) - An Oregon lawmaker called Tuesday for state and federal investigations into possible Medicaid fraud and state oversight failures at a Lake Oswego addiction treatment center. Rep. Ed Diehl, R-Stayton, cited reporting by Oregon Roundup, a Substack site run by Oregon-based writer Jeff Eager, that said an Oregon addiction recovery provider received more than $2.3 million in
- [Tri-Cities Urgent Care Clinic Agrees to Pay $2.8 Million to Resolve Claims of Overbilling for Diagnostic Tests](https://insurancefraud.org/news_archives/tri-cities-urgent-care-clinic-agrees-to-pay-2-8-million-to-resolve-claims-of-overbilling-for-diagnostic-tests/) - United States Attorney Pete Serrano announced that Health First Urgent Care, an urgent care clinic with locations in Richland and Pasco, Washington, has agreed to pay $2,807,729 to resolve claims that it fraudulently overbilled Medicare and Medicaid for diagnostic tests. According to the settlement agreement, a False Claims Act (FCA) claim arose from allegations that
- [DOJ Expands Health Care Fraud Strike Force to Massachusetts](https://insurancefraud.org/news_archives/doj-expands-health-care-fraud-strike-force-to-massachusetts/) - On September 23, 2025, the Department of Justice (DOJ) and the U.S. Attorney’s Office for the District of Massachusetts announced that the New England Health Care Fraud Strike Force will now work with federal prosecutors in Boston to combat healthcare fraud in the District of Massachusetts. The expansion will allow it “to accelerate the detection,
- [Attorney General Hanaway Secures Felony Indictments In Four Major Medicaid Fraud Cases In St. Louis](https://insurancefraud.org/news_archives/attorney-general-hanaway-secures-felony-indictments-in-four-major-medicaid-fraud-cases-in-st-louis/) - Today, Missouri Attorney General Catherine Hanaway announced that a grand jury in Cole County has returned indictments in four major cases of alleged Medicaid fraud in the St. Louis region. Collectively, these cases account for more than $230,000 in fraudulent claims, demonstrating the Office’s Medicaid Fraud Control Unit’s (MFCU) ongoing commitment to protecting taxpayer dollars
- [How Fake Health Insurance Is Luring People In](https://insurancefraud.org/news_archives/how-fake-health-insurance-is-luring-people-in/) - After a long career as a nurse, Lisa Bower, now 61, retired, started working as a part-time nanny, and, in 2021, realized she needed health insurance. The Illinois resident took to the Internet to sign up for a plan on the Affordable Care Act (ACA) marketplace. But something went wrong and she somehow ended up
- [Auto Insurance Fraud: Another Affordability Crisis Hitting New York City Drivers](https://insurancefraud.org/news_archives/auto-insurance-fraud-another-affordability-crisis-hitting-new-york-city-drivers/) - While politicians talk about housing costs and the high price of groceries, there’s another affordability crisis squeezing New York City families – soaring auto insurance rates. Behind these sky-high premiums lies a web of scams costing everyone money. From fake crashes on neighborhood streets to phony medical bills, crime rings are gaming New York’s insurance
- [Bethel Psychologist Charged With Medicaid Fraud](https://insurancefraud.org/news_archives/bethel-psychologist-charged-with-medicaid-fraud/) - A Bethel psychologist has been charged with four felony counts of Medicaid fraud after an investigation determined Vermont Medicaid had been defrauded of more than $600,000 in public health care funds. Robert Vaillancourt, 76, is accused of overbilling and billing for services never rendered, hundreds of times, according to an investigation by the attorney general’s
- [Blockchain in Insurance Market Set to Reach USD 82.56 Billion by 2033, Driven by Demand for Secure and Transparent Processes](https://insurancefraud.org/news_archives/blockchain-in-insurance-market-set-to-reach-usd-82-56-billion-by-2033-driven-by-demand-for-secure-and-transparent-processes/) - The Blockchain in Insurance Market size was valued at USD 2.74 Billion in 2025E and is projected to reach USD 82.56 Billion by 2033, growing at a CAGR of 53.09% during 2026–2033. The market is expected to develop significantly through 2033 due to rising need for digital transformations, fraud prevention, and safe, transparent, and effective
- [AG’s Office Secures Guilty Plea From Leominster Woman For Posing As Caregiver To Steal From Elderly Victims In Worcester And Middlesex Counties](https://insurancefraud.org/news_archives/ags-office-secures-guilty-plea-from-leominster-woman-for-posing-as-caregiver-to-steal-from-elderly-victims-in-worcester-and-middlesex-counties/) - The Attorney General’s Office (AGO) today announced that Regina Henaku, 33, of Leominster, has pleaded guilty to stealing thousands of dollars from multiple elderly victims while posing as a professional caregiver and working at health care agencies and long-term care facilities throughout Worcester and Middlesex Counties. Through various jobs as a supposed health care worker,
- [NICB Warns Consumers Nationwide: Insurance Fraud Is Coming for Your Pocketbook](https://insurancefraud.org/news_archives/nicb-warns-consumers-nationwide-insurance-fraud-is-coming-for-your-pocketbook-2/) - The National Insurance Crime Bureau (NICB), the nation's leading not-for-profit organization dedicated to preventing and combating insurance crime, is warning consumers across the nation about the growing impact of insurance fraud. As part of a new campaign with the Anti-Fraud Alliance, NICB is encouraging policyholders everywhere to join in combating the deceptive schemes that drive
- [Comparative Study of Generative Models in Auto Insurance Fraud](https://insurancefraud.org/news_archives/comparative-study-of-generative-models-in-auto-insurance-fraud-2/) - Auto insurance fraud presents a significant challenge to the industry, costing billions of dollars annually. Traditional methods of detecting fraudulent claims have relied on straightforward data analysis techniques, which, while useful, often fall short in addressing the complexity and nuance of fraudulent behavior. A new wave of research highlights the potential of generative hybrid models,
- [Pennsylvanians Urged to be Vigilant Against Fraud, Scams During International Fraud Awareness Week  ](https://insurancefraud.org/news_archives/pennsylvanians-urged-to-be-vigilant-against-fraud-scams-during-international-fraud-awareness-week/) - The Pennsylvania Insurance Department (PID) and the Department of Banking and Securities (DoBS) urge Pennsylvanians to remain on the lookout for attempted fraud and other deceptive business practices that could cause financial strain and hardship. Pennsylvania joins this week’s global observance of fraud awareness, as November 16-22 marks the 25th International Fraud Awareness Week. “International
- [E&C Leaders Expand Investigation into Medicaid Fraud Nationwide](https://insurancefraud.org/news_archives/ec-leaders-expand-investigation-into-medicaid-fraud-nationwide/) - Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, are continuing their ongoing investigation into waste, fraud, and abuse within Medicaid
- [Fifth Circuit Decision in Health Care Fraud Case Highlights Importance of Careful Drafting in Civil RICO Complaints](https://insurancefraud.org/news_archives/fifth-circuit-decision-in-health-care-fraud-case-highlights-importance-of-careful-drafting-in-civil-rico-complaints/) - What You Need to KnowKey takeaway #1 Insurers and other health care payors often use RICO to pursue claims against providers or others for fraudulent billing. Key takeaway #2 Pleading a RICO claim requires describing a racketeering “enterprise.” While the U.S. Supreme Court has created a flexible standard for this requirement, a complaint that fails
- [Over $12 Million Medicaid Fraud Scheme Leads to 14 Years of Prison for Substance Abuse Facility, Owner, Compliance Officer, and Office Manager](https://insurancefraud.org/news_archives/over-12-million-medicaid-fraud-scheme-leads-to-14-years-of-prison-for-substance-abuse-facility-owner-compliance-officer-and-office-manager/) - A federal judge has handed down more than 14 years in federal prison to participants in a $12.7 Million Medicaid fraud scheme that paid more than $1 Million in kickbacks to drug addict patients. The case also resulted in the permanent closure of the fake substance abuse facility that carried out the crime, a $15
- [Former NASCAR champion Kyle Busch settles $8.5M lawsuit against life insurance company](https://insurancefraud.org/news_archives/former-nascar-champion-kyle-busch-settles-8-5m-lawsuit-against-life-insurance-company/) - Two-time NASCAR champion Kyle Busch and a life insurance company have settled an $8.5 million lawsuit in which the driver said he was misled into purchasing policies marketed as safe retirement plans. Kyle and Samantha Busch reached an out-of-court settlement with Pacific Life Insurance Company, according to a Feb. 26 court filing. Terms were confidential.
- [Insurance Company Alleges Fraud Scheme with Staged Accidents and Litigation‑Driven Medicine](https://insurancefraud.org/news_archives/insurance-company-alleges-fraud-scheme-with-staged-accidents-and-litigation-driven-medicine/) - Greater New York Mutual Insurance Company (“GNY”) recently filed a sweeping 207 page civil RICO complaint in the Eastern District of New York alleging a multi-layered insurance fraud enterprise involving personal injury law firms, medical providers, litigation funders, “runners” and claimants. According to the complaint, the defendants orchestrated a years long scheme designed to manufacture
- [AARP Indiana Hosts Congressional Town Halls on Fraud Prevention](https://insurancefraud.org/news_archives/aarp-indiana-hosts-congressional-town-halls-on-fraud-prevention/) - Congressional Telephone Town Halls: How Congress and Local Communities Are Taking on Fraud Fraud and scams continue to threaten the financial security of families across the country, especially older adults. From impostor scams and identity theft to cryptocurrency and payment fraud, criminals are constantly changing their tactics. AARP Indiana’s upcoming telephone town halls can connect
- [12 arrested for obtaining illegal insurance licenses at fake testing center: MDSO](https://insurancefraud.org/news_archives/12-arrested-for-obtaining-illegal-insurance-licenses-at-fake-testing-center-mdso/) - State investigators arrested 12 people for allegedly obtaining illegal insurance licenses at a fraudulent testing center in Miami-Dade County. The investigation dates back to 2024, when investigators arrested Rainier Salas, the owner and operator of D and R Financial Services in Virginia Gardens. Investigators say he operated a criminal enterprise that involved illegal insurance testing
- [D.C. Dentist and Hygienist Found Guilty in Scheme to Defraud D.C. Medicaid of $4 Million](https://insurancefraud.org/news_archives/d-c-dentist-and-hygienist-found-guilty-in-scheme-to-defraud-d-c-medicaid-of-4-million/) - Steven A. Price, 69, of the District of Columbia, and Keidi C. Moore, 39, of Temple Hills, Maryland, were found guilty today in U.S. District Court of conspiring to defraud D.C. Medicaid of $4 million, announced U.S. Attorney Jeanine Ferris Pirro. The jury deliberated for more than a week before finding Price and Moore guilty
- [Rising ‘fraud fatigue’ prompts call for more structured client guidance](https://insurancefraud.org/news_archives/rising-fraud-fatigue-prompts-call-for-more-structured-client-guidance/) - First-party fraud and consumer "fraud fatigue" are both on the rise in Canada, creating fresh challenges for insurers, brokers and other financial institutions as they try to manage identity and claims risk. Equifax Canada's latest Market Pulse Fraud Trends and Insights report showed first-party fraud – where an individual uses their own, real identity but
- [Couple Convicted in $12M Arizona Medicaid Fraud Scheme](https://insurancefraud.org/news_archives/couple-convicted-in-12m-arizona-medicaid-fraud-scheme/) - A New River couple has been convicted in a multimillion-dollar fraud that federal prosecutors say bled more than $12 million from Arizona's Medicaid system, AHCCCS, and helped bankroll houses and luxury cars, including a Lamborghini. Thvoughn Lynden Curry and Alexis Daneen Curry were found guilty of conspiracy to commit health care fraud, multiple counts of
- [Insurance agency owner accused of cheating customers](https://insurancefraud.org/news_archives/insurance-agency-owner-accused-of-cheating-customers/) - A Jamestown man who owns an Archdale insurance agency has been arrested on multiple felonies related to accepting insurance premium payments without forwarding the money to the insurers, the N.C. Department of Insurance announced Wednesday. Jeffrey Martin Webster of Teague Drive, the owner of of Webster Insurance & Associates, is accused of accepting premium payments
- [Inside the multimillion dollar fraud scheme that targeted two former Rockets](https://insurancefraud.org/news_archives/inside-the-multimillion-dollar-fraud-scheme-that-targeted-two-former-rockets/) - Two former Houston Rockets players got a big win on Tuesday after being defrauded out of nearly $5 million. A Manhattan federal jury on Tuesday convicted a former Morgan Stanley investment adviser on fraud charges, for allegedly defrauding three NBA player clients out of millions of dollars by overcharging them for life insurance investments and
- [Coral Springs insurance agent accused of cheating on license exam now charged](https://insurancefraud.org/news_archives/coral-springs-insurance-agent-accused-of-cheating-on-license-exam-now-charged/) - A life insurance agent based in Coral Springs not only has had his license revoked, but also is facing criminal charges after investigators said they learned he didn’t take his own licensing exam. Robinson Lopez Tiberio, 55, is charged with organized scheme to defraud, communications fraud $300 or more and false official statements. The Venezuela
- [Billing fraud tops list of employee crimes at large US companies](https://insurancefraud.org/news_archives/billing-fraud-tops-list-of-employee-crimes-at-large-us-companies/) - Eight in 10 risk managers at large American companies said their organizations experienced employee theft, fraud, or embezzlement in the past 12 months, a new QBE Insurance survey has found, as artificial intelligence reshapes how workplace crimes are both committed and detected. The survey polled 200 US risk managers at firms with at least $500
- [Owner and Operations Manager of Wholesale Drug Distributor Admit Conspiring to Divert Nearly $50m of Cancer Medication to Sell Illegally For Profit](https://insurancefraud.org/news_archives/owner-and-operations-manager-of-wholesale-drug-distributor-admit-conspiring-to-divert-nearly-50m-of-cancer-medication-to-sell-illegally-for-profit/) - Two North Jersey men have admitted to conspiring with doctors and others to purchase nearly $50 million worth of oncology and ophthalmology medications, under false pretenses, and then diverting and reselling these medications for profit, Senior Counsel Philip Lamparello announced. Frank Incognito, 46, of Englishtown, New Jersey, and Stephen Corba, 50, of Farmingdale, New Jersey,
- [Fraud-plagued Minnesota sues Trump admin for withholding $243M in Medicaid payments](https://insurancefraud.org/news_archives/fraud-plagued-minnesota-sues-trump-admin-for-withholding-243m-in-medicaid-payments/) - Minnesota filed a federal lawsuit Monday against the Trump administration, accusing federal health officials of illegally withholding $243 million in Medicaid payments from the state. Attorney General Keith Ellison and the Minnesota Department of Human Services sued the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS),
- [GEICO hits Florida doctor, five clinics with $2.89 million PIP fraud suit](https://insurancefraud.org/news_archives/geico-hits-florida-doctor-five-clinics-with-2-89-million-pip-fraud-suit/) - GEICO takes aim at a Florida physician and five clinics in a $2.89 million alleged PIP fraud scheme. Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company, and GEICO Casualty Co. have filed a 26-count complaint in the United States District Court for the Middle District of Florida, Tampa Division, targeting physician Albert
- [Can Gov. Hochul stop staged car crashes in New York?](https://insurancefraud.org/news_archives/can-gov-hochul-stop-staged-car-crashes-in-new-york/) - When Ian Davey of Davenport, Florida, filed an insurance claim for a 2023 car crash with a day care bus in Queens, he filled in a section asking whether the incident was staged with a definitive answer: “Hells F–ing NO.” But there were some red flags. The doctor who declared Davey “totally disabled” by his
- [Can you spot auto insurance fraud?](https://insurancefraud.org/news_archives/can-you-spot-auto-insurance-fraud/) - Auto insurance fraud is a serious issue – and it isn’t always easy to spot as a consumer. Picture this: you’re scrolling through social media, and an insurance ad pops up that appears to be written just for you. The broker featured in the ad says they can secure you the lowest rates on auto
- [Beneficial changes for farmers made to crop insurance](https://insurancefraud.org/news_archives/beneficial-changes-for-farmers-made-to-crop-insurance/) - Major changes have been made to crop insurance that will reduce the cost and provide more coverage for farmers. "Today is a positive day, the insurance premiums are coming down," said Greg Brucker, crop insurance agent with Strategic Farm Marketing and Crop Insurance. "I don't know what else has come down in your budget this
- [Plea in workers’ comp fraud case in San Mateo](https://insurancefraud.org/news_archives/plea-in-workers-comp-fraud-case-in-san-mateo/) - A 58-year-old San Mateo man pleaded no contest to workers’ compensation fraud and failure to pay insurance for defrauding the state out of $232,369 in insurance premiums and taxes by failing to report at least nine employees at his business, Trans One Moving Company, San Mateo County District Attorney Steve Wagstaffe said. The man, Adolfo
- [Central NY man took $10,000 in worker’s comp for injury but continued to work as a painter](https://insurancefraud.org/news_archives/central-ny-man-took-10000-in-workers-comp-for-injury-but-continued-to-work-as-a-painter/) - An Oswego County man admitted in court Tuesday that he collected more than $10,000 in worker’s compensation benefits while lying about being out of work due to an injury. Christopher Cronk, 58, of Central Square, admitted in Onondaga County Court to being employed while collecting the benefits, according to a news release from the state
- [Arson investigators looking for person seen in surveillance video](https://insurancefraud.org/news_archives/arson-investigators-looking-for-person-seen-in-surveillance-video/) - Austin fire investigators are asking for help in identifying a man seen on camera near the site of an arson fire last month. What we know: The fire happened at 1006 E. Cesar Chavez Street on Feb. 11. Investigators are looking for a man described as a white male between 30 and 40 years old
- [Younger people are increasingly victims of online scams due to AI technology](https://insurancefraud.org/news_archives/younger-people-are-increasingly-victims-of-online-scams-due-to-ai-technology/) - Protecting yourself from scamsThe Ohio Department of Commerce estimates that Ohioans collectively lose $150 million to scammers. Last year, in Cuyahoga County alone, the losses to scams were more than $5 million. Senior citizens have long been the focus of consumer protection efforts due to scammers preying on them using fear and high-pressure techniques to
- [Fraud warning: Michigan lost $200 million to scams in 2024, officials say](https://insurancefraud.org/news_archives/fraud-warning-michigan-lost-200-million-to-scams-in-2024-officials-say-2/) - The holiday season brings increased risk of fraud, and Michigan residents need to stay vigilant to protect their finances and personal information. Michigan residents lost over $200 million to fraud in 2024, with common scams including AI fraud, credit card theft and ransomware.Many scammers operate from overseas, though some may be local, according to Michigan
- [FBI: Health insurance scam zeroes in on Chinese speakers](https://insurancefraud.org/news_archives/fbi-health-insurance-scam-zeroes-in-on-chinese-speakers-2/) - The FBI has warned that Chinese speakers across the U.S. have been subjected to a new health insurance fraud scheme that threatens extradition should they fail to pay their surgical bills, The Register reports. Targets have been contacted using spoofed phone numbers from health insurers' claims departments, with attackers informing them about a bogus surgery
- [Texas based Advanced Pain Care agrees to pay over $13.5 million for violating False Claims Act](https://insurancefraud.org/news_archives/texas-based-advanced-pain-care-agrees-to-pay-over-13-5-million-for-violating-false-claims-act/) - Advanced Pain Care, a pain care clinic with nine locations in Texas, has agreed to pay over $13.5 million to the federal government and the state of Texas for violating the False Claims Act. According to a press release from the United States Attorney’s Office, Western District of Texas, from Jan. 2017 to Dec. 2021,
- [At least $9B billed across 14 Medicaid services in Minnesota may be fraudulent, top prosecutor says](https://insurancefraud.org/news_archives/at-least-9b-billed-across-14-medicaid-services-in-minnesota-may-be-fraudulent-top-prosecutor-says/) - A top prosecutor suggested on Thursday that the total amount of fraud in Minnesota could be $9 billion or more. According to First Assistant U.S. Attorney Joe Thompson, 14 Medicaid services under audit and deemed “high risk” for fraud have cost the state $18 billion since 2018. Thompson said a substantial amount of money billed
- [Medicare scam calls have jumped 40%, with fraudsters using dark-web data to fool seniors. How to protect your family](https://insurancefraud.org/news_archives/medicare-scam-calls-have-jumped-40-with-fraudsters-using-dark-web-data-to-fool-seniors-how-to-protect-your-family/) - For many older Americans, the phone has become a source of anxiety instead of connection. The calls often start early, around 7 a.m., and don’t let up until dinner. They arrive every few minutes, sometimes 40 or 50 times a day, from numbers that look local and legitimate. When seniors answer, a cheerful voice claims
- [SLED: Third person arrested in Sumter insurance fraud scheme](https://insurancefraud.org/news_archives/sled-third-person-arrested-in-sumter-insurance-fraud-scheme/) - The South Carolina Law Enforcement Division (SLED) has charged a man in connection with insurance fraud after filing a false claim for over $10,000. SLED charged 21-year-old Jakeem Jamal Samuel, with him becoming the third person arrested in the fraud scheme. Co-defendants Ulanda Shamicka Yarborough, 44, and Jamari Demetrius Pringle, 19, were arrested in October
- [Couple lied about crash to defraud insurance company, AG’s office says](https://insurancefraud.org/news_archives/couple-lied-about-crash-to-defraud-insurance-company-ags-office-says/) - A couple lied about a crash to defraud an insurance company out of thousands of dollars, officials said. According to Louisiana Attorney General Liz Murrill’s office, Rhashiedi Porter, 48, and Sarai Stansberry, 37, are both facing charges. The investigation began after agents with the Louisiana Bureau of Investigation received a criminal referral from the Louisiana
- [Founders/Owners of Hertel & Brown Physical and Aquatic Therapy Each Sentenced to Six Years in Prison and Fined $250,000 for Wire and Healthcare Fraud Conspiracy](https://insurancefraud.org/news_archives/founders-owners-of-hertel-brown-physical-and-aquatic-therapy-each-sentenced-to-six-years-in-prison-and-fined-250000-for-wire-and-healthcare-fraud-conspiracy/) - Two residents of Erie County, Pennsylvania, each have been sentenced in federal court to six years in prison, to be followed by three years of supervised release, and ordered to pay a $250,000 fine on their convictions of conspiracy to commit wire fraud and healthcare fraud, United States Attorney Troy Rivetti announced today. United States
- [2 Mesa residents sentenced to prison for scamming $3.3M from Arizona Medicaid agency](https://insurancefraud.org/news_archives/2-mesa-residents-sentenced-to-prison-for-scamming-3-3m-from-arizona-medicaid-agency/) - Two Mesa residents were each sentenced to at least a year in prison for defrauding Arizona’s Medicaid agency out of over $3 million, authorities announced Friday. Eric Riley, 39, and Britney Gooch, 38, previously pleaded guilty to health care fraud, according to the U.S. Attorney’s Office for the District of Arizona. Riley was sentenced to
- [CMS’ fraud crackdown and musculoskeletal care](https://insurancefraud.org/news_archives/cms-fraud-crackdown-and-musculoskeletal-care/) - CMS’ six-month moratorium on Medicare enrollment for certain durable medical equipment, prosthetics, orthotics and supplies vendors is the latest move in its broader fraud crackdown, but musculoskeletal leaders are divided on what it will mean for care delivery. While some view the policy as necessary upstream enforcement to curb long-standing abuse in orthotics and equipment
- [CMS Requests Information on Medicaid Payment Fraud](https://insurancefraud.org/news_archives/cms-requests-information-on-medicaid-payment-fraud/) - The Centers for Medicare & Medicaid Services (CMS) seeks stakeholder feedback on potential regulatory changes to address fraud in health care in a new RFI Related to Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). CMS is requesting information on Medicaid, the Children’s Health Insurance Program (CHIP), and services to immigrants. Specifically, CMS wants to address
- [Former Beaver Dam Insurance Agent Arrested Again](https://insurancefraud.org/news_archives/former-beaver-dam-insurance-agent-arrested-again/) - A former Beaver Dam insurance agent is in trouble with the law again. The Dane County Sheriff’s Office said Mason Gunderson was arrested Saturday night in Bristol. The criminal complaint states that Gunderson crashed his vehicle into another vehicle with two people inside. He had allegedly been kicked out of a bar earlier that night.
- [Long Island Medical Doctor Sentenced to 7 Years in Prison for Operating Oxycodone Pill Mill Out of her Great Neck Office](https://insurancefraud.org/news_archives/long-island-medical-doctor-sentenced-to-7-years-in-prison-for-operating-oxycodone-pill-mill-out-of-her-great-neck-office/) - Earlier today, in federal court in Central Islip, Dr. Roya Jafari-Hassad was sentenced by United States District Judge Gary R. Brown to 7 years’ imprisonment for prescribing oxycodone pills without a legitimate medical purpose and fraudulently billing insurance providers for procedures which were never performed. In addition to the term of imprisonment, Judge Brown imposed
- [Tragic death uncovers alleged insurance fraud by Oxnard licensed agent](https://insurancefraud.org/news_archives/tragic-death-uncovers-alleged-insurance-fraud-by-oxnard-licensed-agent/) - Licensed insurance agent Gonzalo Lorona, 58, of Oxnard, has been charged with 37 felony counts, including insurance fraud and grand theft, after a California Department of Insurance investigation found he allegedly stole client premium payments and issued fraudulent insurance certificates leaving organizations uninsured and at financial risk. The investigation began after a soccer player tragically
- [Louisiana Contractor Arrested for Fraudulent Activities](https://insurancefraud.org/news_archives/louisiana-contractor-arrested-for-fraudulent-activities/) - A Louisiana contractor was arrested last week on charges of fraud, filing false public records and forgery. The contractor, Jon Andersen, also received a cease-and-desist letter from Louisiana Insurance Commissioner Tim Temple. Andersen was arrested on Feb. 25 in Jefferson Parish. Temple issued the order after determining Andersen and his New Orleans-based company, Andersen Design
- [Key Companies Leading Innovation and Growth in the Fraud Detection and Prevention Market](https://insurancefraud.org/news_archives/key-companies-leading-innovation-and-growth-in-the-fraud-detection-and-prevention-market/) - The fraud detection and prevention market is on track for significant expansion as digital transactions become increasingly prevalent. With the rise of sophisticated cyber threats and the growing complexity of fraud schemes, companies and institutions alike are ramping up their efforts to safeguard financial activities. This report delves into the market's expected growth, key players,
- [Family Members Arraigned in California Auto Insurance Fraud Scheme](https://insurancefraud.org/news_archives/family-members-arraigned-in-california-auto-insurance-fraud-scheme/) - A California family is charged with insurance fraud in what authorities describe as a staged staging accident involving a Porsche. Pasadena residents Sarkis Dishchyan, 47, Ani Suzie Labbad, 47, and Violett Lara Labbad, 44, were arraigned on multiple counts of felony insurance fraud for allegedly staging a vehicle accident involving their Porsche Cayenne to collect
- [Clinton County Woman Charged with Insurance Fraud](https://insurancefraud.org/news_archives/clinton-county-woman-charged-with-insurance-fraud/) - Cristal Gale Kastantin, of Wheatland, Iowa, was arrested on Saturday, January 3, 2026, on outstanding arrest warrants. Kastantin was charged with one count of Ongoing Criminal Conduct (Class B Felony), one count of Theft 1st Degree (Class C Felony), one count of Theft 2nd Degree (Class D Felony), and one count of Fraudulent Submission (Class
- [Risoldi kids succeed in separating fraud trials with mom](https://insurancefraud.org/news_archives/risoldi-kids-succeed-in-separating-fraud-trials-with-mom/) - A Bucks County socialite will face two trials — one alongside her family in a $20 million insurance fraud case involving a 2013 fire at the family's Buckingham mansion and another alone for alleged criminal acts that occurred before the fire. The order for separate trials came from Senior Judge Thomas Gavin earlier this month
- [Plaintiff Alleges Family Conspiracy in Life Insurance Fraud](https://insurancefraud.org/news_archives/plaintiff-alleges-family-conspiracy-in-life-insurance-fraud/) - A dramatic family feud has escalated into a legal battle involving allegations of fraud, impersonation, and conspiracy. On February 17, 2026, Latoya McClean filed a complaint in the United States District Court for the Eastern District of New York against multiple family members, including Magaly McClean. The lawsuit accuses them of orchestrating a complex scheme
- [Morning Digest: Meta launches scam prevention tools to fight fraud](https://insurancefraud.org/news_archives/morning-digest-meta-launches-scam-prevention-tools-to-fight-fraud/) - National Consumer Protection Week is now underway. Good Morning Cleveland anchor Mike Brookbank is trying to help you stay one step ahead of scammers by highlighting some of the top strategies they use to steal your personal information or hard-earned money. This morning, he learned Meta, the owner of Facebook and Instagram, is rolling out
- [Trial begins in New Orleans staged-crash cases that involve conspiracy, murder](https://insurancefraud.org/news_archives/trial-begins-in-new-orleans-staged-crash-cases-that-involve-conspiracy-murder/) - The words of a slain federal witness are expected to loom large in a New Orleans courtroom this week as a trial begins for two local lawyers and two others accused in a wild scheme to stage vehicle wrecks with big rig trucks across the Crescent City. The trial, slated to start Monday in federal
- [Insurance investigations could see faster involvement from state inspectors if Georgia passes bill](https://insurancefraud.org/news_archives/insurance-investigations-could-see-faster-involvement-from-state-inspectors-if-georgia-passes-bill/) - Georgia lawmakers want to lower insurance costs for families and make it easier to hold “bad actor” insurance companies accountable. House Bill 1344, the Georgia Insurance Affordability and Claims Integrity Act, would strengthen the Commissioner of Insurance’s ability to enforce state laws by clarifying the rules for insurance and investigations related to it. According to
- [Medicare revokes Houston company's billing after 13 Investigates unrecognized charges](https://insurancefraud.org/news_archives/medicare-revokes-houston-companys-billing-after-13-investigates-unrecognized-charges/) - Medicare will no longer allow a Houston-based company to bill it after 13 Investigates heard from residents with charges on their accounts that they didn't recognize. Medicare revokes Houston company's billing after 13 Investigates unrecognized charges
- [Minnesota Creates Nation’s First Fraud Fund](https://insurancefraud.org/news_archives/minnesota-creates-nations-first-fraud-fund/) - John Larkin of Falcon Heights didn’t initially think it odd when texts from his pastor requested gift cards totaling $2,000 for the church staff. The pastor said he’d reimburse Larkin. He and his wife headed out to purchase the cards but stopped first for lunch, where Larkin began to wonder about the strange request. He
- [Big Losses Propel Fraud Cases](https://insurancefraud.org/news_archives/big-losses-propel-fraud-cases/) - For Chris Malloy, a fraud detective with the Guilford County Sheriff’s Office in Greensboro, there’s often little he can do when faced with a horrific case of cryptocurrency fraud. “When the victim puts the money in a crypto ATM, it goes straight to the bad guy’s wallet,” explains Malloy, who adds that he’s “had more
- [‘Fraudlettes’ on Guard Against Scams](https://insurancefraud.org/news_archives/fraudlettes-on-guard-against-scams/) - Annetta Works Salley is an outspoken advocate for veterans and Black women’s health, unafraid to ask questions and speak her mind for herself and others. But the U.S. Army veteran, 63, nonetheless felt embarrassed and frightened during the two times she was hit with debit-card fraud. And she wants her story to help others. “I’m
- [Telemedicine Company Owner Sentenced to 7 Years in Prison for $56M Medicare Fraud Scheme](https://insurancefraud.org/news_archives/telemedicine-company-owner-sentenced-to-7-years-in-prison-for-56m-medicare-fraud-scheme/) - The owner of two telemedicine companies was sentenced today to 7 years in prison and ordered to pay $27.9 million in restitution for his role in a scheme to fraudulently bill Medicare for unnecessary durable medical equipment. “Instead of connecting patients with legitimate care, Reinaldo Wilson used his telemedicine companies to exploit Medicare and line
- [Gov. Walz unveils anti-fraud bill after feds halt $259 million in Medicaid to Minnesota](https://insurancefraud.org/news_archives/gov-walz-unveils-anti-fraud-bill-after-feds-halt-259-million-in-medicaid-to-minnesota/) - Democratic Minnesota Gov. Tim Walz laid out his anti-fraud legislative package on Thursday, one day after the White House paused $259 million in federal Medicaid payments to the state until a comprehensive action plan is laid out to fight fraud. The package focuses on three main components, according to Walz's office: Better detection and oversightStrengthened
- [Illinois Man Sentenced for Multiple Counts of Forgery](https://insurancefraud.org/news_archives/illinois-man-sentenced-for-multiple-counts-of-forgery/) - Scott Lennington, age 49, of Morton, IL, was sentenced on February 11, 2026, in Polk County, Iowa after being found guilty of nine counts of Forgery (Class D Felony) on November 25, 2025. According to the criminal complaints filed by the Iowa Insurance Division’s Fraud Bureau, Lennington entered into agreements with the victims to act
- [How AI Can Both Detect and Enable Fraudulent Research](https://insurancefraud.org/news_archives/how-ai-can-both-detect-and-enable-fraudulent-research/) - HighlightsNearly 10% of cancer research papers showed signs of being fabricated by “paper mills” that sell manuscripts at industrial scale, with the share increasing exponentially over time, according to new research. The problem may intensify as generative AI becomes more sophisticated, prompting lawmakers to demand information from federal agencies about safeguards in place. And, persistent
- [L.A. police officer arrested for allegedly skydiving while on disability leave](https://insurancefraud.org/news_archives/l-a-police-officer-arrested-for-allegedly-skydiving-while-on-disability-leave/) - An 18-year veteran of the Los Angeles Police Department was taken into custody on suspicion of insurance fraud, investigators announced Wednesday. Detectives with the department’s Special Operations Division, Major Complaint Unit arrested Police Officer Christopher Carnahan, a 43-year-old resident of Norwalk, on Feb. 25 after an investigation allegedly revealed he’d exaggerated an on-duty injury to
- [Insurance Fraud Detection Market See Strong Future Growth By 2033 | SAS Institute • FICO • IBM • Verisk Analytics • FRISS](https://insurancefraud.org/news_archives/insurance-fraud-detection-market-see-strong-future-growth-by-2033-sas-institute-fico-ibm-verisk-analytics-friss/) - Coherent Market Insights' most recent research study, "Global Insurance Fraud Detection Market Size, Share, Pricing, Trends, Growth, Opportunities and Forecast 2026-2033," provides a thorough overview of the market for Insurance Fraud Detection Market on a global scale. The research contains future sales projections, consumer demand, regional analyses, and other crucial data about the target market,
- [Auto insurance fraud is driving premiums through the roof — Suffolk County court shows why reform can’t wait](https://insurancefraud.org/news_archives/auto-insurance-fraud-is-driving-premiums-through-the-roof-suffolk-county-court-shows-why-reform-cant-wait/) - A sweeping decision from Suffolk County has exposed what many New Yorkers feel when paying their car insurance bills: fraudsters are exploiting our auto insurance system, and law-abiding drivers are footing the bill. In Integon v. Salazar-Ochoa, Suffolk County Supreme Court Justice Maureen T. Liccione dismissed eight auto accident claims after finding they were part
- [Vance says administration is pausing some Medicaid funding to Minnesota because of fraud concerns](https://insurancefraud.org/news_archives/vance-says-administration-is-pausing-some-medicaid-funding-to-minnesota-because-of-fraud-concerns/) - Vice President JD Vance announced Wednesday that the Trump administration would “temporarily halt” some Medicaid funding to the state of Minnesota over fraud concerns, as part of what he described as an aggressive crackdown on misuse of public funds. Vance, who made the announcement with Dr. Mehmet Oz, the administrator for the Centers for Medicare
- [Lancaster trio sentenced for Medicaid fraud scheme targeting children](https://insurancefraud.org/news_archives/lancaster-trio-sentenced-for-medicaid-fraud-scheme-targeting-children/) - Three Lancaster residents have been sentenced in federal court for conspiring to defraud Medicaid out of nearly $250,000 by billing for behavioral health services that were either never rendered, performed in unauthorized group settings or provided by unlicensed therapists. Charles McKinley Griffin, 56, and his wife Tika Michelle Griffin, 48, were each sentenced to 30
- [Insurance fraud effects everyone](https://insurancefraud.org/news_archives/insurance-fraud-effects-everyone/) - Insurance fraud is not a victimless crime. It’s been around for as long as insurance, and it costs businesses billions of dollars each year – an expense that is passed on to consumers in the form of higher premiums. Although the overwhelming majority of insurance agents and companies are honest and reputable, there are some
- [DWC warns: Scammers impersonating officials for fraud schemes](https://insurancefraud.org/news_archives/dwc-warns-scammers-impersonating-officials-for-fraud-schemes/) - The Texas Department of Insurance, Division of Workers’ Compensation, has issued a scam alert regarding individuals impersonating agency officials and court personnel. These scammers are targeting Texas workers by falsely claiming that payments are required to receive workers’ compensation benefits. The Division of Workers’ Compensation, or DWC, emphasizes that no worker in Texas is ever
- [Formerly licensed Orange County insurance agent arraigned on grand theft and embezzlement charges](https://insurancefraud.org/news_archives/formerly-licensed-orange-county-insurance-agent-arraigned-on-grand-theft-and-embezzlement-charges/) - Insurance broker, Andre De Gazon, 56, of Bellflower, was arraigned today at the Orange County Superior Court on multiple felony counts of grand theft and embezzlement after allegedly using his status as a licensed insurance agent to pocket more than $100,000 of unremitted insurance policy premiums from victims. An investigation by the Department of Insurance
- [Texas Doctor Sentenced to 8.5 Years in Prison for $145 Million Health Care Fraud Scheme](https://insurancefraud.org/news_archives/texas-doctor-sentenced-to-8-5-years-in-prison-for-145-million-health-care-fraud-scheme/) - An orthopedic surgeon was sentenced today to 102 months in prison and ordered to pay over $13 million in restitution for his role in a $145 million scheme to defraud the Department of Labor through the submission of fraudulent claims for prescription compound creams. “The Department is committed to protecting victims and combating fraud against
- [Pharmacist and Business Owner Convicted of $3M Medicare, Medicaid, and Private Insurer Fraud Scheme](https://insurancefraud.org/news_archives/pharmacist-and-business-owner-convicted-of-3m-medicare-medicaid-and-private-insurer-fraud-scheme/) - A pharmacist and business owner who engaged in a five-year pharmacy shortage fraud scheme at two separate pharmacies pleaded guilty today, announced United States Attorney Jerome F. Gorgon, Jr. Gorgon was joined in the announcement by Mario M. Pinto, Special Agent in Charge at the U.S. Department of Health and Human Services Office of Inspector
- [Zynex class action alleges $873 million insurance overbilling scheme](https://insurancefraud.org/news_archives/zynex-class-action-alleges-873-million-insurance-overbilling-scheme/) - A federal securities class action filed on February 20, 2026 has laid bare what prosecutors describe as an $873 million insurance billing fraud machine run by the former top executives of medical device maker Zynex, Inc. The case, Beidel v. Sandgaard et al. (Case No. 1:26-cv-00714, US District Court for the District of Colorado), pulls
- [CMS saved $2 billion by using AI to fight fraud, official says](https://insurancefraud.org/news_archives/cms-saved-2-billion-by-using-ai-to-fight-fraud-official-says/) - The Centers for Medicare and Medicaid Services has been able to save billions of dollars in less than a year by applying artificial intelligence to tackle duplicative contracts and fraudulent claims, according to Kim Brandt, deputy administrator and chief operating officer at CMS, who spoke at the Nextgov/FCW Fed Tech Priorities summit on Feb. 18.
- [Owners of vocational schools in Whittier and San Luis Obispo stole thousands in injured workers’ benefits, investigators say](https://insurancefraud.org/news_archives/owners-of-vocational-schools-in-whittier-and-san-luis-obispo-stole-thousands-in-injured-workers-benefits-investigators-say/) - The owner of one of California’s largest vocational return-to-work counseling centers was among those accused of forging injured workers’ signatures to take thousands of dollars in funds meant to help employees reenter the workforce, according to state officials. Hazel Ortega of La Habra, who owns Ortega Counseling Center in Whittier, along with alleged co-conspirators Gemi
- [Insurance Executives Sentenced to 20 Years for $233 Million ACA Enrollment Fraud Scheme](https://insurancefraud.org/news_archives/insurance-executives-sentenced-to-20-years-for-233-million-aca-enrollment-fraud-scheme/) - On February 18, the US Department of Justice (DOJ) announced that two insurance industry executives — the president of an insurance brokerage firm and the CEO of a marketing company — were each sentenced to 20 years in federal prison for orchestrating a multi-year scheme that defrauded the Affordable Care Act (ACA) program of approximately
- [Senior flags Medicare misbilling by Houston company](https://insurancefraud.org/news_archives/senior-flags-medicare-misbilling-by-houston-company/) - 13 Investigates what happens when you report unrecognizable Medicare charges to the federal government.
- [New York man sentenced in Massachusetts court for scheme that led to approximately $70.6 million in fraudulent bills submitted to Medicare](https://insurancefraud.org/news_archives/new-york-man-sentenced-in-massachusetts-court-for-scheme-that-led-to-approximately-70-6-million-in-fraudulent-bills-submitted-to-medicare/) - A former New York based sales director for the Northeast region of a mobile medical diagnostics company was sentenced in federal court in Boston for conspiring to offer and pay kickbacks to doctors in exchange for ordering medically unnecessary brain scans. According to a release from the Massachusetts Department of Justice, 57-year-old James Rausch of
- [NY’s monster, $124B taxpayer-funded Medicaid program riddled with fraud, waste: US regulator Dr. Oz](https://insurancefraud.org/news_archives/nys-monster-124b-taxpayer-funded-medicaid-program-riddled-with-fraud-waste-us-regulator-dr-oz/) - New York’s mind-boggling $124 billion taxpayer-funded Medicaid program is riddled with fraud and waste, US regulator Dr. Mehmet Oz said Sunday — and dogged federal investigators are digging into it. “In the beautiful city of New York and surrounding New York state, we know that there are a lot of people who are providing services
- [United States v. Yoon — Face-Value Billing Presumption for Intended Loss in Private Health-Insurance Fraud and § 3B1.3 Position-of-Trust for Health-Care Providers](https://insurancefraud.org/news_archives/united-states-v-yoon-face-value-billing-presumption-for-intended-loss-in-private-health-insurance-fraud-and-§-3b1-3-position-of-trust-for-health-care-providers/) - United States v. Yoon: Face-Value Billing Presumption for Intended Loss in Private Health-Insurance Fraud; Health-Care Providers as “Positions of Trust” Under U.S.S.G. § 3B1.3 Court: U.S. Court of Appeals for the First Circuit Date: February 20, 2026 Case: United States v. Yoon, No. 24-1520 (Aframe, J.) I. Introduction United States v. Yoon arose from a multi-year billing scheme by
- [Identity verification systems are struggling with synthetic fraud](https://insurancefraud.org/news_archives/identity-verification-systems-are-struggling-with-synthetic-fraud/) - Fake and expired IDs keep showing up in routine customer transactions, from alcohol purchases to credit card applications. The problem shows up most often in industries that depend on fast onboarding and remote transactions, where identity checks rely heavily on scanned documents and automated workflows. Intellicheck analyzed nearly 100 million identity verification transactions collected through its cloud-based
- [Colorado Medicaid probe uncovers millions of dollars in alleged transport fraud ring](https://insurancefraud.org/news_archives/colorado-medicaid-probe-uncovers-millions-of-dollars-in-alleged-transport-fraud-ring/) - Colorado Medicaid officials detected $25 million in abnormal billing over just four months two years ago — a surge that prompted a new state law and the suspension of dozens of providers in what authorities now describe as an organized fraud ring. State and federal prosecutors have since charged two transportation providers in separate indictments,
- [Middletown Resident Sentenced in Medicaid Fraud Case](https://insurancefraud.org/news_archives/middletown-resident-sentenced-in-medicaid-fraud-case/) - Darlene Shuff-Porter, a 66-year-old Middletown resident who owned a counseling practice in Meriden, was sentenced to three years in prison, execution suspended, with five years of conditional discharge for defrauding Medicaid by submitting fraudulent claims for work she did not perform and allowing unlicensed individuals to provide behavioral health services. Shuff-Porter pleaded guilty in October
- [EmblemHealth will pay $2.5M after investigation reveals 'ghost network' of providers](https://insurancefraud.org/news_archives/emblemhealth-will-pay-2-5m-after-investigation-reveals-ghost-network-of-providers/) - NEW YORK ATTORNEY GENERAL LETITIA JAMES ON THURSDAY SECURED MORE THAN $2.5 MILLION FROM HEALTH INSURER EMBLEMHEALTH after an investigation revealed the company repeatedly failed to ensure that New Yorkers could access mental health care services. An Office of the Attorney General investigation found that Emblem maintained inaccurate provider directories, overstated the availability of in-network
- [Becker bill aims to curb fraud involving AI deepfakes](https://insurancefraud.org/news_archives/becker-bill-aims-to-curb-fraud-involving-ai-deepfakes/) - Seeking to combat the increasing use of artificial intelligence for fraud and defamation, State Sen. Josh Becker introduced legislation on Feb. 19 that would raise penalties for scams involving deepfake technology and create new avenues for removing the offending images. The impetus for Becker’s bill is rooted in cases where bad actors have used the
- [Former NFL Player and Laboratory Owner Convicted in $328M Genetic Testing Fraud Scheme](https://insurancefraud.org/news_archives/former-nfl-player-and-laboratory-owner-convicted-in-328m-genetic-testing-fraud-scheme/) - A federal jury in Dallas convicted a Texas laboratory owner and former NFL player yesterday for his role in a $328 million cardiovascular genetic testing fraud scheme. According to court documents and evidence presented at trial, Keith J. Gray, 39, of McKinney, Texas, orchestrated a scheme to bill Medicare for medically unnecessary genetic tests designed
- [Governor Hochul Unveils Grassroots Support Behind Her Proposals to Lower the Cost of Auto Insurance](https://insurancefraud.org/news_archives/governor-hochul-unveils-grassroots-support-behind-her-proposals-to-lower-the-cost-of-auto-insurance/) - Governor Kathy Hochul today unveiled support from local electeds, union leaders, business and community organizations, and nonprofits behind her proposals to lower the cost of auto insurance. Here is what they are saying: MTA Chair and CEO Janno Lieber said, “The MTA operates thousands of vehicles on the street level, and that makes us a
- [Washington bill expands insurance fraud to include vehicle repairs and appraisals](https://insurancefraud.org/news_archives/washington-bill-expands-insurance-fraud-to-include-vehicle-repairs-and-appraisals/) - A Washington State insurance commissioner-sponsored bill to combat insurance fraud, including for vehicle repairs or appraisals, passed the Senate Tuesday. SB 6031 expands insurance fraud to include medical, vehicle or property services not rendered or vehicle or property repairs not made or supplies not provided. It also makes insurance fraud a Class B felony in
- [Insurance Fraud Arrest Made By Bryan Police](https://insurancefraud.org/news_archives/insurance-fraud-arrest-made-by-bryan-police/) - Bryan police make an arrest on a charge of insurance fraud. The BPD arrest report says the case began in September 2025 when a hotel guest reported someone broke the rear window of his rental van and took property. The guest later filed an insurance claim for $10,000 dollars. A three month investigation involved a
- [Attorney General Hanaway Obtains Medicaid Fraud Conviction Against Medicaid Recipient, Attendants For Services Billed While In Jail.](https://insurancefraud.org/news_archives/attorney-general-hanaway-obtains-medicaid-fraud-conviction-against-medicaid-recipient-attendants-for-services-billed-while-in-jail/) - Today, Missouri Attorney General Catherine Hanaway announced that her Medicaid Fraud Control Unit (MFCU) obtained Medicaid Fraud convictions against Medicaid recipient Ronale Rankins and his attendants, Charlene Otey and Tifiney Lothridge, who received payment for services while Rankins was incarcerated. Rankins collaborated with his attendants, telling them to continue clocking in and out as if
- [AI Fraud Prevention Statistics for 2026](https://insurancefraud.org/news_archives/ai-fraud-prevention-statistics-for-2026/) - Artificial intelligence and the new tools based on it that are hitting the market every new day are starting to have a massive impact on the state of fraud. As these systems are weaponized against consumers in every sector more and more, it is crucial to understand their impact and how they affect the market
- [Man charged with insurance fraud after the death of his wife](https://insurancefraud.org/news_archives/man-charged-with-insurance-fraud-after-the-death-of-his-wife/) - A man in North Dakota is now facing jail time on accusations of trying to get insurance money after his wife passed away. John Unruh is being charged with fraudulent insurance act of over $50,000. An investigator from the state’s insurance department fraud unit was looking closer at a life insurance policy for a woman.
- [Georgia Supreme Court creates new framework for detecting STOLI schemes](https://insurancefraud.org/news_archives/georgia-supreme-court-creates-new-framework-for-detecting-stoli-schemes/) - Georgia's highest court just handed insurers a playbook for spotting stranger-originated life insurance schemes, rejecting simplistic tests in favor of examining the full picture. The Supreme Court of Georgia ruled February 17 that determining whether third-party investors illegally procured a life insurance policy requires looking at the totality of circumstances, not just who paid premiums
- [San Francisco Tow Company Operator Sentenced To Five Years For Arson Conspiracy And More Than Two Years For Mail And Wire Fraud Conspiracy](https://insurancefraud.org/news_archives/san-francisco-tow-company-operator-sentenced-to-five-years-for-arson-conspiracy-and-more-than-two-years-for-mail-and-wire-fraud-conspiracy/)
- [Hendersonville man accused of insurance fraud](https://insurancefraud.org/news_archives/hendersonville-man-accused-of-insurance-fraud/) - A Hendersonville man has been arrested after police conducted a years-long investigation regarding insurance fraud. According to the Hendersonville Police Department, investigators began looking into a complaint from a business on Nov. 18, 2024, that 67-year-old Richard Wolfe was selling insurance policies without remitting the required premiums. Police said that resulted in the policies being
- [Coalition Against Insurance Fraud Announces New Leadership Appointments](https://insurancefraud.org/news_archives/coalition-against-insurance-fraud-announces-new-leadership-appointments/) - The Coalition Against Insurance Fraud announced new leadership appointments across several of its committees and task forces, reinforcing its commitment to collaboration, innovation, and excellence in fraud prevention. The Coalition’s 14 committees and task forces play a vital role in advancing industry best practices, strengthening partnerships, and addressing emerging insurance fraud challenges. These leaders have
- [2 arrested in South Florida insurance fraud involving dozens of fake tow-truck policies](https://insurancefraud.org/news_archives/2-arrested-in-south-florida-insurance-fraud-involving-dozens-of-fake-tow-truck-policies/) - State investigators have arrested two men accused of selling fraudulent commercial insurance policies to tow-truck operators in Miami-Dade County, according to the Florida Department of Financial Services’ Criminal Investigation Division. Investigators announced on Tuesday that 24 tow-truck insurance policies were issued using falsified or inaccurate information to meet state-required insurance limits. The policies were sold
- [Local home healthcare company owner admits $210,000 fraud](https://insurancefraud.org/news_archives/local-home-healthcare-company-owner-admits-210000-fraud/) - The owner of a home healthcare company appeared in federal court Tuesday and admitted defrauding the Missouri Medicaid Program and the U.S. Department of Veterans Affairs out of $210,000. Prosecutors with the U.S. Attorney’s Office for the Eastern District of Missouri said Natavia Boyd-Wells, 41, enrolled her business, Touch of the Heart Home Health Care
- [St. Louis County Home Healthcare Company Owner, Associates Accused of $1.46 Million Fraud](https://insurancefraud.org/news_archives/st-louis-county-home-healthcare-company-owner-associates-accused-of-1-46-million-fraud/) - The owner of a home healthcare company based in Bridgeton, Missouri and her associates have been accused of fraudulently billing the Missouri Medicaid Program $1.46 million. Daniell Green, 48, of St. Charles; Dejuan Bingham, 51, of Florissant; Kimberly Diazascencio, 51; and Thomas Keith, 34, of East Prairie, Missouri; were indicted Feb. 11, 2026, in U.S.
- [Legislative outlook for containing third-party litigation funding in 2026](https://insurancefraud.org/news_archives/legislative-outlook-for-containing-third-party-litigation-funding-in-2026/) - Outside investors are flocking to the insurance industry as third-party litigation funding (TPLF) enables them to receive portions of the settlement from plaintiffs and law firms. At the same time, litigation funding can lead to a rise in fraudulent claims and a subsequent spike in insurance premiums. Recently, PropertyCasualty360.com spoke to legislative experts Brian Allen,
- [Washington Senate advances wildfire grants and insurance fraud overhaul](https://insurancefraud.org/news_archives/washington-senate-advances-wildfire-grants-and-insurance-fraud-overhaul/) - The Washington state Senate has passed Senate Bill 6079, establishing a wildfire-risk mitigation grant program designed to curb non-renewals and policy cancellations tied to wildfire exposure. Insurance Commissioner Patty Kuderer said the program relies on science-based mitigation benchmarks intended to reduce losses and stabilize underwriting results. She described the initiative as a pilot, structured to
- [Inside one of Minnesota's most complicated fraud cases](https://insurancefraud.org/news_archives/inside-one-of-minnesotas-most-complicated-fraud-cases/) - The Minnesota Attorney General's Office's Medicaid Fraud Control Unit just scored a major victory in one of its fraud cases as the woman they labeled the top defendant, Nasro Takhal, pleaded guilty. In return, she agrees to testify against the remaining defendants in the PITSTOP 66 case, which involved a complicated scheme to defraud Minnesota
- [Beyond Minnesota: Four Medicaid Services Vulnerable to Fraud and the Case for Stronger CMS Enforcement](https://insurancefraud.org/news_archives/beyond-minnesota-four-medicaid-services-vulnerable-to-fraud-and-the-case-for-stronger-cms-enforcement/) - In December 2025 and January 2026, citizen journalist and YouTuber Nick Shirley ignited a national firestorm with multiple videos alleging welfare fraud in Minnesota that have attracted more than 148 million views on X alone. The federal government had been investigating welfare program fraud in Minnesota for years. In October, Assistant U.S. Attorney for Minnesota
- [Minnesota fraud crackdown leaving disabled Medicaid recipients without housing](https://insurancefraud.org/news_archives/minnesota-fraud-crackdown-leaving-disabled-medicaid-recipients-without-housing/) - Brently Davis, a disabled 55-year-old man, is being threatened with eviction from his downtown St. Paul apartment. In the home he will soon lose, surrounded by his artwork — masks, Chinese calligraphy, paintings — he described the slew of issues he’s faced as a recipient of Integrated Community Supports, a state-run Medicaid-funded disability service. For
- [Idaho Cracks Down on Insurance Fraud: Two Idaho Men Sentenced in $200K Scheme](https://insurancefraud.org/news_archives/idaho-cracks-down-on-insurance-fraud-two-idaho-men-sentenced-in-200k-scheme/) - The Idaho Department of Insurance (DOI) announced that two Idaho residents have pled guilty to insurance fraud in connection with a scheme to obtain coverage for three classic vehicles that were destroyed by fire. On January 26, 2026, Tanner Evans, a licensed insurance agent from Pocatello, pled guilty to one count of insurance fraud. On
- [Albany children's nursing home pays $1.3M for years of neglect](https://insurancefraud.org/news_archives/albany-childrens-nursing-home-pays-1-3m-for-years-of-neglect/) - An Albany nursing home that cares for some of the state's most vulnerable children will pay $1.3 million after investigators found it had neglected its young residents for years while fraudulently billing Medicaid for care it failed to provide. St. Margaret's Center, a not-for-profit pediatric skilled nursing facility operated by the Center for Disability Services,
- [Florida Senator Targeting Health Care Fraudsters, Pushing Tougher Penalties](https://insurancefraud.org/news_archives/florida-senator-targeting-health-care-fraudsters-pushing-tougher-penalties/) - Florida Senator Ashley Moody is targeting health care fraudsters and pushing for tougher penalties to bring criminals to justice. The Republican Senator introduced her Punishing Health Care Fraudsters Act, legislation that will enhance harsher financial and criminal penalties for health care fraud. “For too long, the American taxpayer has been abused at the hands of
- [Plainfield, Vermont Man Sentenced to 2 Years of Probation for Social Security Disability Fraud](https://insurancefraud.org/news_archives/plainfield-vermont-man-sentenced-to-2-years-of-probation-for-social-security-disability-fraud/) - The United States Attorney's Office for the District of Vermont stated that on February 10, 2026, John Cozza, 64, of Plainfield, Vermont, was sentenced by Chief United States District Judge Christina Reiss to a two-year term of probation and ordered to pay $68,323.20 in restitution to the United States Social Security Administration. Cozza previously pleaded
- [5 artificial intelligence scams targeting you right now](https://insurancefraud.org/news_archives/5-artificial-intelligence-scams-targeting-you-right-now/) - There’s no doubt that artificial intelligence (AI) is changing the world we live in. That includes the methods used by scammers to go after your money and sensitive information. According to ID Shield, AI-enhanced fraud attempts increased by 300% in 2025. The ID theft protection company identified five primary AI scams targeting all of us
- [Prosecutors: Colorado medical transportation businesses invoiced Medicaid for family trips, dead person](https://insurancefraud.org/news_archives/prosecutors-colorado-medical-transportation-businesses-invoiced-medicaid-for-family-trips-dead-person/) - Two Colorado business owners have been separately charged for fraudulently billing the federal government's Medicaid program. The pair ran non-emergency medical transportation businesses in Douglas County and Mesa County. They provided rides for Medicaid patients - most often people without vehicles - to medical appointments or treatments. The service is reimbursed by the federal Medicaid
- [10 Ohioans formally charged for allegedly stealing nearly $500K combined from Medicaid](https://insurancefraud.org/news_archives/10-ohioans-formally-charged-for-allegedly-stealing-nearly-500k-combined-from-medicaid/) - Nine Medicaid providers and one recipient have been indicted for allegedly stealing a combined $478,000 from the state’s health care program for the needy. The indictments were filed this month in Franklin County Common Pleas Court following investigations by the Ohio Medicaid Fraud Control Unit, according to Ohio Attorney General Dave Yost’s Office. The cases
- [Patient recounts fraud experience with Colorado medical company after former executives indicted](https://insurancefraud.org/news_archives/patient-recounts-fraud-experience-with-colorado-medical-company-after-former-executives-indicted/) - A patient who says she fell victim to a fraud scheme allegedly perpetrated by former executives of a Colorado-based medical device company is sharing her story. The company, based in Englewood, produces and markets electrotherapy devices used in pain management, rehabilitation and stroke recovery. Since CBS Colorado first covered the federal indictment of two former
- [Florida arrests 4 more in $1.7M fraud scheme involving over 200 fake claims](https://insurancefraud.org/news_archives/florida-arrests-4-more-in-1-7m-fraud-scheme-involving-over-200-fake-claims/) - Florida's Chief Financial Officer announced the arrest of four more people in a scheme to defraud the Sunshine State out of $1.7 million. The four arrests come after six other arrests were made in the same investigation, where Florida officials say a state employee processed more than 220 bogus property damage claims that siphoned approximately
- [Florida health insurance agent accused of $323k fraud involving hundreds of fake policies](https://insurancefraud.org/news_archives/florida-health-insurance-agent-accused-of-323k-fraud-involving-hundreds-of-fake-policies/) - A licensed health insurance agent in Florida has been arrested, accused of orchestrating a staggering $323,000 fraud scheme, allegedly creating over 100 fake policies using another agent's personal information. The arrest was announced by Chief Financial Officer Blaise Ingoglia, who emphasized the commitment of the Department of Financial Services Criminal Investigations Division to combat fraud
- [Arrests made after $1.5-million Burbank home sells without the owner or buyer being aware](https://insurancefraud.org/news_archives/arrests-made-after-1-5-million-burbank-home-sells-without-the-owner-or-buyer-being-aware/) - Using fake identities and purchase agreements and forged loan applications, four people allegedly cooked up a months-long scheme to sell a Burbank house with neither the homeowner nor the buyer being aware of the $1.5-million deal. The group, which included a licensed real estate broker, falsified signatures, submitted fraudulent loan applications and even discussed using
- [Musk declares victory with Medicaid data release](https://insurancefraud.org/news_archives/musk-declares-victory-with-medicaid-data-release/) - Elon Musk took a victory lap Friday as a Department of Government Efficiency team released a huge trove of Medicaid spending data he said the public could use to look for fraud themselves. Why it matters: The Trump administration often cites waste, fraud and abuse as justification for deep program cuts — including the nearly
- [HHS OIG Found Hundreds of Millions in Medicaid Payments for Deceased Individuals in a 2021 Audit. Republicans are Continuing to Crack Down on Waste, Fraud, and Abuse.](https://insurancefraud.org/news_archives/hhs-oig-found-hundreds-of-millions-in-medicaid-payments-for-deceased-individuals-in-a-2021-audit-republicans-are-continuing-to-crack-down-on-waste-fraud-and-abuse/) - The following information was released by the U.S. House of Representatives Committee on Energy and Commerce, Republicans : Last December, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a report showing that since 2016, OIG has conducted 18 audits, which revealed Medicaid agencies improperly paid states nearly $289 million
- [Department of Justice: Two Foreign Nationals Indicted in Chicago as Part of $10M Health Care Fraud Scheme](https://insurancefraud.org/news_archives/department-of-justice-two-foreign-nationals-indicted-in-chicago-as-part-of-10m-health-care-fraud-scheme/) - Two Foreign Nationals Indicted in Chicago as Part of $10M Health Care Fraud Scheme Two foreign nationals participated in a $10 million scheme to fraudulently bill Medicare and private insurers for nonexistent health care services, according to an indictment returned in federal court in Chicago. In 2023 and 2024, Burhan Mirza and Kashif Iqbal, along
- [New York Man Sentenced to 14 Months in Prison for Kickback Scheme](https://insurancefraud.org/news_archives/new-york-man-sentenced-to-14-months-in-prison-for-kickback-scheme/) - A former New York operations manager was sentenced in federal court in Boston for conspiring to offer and pay kickbacks to doctors in exchange for ordering medically unnecessary brain scans. Timothy Doyle, 45, of Selden, N.Y. was sentenced by U.S. District Court Judge Nathaniel M. Gorton to 14 months in prison, to be followed by
- [Lebanon Woman Charged with Criminal Simulation](https://insurancefraud.org/news_archives/lebanon-woman-charged-with-criminal-simulation/) - Special agents with the Tennessee Bureau of Investigation have obtained indictments charging a Lebanon woman with criminal simulation. In June 2023, Special agents began investigating the owner of a home health care business, following allegations of TennCare fraud and abuse. During the course of the investigation, agents learned that between January of 2022 and November
- [Kansas Man Sentenced for Insurance Fraud, Forgery](https://insurancefraud.org/news_archives/kansas-man-sentenced-for-insurance-fraud-forgery/) - Kansas Insurance Commissioner Vicki Schmidt announced a Reno County man has been sentenced to 21 months in prison for insurance fraud, making false information, and forgery. Larry Wilson, aged 54, pleaded guilty on December 11, 2025, in Reno County District Court to one felony count of insurance fraud, two felony counts for making false information,
- [Hochul cites Queens fraud ring as she pushes auto insurance overhaul in budget](https://insurancefraud.org/news_archives/hochul-cites-queens-fraud-ring-as-she-pushes-auto-insurance-overhaul-in-budget/) - Governor Kathy Hochul earlier this week cited a sprawling insurance fraud ring run by two Queens women when pushing for a slate of auto insurance reforms she hopes to pass in the state budget. Hochul said Wednesday on Long Island that staged accidents and the fraudulent medical insurance claims that follow are to blame for
- [Philadelphia men repeatedly traveled to Minneapolis to carry out $3.5M housing fraud scheme: DOJ](https://insurancefraud.org/news_archives/philadelphia-men-repeatedly-traveled-to-minneapolis-to-carry-out-3-5m-housing-fraud-scheme-doj/) - Two men from Pennsylvania admitted to repeatedly traveling from Philadelphia to Minneapolis in an effort to defraud Minnesota’s Housing Stabilization Services (HSS) program, prosecutors announced. The men allegedly defrauded approximately $3.5 million from the program and used artificial intelligence to create false records. The two men, identified as Anthony Waddell Jefferson, 37, and Lester Brown,
- [Healthcare fraud has proliferated nationwide, House Republicans warn](https://insurancefraud.org/news_archives/healthcare-fraud-has-proliferated-nationwide-house-republicans-warn/) - House Republicans have uncovered a nationwide “epidemic” of healthcare fraud extending far beyond the fraud-fraught states of Minnesota and California, according to congressional research into underreported cases of Medicare and Medicaid abuse shared with the Washington Examiner. For instance, in Florida, a foreign national from Cuba was federally sentenced in May 2025 for his role
- [McBee Moves to Dismiss Fraud Lawsuit](https://insurancefraud.org/news_archives/mcbee-moves-to-dismiss-fraud-lawsuit/) - Reality television star Steve A. McBee and two of his sons, Cole and Jesse, motioned a federal court to dismiss a lawsuit alleging they hid assets to avoid paying court-ordered restitution for crop insurance fraud. Attorneys argue the trusts for the two sons were created more than a decade before a transfer of assets was
- [$120M adult day care, pharmacy Medicare and Medicaid fraud; U.S. birth rates fall; don’t forget your coffee – Morning Medical Update](https://insurancefraud.org/news_archives/120m-adult-day-care-pharmacy-medicare-and-medicaid-fraud-u-s-birth-rates-fall-dont-forget-your-coffee-morning-medical-update/) - Federal prosecutors have charged two Queens men with conspiracy to commit health care fraud in an alleged $120 million scheme involving a pharmacy and social adult day care centers. Authorities say the defendants, Inwoo Kim, 42, and Daniel Lee, 56, both of Flushing, New York, paid illegal cash bribes and gift cards to seniors to
- [Prison sentence for forged insurance document](https://insurancefraud.org/news_archives/prison-sentence-for-forged-insurance-document/) - A young army hopeful who produced a false insurance document in court as part of a “premediated plan to deceive everyone” was handed a prison sentence recently. Theo Cavanagh (24) of 73 Marymount, Ferrybank, Waterford, appeared before Judge Kevin Staunton at a sitting of Waterford District Court in January, and pleaded guilty to using a
- [Oregon lawmakers consider tightening hospice oversight over fraud, abuse concerns](https://insurancefraud.org/news_archives/oregon-lawmakers-consider-tightening-hospice-oversight-over-fraud-abuse-concerns/) - For the second year in a row, Oregon lawmakers are considering a bill designed to tighten state oversight of the hospice industry, which has been rife with fraud and abuse. Senate Bill 1575 aims to block new hospices from Oregon that have committed fraud or neglected patients in other states. It would require the Oregon
- [US House panel issues subpoenas to eight health insurers on alleged Obamacare fraud](https://insurancefraud.org/news_archives/us-house-panel-issues-subpoenas-to-eight-health-insurers-on-alleged-obamacare-fraud/) - House Judiciary Committee Republicans have subpoenaed eight Affordable Care Act health insurers for documents as part of an investigation of potential fraud surrounding Obamacare subsidies. The subpoenas to Elevance Health (ELV.N), opens new tab, CVS Health (CVS.N), opens new tab, Centene (CNC.N), opens new tab, GuideWell, Oscar Health (OSCR.N), opens new tab, Kaiser Permanente, Health
- [California man sentenced to 4 years for acting as Beijing’s agent while working for local politician](https://insurancefraud.org/news_archives/california-man-sentenced-to-4-years-for-acting-as-beijings-agent-while-working-for-local-politician/) - A California man has been sentenced to four years in prison for acting as an illegal agent for the Chinese government while working as a campaign adviser for a local politician. Yaoning “Mike” Sun, 65, was sentenced Monday in federal court in Los Angeles after pleading guilty last year in a deal with prosecutors. Under
- [Neurosurgeon Reaches Agreement with Prosecutors in Fraud Case](https://insurancefraud.org/news_archives/neurosurgeon-reaches-agreement-with-prosecutors-in-fraud-case/) - A San Diego neurosurgeon acquitted of conspiracy to commit workers’ compensation insurance fraud but was still facing another felony related to the case reached a settlement with prosecutors Wednesday and the remaining count was dismissed.. Dr. Vrijesh Shantanu Tantuwaya agreed to waive some liens associated with the case and paid $150,000 and prosecutors dismissed a
- [US Medicare agency proposes rules to reduce health insurance fraud](https://insurancefraud.org/news_archives/us-medicare-agency-proposes-rules-to-reduce-health-insurance-fraud/) - The Centers for Medicare & Medicaid Services on ​Monday proposed regulations to crack ‌down on fraud and misleading practices ‌by health insurance agents and brokers to lower healthcare costs. The 2027 Payment Notice sets standards for ⁠health insurance issuers, ‌brokers and agents who offer Affordable Care Act ‍coverage. "This proposed rule lowers premiums, expands consumer
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-26/) - On December 22, 2025, Justin D. Eyer of Hanover, PA pleaded Guilty to Insurance Fraud and was sentenced to three months confinement and 30 months probation and ordered to pay a $744 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs of $2,749.25. On February 26, 2025, detectives of the York County
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-25/) - On December 19, 2025, Cesar K. Plua of Hawley, PA pleaded Guilty to Insurance Fraud and was sentenced to two years probation, ordered to pay a $500 fine and court costs of $2,238. On February 18, 2025, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging Plua with Insurance Fraud
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-24/) - On December 18, 2025, Jose Rivera of Homestead, PA pleaded Guilty to Attempted Theft by Deception and was ordered to perform 50 hours of community service and to pay $2,544.75 in court costs. On May 22, 2025, Office of Attorney General special agents arrested Rivera and charged him with Insurance Fraud and Attempted Theft by
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-23/) - On December 16, 2025, Tishon A. Dodd-Gray of Uniondale, NY pleaded Guilty to Insurance Fraud and Unsworn Falsification and was sentenced to two years probation and ordered to pay a $250 civil penalty to the Insurance Fraud Prevention Trust Fund, $39,525.19 in restitution and court costs of $1,030.25. On May 31, 2024, Office of Attorney
- [Entrepreneur Sentenced for Fraudulent Business Practices](https://insurancefraud.org/news_archives/entrepreneur-sentenced-for-fraudulent-business-practices/) - On December 9, 2025, from a Negotiated Guilty plea to Attempted Theft by Deception, Domenic Davis of Stone Mountain, GA was sentenced to 12 months probation and ordered to pay $27,850.10 in restitution and court costs. On September 26, 2024, Office of Attorney General special agents arrested Davis and charged him with four counts of
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-22/) - On December 4, 2025, from a Negotiated Guilty plea to Insurance Fraud, Heaven K. Franklin-Pitts of Homestead, PA was sentenced to three years probation and ordered to pay $978.95 in court costs. On December 6, 2019, detectives of the Allegheny County Police Department filed a criminal complaint charging Franklin Pitts with two counts of Insurance
- [Pennsylvania Renter's Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-renters-insurance-fraud-sentencing-2/) - On December 1, 2025, from a Negotiated Guilty plea to Insurance Fraud, Shelby T. Kane of Philadelphia, PA was sentenced to two years probation and ordered to pay a $3,000 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs of $847.75. On October 21, 2025, detectives of the Philadelphia District Attorney's Insurance
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-21/) - On November 25, 2025, Richard Holmes of Pittston, PA pleaded Guilty to Insurance Fraud and was sentenced to just under two years confinement followed by one month probation and ordered was ordered to pay $2,490.15 in court costs. On March 4, 2025, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint
- [Pennsylvania Renter's Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-renters-insurance-fraud-sentencing/) - On November 24, 2025, Adam R. Schick of State College, PA pleaded Guilty to Insurance Fraud and was sentenced to nine months probation and ordered to pay $945.50 in court costs. On September 5, 2024, Office of Attorney General special agents arrested Schick and charged him with Insurance Fraud and Attempted Theft by Deception. According
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-20/) - On November 20, 2025, Michael Reid of Brooklyn, NY pleaded Guilty to Insurance Fraud and Unsworn Falsification and was sentenced to two years probation, ordered to pay $250 in fines and court costs of $1,982.75. On May 2, 2025, Office of Attorney General special agents arrested Reid and charged him with three counts of Insurance
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-19/) - On November 17, 2025, from a Negotiated Guilty plea to Attempted Theft by Deception, Cheryl L. Hika of New Kensington, PA was sentenced to two years probation, ordered to perform 50 hours of community service and to pay $2,017.84 in court costs. On May 2, 2025, Office of Attorney General special agents arrested Hika and
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-18/) - On November 14, 2025, from a Negotiated Guilty plea to Attempted Theft by Deception, Cayla M. Burdick of Greensburg, PA was sentenced to 12 months probation and ordered to pay $1,155.84 in court costs. On July 22, 2025, Office of Attorney General special agents arrested Burdick and charged her with two counts of Insurance Fraud
- [Tow Company Owner Sentenced for Fraud](https://insurancefraud.org/news_archives/tow-company-owner-sentenced-for-fraud/) - On November 13, 2025, Vincent F. Fannick of Pittsburgh, PA pleaded Guilty to Insurance Fraud, Theft by Deception and Secure Execution Docs by Deception and was sentenced to five years probation and ordered to pay $379,279 in restitution and court costs of $5,080.25. On April 15, 2024, detectives of the Allegheny County Police Department filed
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-17/) - On November 12, 2025, Nicholas G. Pepe of Sinking Spring, PA pleaded Guilty to Insurance Fraud and was sentenced to 12 months probation and was ordered to pay $1,651 in court costs. On March 13, 2025, Pepe was arrested by Office of Attorney General special agents and charged with Insurance Fraud and Attempted Theft by
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-16/) - On November 6, 2025, Anthony Clay of Norristown, PA pleaded Guilty to Insurance Fraud and was sentenced to three months confinement to run concurrently with six months probation and was ordered to pay $2,619.50 in court costs. On June 26, 2025, Office of Attorney General special agents arrested Clay and charged him with four counts
- [Pennsylvania Resident Sentenced for Homeowner's Insurance Fraud](https://insurancefraud.org/news_archives/pennsylvania-resident-sentenced-for-homeowners-insurance-fraud/) - On November 6, 2025, Joseph H. Bardi of Lake Ariel, PA pleaded No Contest to Risking Catastrophe and was sentenced to three years probation and ordered to pay $152,569.34 in restitution and court costs of $2,627.20. On October 30, 2023, troopers of the Pennsylvania State Police Fire Marshal Unit (PSPFM) arrested Bardi and charged him
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-15/) - On November 3, 2025, Bruce J. Carey of Pittston, PA pleaded Guilty to Insurance Fraud and was sentenced to two years probation, ordered to pay $200 in restitution and court costs of $2,371.75. On June 10, 2025, Office of Attorney General special agents arrested Carey with Insurance Fraud and Attempted Theft by Deception. According to
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-14/) - On October 30, 2025, Minor Perez of Plainsboro, NJ pleaded Guilty to Insurance Fraud and was sentenced to two years probation and ordered to pay a $400 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs of $1,202.25. On August 13, 2025, detectives of the Bucks County District Attorney's Office filed a
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-13/) - On October 30, 2025, from a Negotiated Guilty plea to Insurance Fraud, Rayone N. Hyatt of Pittsburgh, PA was sentenced to six months probation and ordered to pay $1,374.75 in court costs. On February 14, 2025, detectives of the Allegheny County Police Department filed a criminal complaint charging Hyatt with Insurance Fraud. According to the
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-12/) - On October 27, 2025, from a Negotiated Guilty plea to Insurance Fraud, Peter Baptiste of Yeadon, PA was sentenced to two years probation and ordered to pay $1,831.25 in court costs. On June 11, 2025, detectives of the Delaware County District Attorney's Office arrested Baptiste and charged him with Insurance Fraud and Criminal Use of
- [Pennsylvania Medical False Billing Conviction and Sentencing](https://insurancefraud.org/news_archives/pennsylvania-medical-false-billing-conviction-and-sentencing/) - On October 27, 2025, Michael W. Armstrong of Cherry Hill, NJ pleaded Guilty to Insurance Fraud and Conspiracy and was sentenced to 23 months confinement and ordered to $53,000 in restitution and court costs of $1,306.25. In March 2019, Office of Attorney General special agents arrested 11 people and 9 businesses in connection with an
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-11/) - On October 24, 2025, Landon Matthews of Chester, PA pleaded No Contest to Insurance Fraud and was sentenced to 18 months confinement and ordered to pay $796 in court costs. On April 25, 2023, detectives of the Delaware County District Attorney’s Office arrested Matthews and charged him with Insurance Fraud and Criminal Use of Communication
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-10/) - On October 23, 2025, Austin L. Sharrock of Brentwood, PA pleaded Guilty to Attempted Theft by Deception and was sentenced to two years probation, ordered to perform 50 hours of community service, to pay $500 in restitution and court costs of $2,549.75. On May 8, 2025, Office of Attorney General special agents arrested Sharrock and
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-9/) - On October 23, 2025, from a Negotiated Guilty plea to Insurance Fraud and Tamper with Public Records, Rayvon O. Green of Philadelphia, PA was sentenced to three years probation and ordered to pay $1,080.08 in court costs. On February 5, 2025, PA State Police in Bucks County arrested and charged him with multiple offenses related
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-8/) - On October 23, 2025, from a Negotiated Guilty plea to Disorderly Conduct, Kevin M. McGraw of Morton, PA was sentenced to three months probation, ordered to perform 16 hours of community service and to pay $367.75 in court costs. On June 6, 2024, detectives of the Delaware County District Attorney's Office filed a criminal complaint
- [Pennsylvania Homeowner's Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-homeowners-insurance-fraud-sentencing/) - On October 21, 2025, from a Negotiated Guilty plea to Insurance Fraud and Conspiracy, Kathryn B. Hansen of Telford, PA was sentenced to 18 months probation and ordered to pay a $400 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs of $1,786.25. On May 27, 2025, detectives of the Bucks County
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-7/) - On October 16, 2025, Danielle L. Watkins of Harrisburg, PA pleaded Guilty to Insurance Fraud and Attempted Theft by Deception and was sentenced to 12 months probation, ordered to pay a $50 fine and court costs of $1,646.75. On September 18, 2024, Office of Attorney General special agents arrested Watkins and charged her with Insurance
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-6/) - On October 16, 2025, Terry L. Moore of Harrisburg, PA pleaded Guilty to Insurance Fraud and Attempted Theft by Deception and was sentenced to 18 months probation and ordered to pay $100 in fines and court costs of $1,061.75. On June 5, 2025, Office of Attorney General special agents arrested Moore and charged her with
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-5/) - On October 16, 2026, from a Negotiated Guilty plea to Attempted Theft by Deception, Eduardo J. Fresneda of Reading, PA was sentenced to two years probation, was ordered to pay a $250 fine, $4,772.43 in restitution and court costs of $985.35. On June 6, 2025, Office of Attorney General special agents arrested Fresneda and charged
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-4/) - On October 16, 2025, Destinee M. Bitler of Danville, PA pleaded Guilty to Attempted Theft by Deception and was sentenced to two years probation, ordered to pay $500 in fines and court costs of $822.75. On May 12, 2025, Office of Attorney General special agents arrested Thomas Mensh of Bloomsburg, PA and Bitler of Danville,
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-3/) - On October 14, 2025, Rahinier A. Paulino of Bronx, NY pleaded Guilty to multiple charges and was sentenced to 23 months confinement and ordered to pay $300,424.45 in restitution and court costs of $1,194.25. On October 2, 2024, detectives of the Bucks County District Attorney’s Office received a case for prosecution regarding six criminal complaints
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing-2/) - On October 14, 2025, from a Negotiated Guilty plea to Insurance Fraud, Phyllis Michaluk of Philadelphia, PA was sentenced to two years probation and ordered to pay $2,000 in restitution and court costs of $1,061.74. On May 5, 2025, detectives of the Bucks County District Attorney's Office filed a criminal complaint charging Michaluk with Insurance
- [Pennsylvania Auto Insurance Fraud Sentencing](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-sentencing/) - On October 8, 2025, Kenneth Torres of Philadelphia, PA pleaded Guilty to Forgery, Conspiracy and several other chargesand was sentenced to three months confinement and two years probation and ordered to pay $12,525 in fines andcourt costs of $5,084.57. On July 13, 2020, authorities filed criminal charges in Dauphin County against Torres and severalothers stemming
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-52/) - On December 29,2025, detectives of the Erie Police Department filed a criminal complaint charging 20 year old Joseph C. Peeples of Erie, PA with Insurance Fraud. According to the complaint, Peeples obtained an auto insurance policy withProgressive Insurance on September 26, 2025, at 7:51 AM to insure his 2017 Chevy Silverado. Subsequently, at 8:26AM, Peeples
- [Pennsylvania Arrest for False Billing Practices](https://insurancefraud.org/news_archives/pennsylvania-arrest-for-false-billing-practices/) - On December 17, 2025, detectives of the Delaware County District Attorney’s Office arrested 53 year old JosephCasterioto of Drexel Hill, PA and charged him with one count each of Insurance Fraud, Criminal Use of CommunicationFacility and Receiving Stolen Property and two counts of Theft by Deception. According to the criminal complaint, it isalleged that Casterioto,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-51/) - On December 15, 2025, detectives of the York County District Attorney’s Office filed a criminal complaint charging 30 year old Michael J. Martinez of York, PA with Insurance Fraud. According to the complaint, on August 26, 2025, Martinez’svehicle was involved in an accident while being driven by his partner. Martinez later filed an application for
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-50/) - On December 12, 2025, detectives of the Allegheny County Police Department filed a criminal complaint charging 38 year old Derrick D. Taylor of Pitcairn, PA with Insurance Fraud. According to the complaint, on December 16, 2024, Taylor reported to Nationwide Insurance that his parked and unattended vehicle was struck by a phantom vehicle, causing damage.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-49/) - On December 10, 2025, detectives of the Allegheny County District Attorney’s Office assisted in the arrest of 56 year old Heidi L. Shaffer of Coraopolis, PA, who was charged with Insurance Fraud and False Reports. According to the criminal complaint, Shaffer reported her vehicle stolen to the police on August 18, 2025, claiming it was
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-48/) - On December 9, 2025, detective of the Philadelphia District Attorney's Insurance Fraud Unit arrested 30 year old Ashley M. English and 31 year old Jaquan E. Jones, each of Philadelphia, PA and charged both with Insurance Fraud, Attempted Theft by Deception and Conspiracy. According to the criminal complaint, on March 8, 2024, at 5:44 PM,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-47/) - On December 8, 2025, detectives of the Lehigh County District Attorney’s Office filed a criminal complaint charging 27 year old Henry A. Acevedo Roque of Allentown, PA with Insurance Fraud. According to the complaint, the defendant filed a claim with GEICO Insurance on October 18, 2025, at 9:03 AM stating that his vehicle was hit
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-46/) - On December 8, 2025, detectives of the Erie Police Department filed a criminal complaint charging 38 year old Jennifer L. Tingley of Erie, PA with Insurance Fraud. According to the complaint, it is alleged that Tingley claimed to AIC Insurance she had been the driver of her vehicle when an accident occurred; however, an investigation
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-45/) - On December 8, 2025, detectives of the Erie Police Department filed a criminal complaint charging 29 year old Arianna M. Jeffress of Erie, PA with Insurance Fraud and False Reports. According to the complaint, on May 24, 2025, a hit and run reportedly occurred involving Jeffress’s vehicle and another vehicle that was parked. Jeffress filed
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-44/) - On December 5, 2025, detectives of the Allegheny County Police Department filed a criminal complaint charging 50 year old Robert J. Lagorio of Pittsburgh, PA with Insurance Fraud. According to the complaint, Lagorio’s GEICO Insurance auto policy was canceled on September 12, 2025, due to nonpayment, and he reinstated the policy on September 18, 2025.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-43/) - On December 4, 2025, detectives of the Allegheny County District Attorney’s Office arrested 34 year old Eric Zazuba of Pittsburgh, PA and charged him with two counts of Insurance Fraud. According to the criminal complaint, on July 12, 2025, a Mitsubishi Outlander owned by Zazuba’s brother was involved in an accident with a parked Nissan
- [Pennsylvania Renter's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-42/) - On December 3, 2025, detectives of the Delaware County District Attorney’s Office arrested 30 year old Ceyaira Smith of Drexel Hill, PA and charged her with Insurance Fraud and Criminal Use of Communication Facility. According to the criminal complaint, Smith purchased a renter’s policy with Lemonade Insurance on October 4, 2025, and, on October 5,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-41/) - On December 1, 2025, detectives of the Delaware County District Attorney’s Office arrested 29 year old Dylan C. Stephano of Glenolden, PA and charged him with Insurance Fraud. According to the criminal complaint, on August 8, 2025, Stephano obtained an auto insurance policy with Progressive Insurance. On August 26, 2025, Stephano filed a claim reporting
- [Pennsylvania Arrest for Staged Slip-and-Fall](https://insurancefraud.org/news_archives/pennsylvania-arrest-for-staged-slip-and-fall/) - On November 26, 2025, detectives of the York County District Attorney’s Office filed a criminal complaint charging 64 year old Keith A. Redman of Harrisburg, PA with Insurance Fraud. According to the complaint, Redman retained an attorney to file a slip-and-fall claim on his behalf to Erie Insurance. Erie Insurance insures the Smoke and Chill
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-40/) - On November 25, 2025, detectives of the Bucks County District Attorney’s Office filed a criminal complaint charging 41 year old Einar B. Rorvik of Warminster, PA with two counts of Insurance Fraud and one count each of Arson, Criminal Use of Communication Facility, Theft by Deception and Defiant Trespass. According to the complaint, on September
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-39/) - On November 24, 2025, Office of Attorney General special agents arrested 30 year old Adam J. Winter of West Pittsburg, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on December 5, 2024, Winter’s Permanent General Insurance (PGI) automobile policy was canceled. On February 3, 2025, at
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-38/) - On November 24, 2025, Office of Attorney General special agents arrested 36 year old Jefferson Arias of Pittsburgh, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on January 22, 2025, at approximately 5:09 PM, Arias added a 2006 Chevrolet Colorado to his active Progressive Insurance Company
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-37/) - On November 21, 2025, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 41 year old Steven N. Owens of Philadelphia, PA and charged him with Insurance Fraud, Forgery, Theft by Unlawful Taking, Theft Receiving Stolen Property, Unauthorized Use of Auto and Securing Execution of Documents. According to the criminal complaint, on April 17,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-36/) - On November 20, 2025, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 45 year old Tiffany J. Thompson of Philadelphia, PA and charged her with Insurance Fraud, Attempted Theft by Deception and Forgery. According to the criminal complaint, on June 23, 2023, Thompson filed a water damage claim with Allstate Insurance alleging that
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-35/) - On November 20, 2025, detectives of the York County District Attorney’s Office filed a criminal complaint charging 31 year old Jim F. Hidlago Mori, address unknown, with Insurance Fraud. According to the complaint, it is alleged that the defendant filed a claim with Progressive Insurance for damage that was present prior to obtaining a Progressive
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-34/) - On November 20, 2025, detectives of the Allegheny County Police Department filed a criminal complaint charging 33 year old Armstead T. Williams of Penn Hills, PA with Insurance Fraud. According to the complaint, it is alleged that when Williams filed an accident claim with Erie Insurance, he claimed damage that was preexisting to his vehicle
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-33/) - On November 19, 2025, detectives of the Lehigh County District Attorney’s Office filed a criminal complaint charging 55 year old Matthew P. Macus of Allentown, PA with Insurance Fraud. According to the complaint, it is alleged that when Macus applied for a Progressive Insurance auto policy that he failed to add his daughter on the
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-32/) - On November 19, 2025, detectives of the Allegheny County District Attorney's Office assisted in the arrest of 28 year old Mykea S. Allen of Natrona Heights, PA who was charged with Insurance Fraud and False Reports. According to the criminal complaint, it is alleged that Allen attempted to defraud her insurance company, Agency Insurance Company
- [Pennsylvania Auto and Homeowner's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-and-homeowners-insurance-fraud-arrest/) - On November 19, 2025, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 43 year old Vincent T. Howell of Philadelphia, PA and charged him with Insurance Fraud, Attempted Theft by Deception and False Reports. According to the criminal complaint, on July 12, 2024, Howell filed a claim with Liberty Mutual Insurance alleging that
- [Pennsylvania False Injury Claim Arrest](https://insurancefraud.org/news_archives/pennsylvania-false-injury-claim-arrest/) - On November 18, 2025, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 22 year old Quimere L. Jackson of Philadelphia, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on October 30, 2024, Jackson filed a personal injury claim against the Southeastern Transportation Authority (SEPTA)
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-31/) - On November 14, 2025, detectives of the Allegheny County District Attorney's Office assisted in the arrest of 30 year old Denis Pavlov of Pittsburgh, PA who was charged with Insurance Fraud. According to the criminal complaint, Pavlov was involved in a two vehicle crash that was nonreportable, but Pavlov and the other involved party exchanged
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-30/) - On November 13, 2025, detectives of the Allegheny County District Attorney’s Office assisted in the arrest of 29 year old London M. Reese Scaife of Pittsburgh, PA. The defendant was charged with two counts of Insurance Fraud. According to the criminal complaint, on July 4, 2025, the defendant purchased a GEICO Insurance auto policy. Prior
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-29/) - On November 12, 2025, Office of Attorney General special agents arrested 26 year old Joseph M. Szuchon of Erie, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, Szuchon had a First Acceptance Insurance/HUGO Insurance auto policy that canceled on December 28, 2024. On January 21, 2025,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-27/) - On November 7, 2025, detectives of the York County District Attorney's Office filed a criminal complaint charging 50 year old Milena Ascencio of York, PA with Insurance Fraud. According to the complaint, it is alleged that Ascencio failed to disclose that her son, who had a valid driver's license, resided with her, was coowner of
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-26/) - On November 5, 2025, Office of Attorney General special agents arrested 62 year old Blythe Smith of Cranberry Township, PA and charged him with Insurance Fraud, Theft by Deception and Tamper with Records. According to the criminal complaint, on February 14, 2025, Smith was involved in a three vehicle accident while driving his 2023 Chrysler
- [Pennsylvania Pet Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-pet-insurance-fraud-arrest/) - On November 5, 2025, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 43 year old Jaclyn B. Krinick of Philadelphia, PA and charged her with Insurance Fraud, Forgery and Attempted Theft by Deception. According to the criminal complaint, on September 6, 2023, Krinick filed a claim with Nationwide Insurance and submitted an invoice
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-25/) - On November 3, 2025, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging 31 year old Marissa K. Smith of Clifford Township, PA with Criminal Mischief. According to the complaint, it is alleged that Smith filed a fraudulent insurance claim with Progressive Insurance in 2025, falsely stating that her vehicle
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-23/) - On October 30, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 29 year old Autumn Carlton Wise of Philadelphia, PA and charged her with two counts of Insurance Fraud and one count of Forgery. According to the criminal complaint, on November 6, 2024, the defendant was involved in a vehicle crash and
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-22/) - On October 30, 2025, detectives of the Delaware County District Attorney's Office arrested 45 year old Oliver Hawkins of Philadelphia, PA and charged him with Insurance Fraud, Conspiracy and False Reports. According to the criminal complaint, on December 29, 2025, a Southeastern Pennsylvania Transportation Authority (SEPTA) trolley collided with a parked vehicle in Darby, PA.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-21/) - On October 29, 2025, Office of Attorney General special agents arrested 50 year old Jennifer K. Grant of Galeton, PA and charged her with Insurance Fraud, Attempted Theft by Deception and Forgery. According to the criminal complaint, on October 16, 2024, Grant obtained a liability policy from Progressive Insurance Company for her 2015 Ford Taurus.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-20/) - On October 29, 2025, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging 44 year old Natalie Rios of Long Pond, PA with Insurance Fraud. According to the complaint, it is alleged that Rios provided a fictitious financial responsibility identification insurance card of Erie Insurance to Auto4Sale as proof of
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-19/) - On October 28, 2025, Office of Attorney General special agents arrested 32 year old Rebecca E. Zook of Harrisburg, PA and charged her with Insurance Fraud, Attempted Theft by Deception and Criminal Use of Communication Facility. According to the criminal complaint, the Progressive Group of Insurance Company (PGIC) rescinded Zook’s vehicle policy on August 29,
- [Pennsylvania Homeowner's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-homeowners-insurance-fraud-arrest-3/) - On October 27, 2025, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a criminal complaint charging 42 year old Cherie Birchard of Brackney, PA with Insurance Fraud and False Reports. According to the complaint, Birchard allegedly made false statements to Erie Insurance regarding a homeowners insurance claim filed by her husband for stolen
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-18/) - On October 27, 2025, Office of Attorney General special agents arrested 46 year old Corey J. Bloom of DuBois, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, at 7:50 PM on June 9, 2025, Bloom reinstated the lapsed GEICO Insurance Company policy covering his 2014 Subaru
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-17/) - On October 27, 2025, Office of Attorney General special agents arrested 27 year old Cheo M. Houston of Philadelphia, PA and charged him with two counts of Insurance Fraud and one count each of Attempted Theft by Deception and Criminal Use of Communication Facility. According to the criminal complaint, at 12:08 PM on Tuesday, December
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-16/) - On October 24, 2025, detectives of the Allegheny County Police Department filed a criminal complaint charging 33 year old Blake T. Wilson of Pittsburgh, PA with Insurance Fraud. According to the complaint, it is alleged that Wilson purchased an auto policy with Progressive Insurance after she was involved in an accident. Wilson reportedly filed a
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-15/) - On October 23, 2025, detectives of the Bucks County District Attorney's Office filed a criminal complaint charging 40 year old Jessica A. Voros of Philadelphia, PA with Insurance Fraud. According to the complaint, it is alleged that Voros was involved in an auto accident prior to obtaining a Progressive Insurance auto policy and that Voros
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-14/) - On October 23, 2025, Office of Attorney General special agents arrested 24 year old Christopher A. Harger of Titusville, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on May 2, 2025, Harger obtained a Progressive Insurance Company policy for his 2023 Kia Forte. Later on May
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-13/) - On October 23, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 37 year old Mia Bishop of Philadelphia, PA and charged her with three counts of Insurance Fraud and Forgery, two counts of Theft by Deception and one count of Attempted Theft by Deception. According to the criminal complaint, on March 20,
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-12/) - On October 22,2025, Office of Attorney General special agents arrested 27 year old Asia D. Harris of Pittsburgh, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on January 26, 2025, Harris added comprehensive coverage with a $250.00 deductible to her existing Progressive Insurance Company policy covering
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-11/) - On October 21, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 52 year old Ralph Stewart of Philadelphia, PA and charged him with Insurance Fraud, Theft by Deception and Conspiracy. According to the criminal complaint, Stewart was arrested based off a referral from the District Attorney's Dangerous Drug Offender Unit (DDOU). DDOU
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-10/) - On October 21, 2025, detectives of the Delaware County District Attorney's Office arrested 48 year old Tanesha Pinkney of Wilmington, DE and charged her with Insurance Fraud. According to the criminal complaint, it is alleged that Pinkney filed a hit and run claim with Goko Advantage Insurance involving her vehicle on June 20, 2025, and
- [Pennsylvania Renter's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-renters-insurance-fraud-arrest/) - On October 21, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 41 year old Shelby T. Kane of Philadelphia, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on September 25, 2023, Kane obtained a renter's policy for her residence with State Farm Insurance.
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-9/) - On October 17, 2025, detectives of the Lehigh County District Attorney's Office filed a criminal complaint charging 31 year old Christian Pagan-Colon of Allentown, PA with Insurance Fraud. According to the complaint, it is alleged that Pagan-Colon knowingly attempted to defraud Glacier Insurance by reporting a claim for a crash that occurred on February 20,
- [Pennsylvania Homeowner's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-homeowners-insurance-fraud-arrest-2/) - On October 16, 2025, Office of Attorney General special agents arrested 37 year old Damian M. Fitterling of Bernville, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on April 10, 2023, Fitterling purchased a homeowner’s policy from State Farm Insurance Company. On May 14, 2023, at
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-8/) - On October 16, 2025, detectives of the PA State Police and Allegheny County District Attorney's Office arrested 30 year old Clarence C. Willis of Homestead, PA and charged him with Insurance Fraud. According to the criminal complaint, Willis allegedly provided false information to Gainsco Auto Insurance regarding an auto accident involving his vehicle. Reportedly, Willis
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-7/) - On October 10, 2025, Office of Attorney General special agents arrested 52 year old Melanie S. Ratcliffe of Lebanon, PA and charged her with two counts of Insurance Fraud and one count of Attempted Theft by Deception. According to the criminal complaint, on November 20, 2024, at 7:30 PM, Ratcliffe obtained a Progressive Insurance Company
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-6/) - On October 10, 2025, detectives of the Allegheny County Police Department filed a criminal complaint charging 26 year old Dorion A. Bowie of Pittsburgh, PA with two counts of Insurance Fraud. According to the complaint, it is alleged that Bowie purchased a GEICO Insurance auto policy after he had been involved in a crash. Bowie
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-5/) - On October 8, 2025, detectives of the Lehigh County District Attorney's Office filed a criminal complaint charging 18 year old Caden J. Wilson of Breinigsville, PA with Insurance Fraud. According to the complaint, Wilson filed an accident claim with Erie Insurance stating that his tire blew and caused him to crash into a barrier; however,
- [Pennsylvania Theft By Deception Arrest](https://insurancefraud.org/news_archives/pennsylvania-theft-by-deception-arrest/) - On October 8, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 56 year old Georgeanna L. Johnson of Philadelphia, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on September 9, 2024, Johnson was on a Southeastern Pennsylvania Transportation Authority (SEPTA) bus when the
- [Pennsylvania Homeowner's Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-homeowners-insurance-fraud-arrest/) - On October 8, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 30 year old Gregory Lurik of Philadelphia, PA and charged him with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on August 2, 2023, Lurik obtained a homeowners policy from Liberty Mutual Insurance. On the application, Lurik
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-4/) - On October 7, 2025, detectives of the Bucks County District Attorney's Office filed a criminal complaint charging 56 year old Dario Nestor of Bronx, NY with Insurance Fraud. According to the complaint, it is alleged that Nestor misrepresented his residential address as 1701 Newport Rd., Croydon, PA to Glacier Insurance, to obtain a lower insurance
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-3/) - On October 7, 2025, detectives of the Bucks County District Attorney's Office filed a criminal complaint charging 61 year old Vladimir Borodyanskiy of Feasterville Trevose, PA with two counts of Insurance Fraud and one count each of Theft by Deception and Receiving Stolen Property. According to the complaint, Borodyanskiy submitted a claim to Erie Insurance
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-2/) - On October 7, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 32 year old Balvin Green of Philadelphia, PA and charged him with Insurance Fraud, Theft by Deception and Conspiracy. According to the criminal complaint, the District Attorney's Insurance Fraud Unit received a referral from the Dangerous Drug Offender Unit regarding an
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-fraud-arrest/) - On October 5, 2025, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested 34 year old Falieca Wilkens-Harvey of Philadelphia, PA and charged her with Insurance Fraud and Attempted Theft by Deception. According to the criminal complaint, on September 4, 2025, the defendant obtained a Liberty Mutual Insurance auto policy and subsequently, on September
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/auto-insurance-fraud-arrest-philadelphia/) - On October 2, 2025, Office of Attorney General special agents arrested 39 year old Jacqueline Hall of Philadelphia, PAand charged her with Insurance Fraud, Attempted Theft by Deception and Criminal Use of Communication Facility. Accordingto the criminal complaint, on January 30, 2023, Jaqueline Hall went online and bought a new automobile policyfrom the Progressive Insurance
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest/) - On October 4, 2025, detectives of the Delaware County District Attorney's Office arrested 30 year old Marissa L. Laird of Marcus Hook, PA and charged her with Insurance Fraud. According to the criminal complaint, Laird was involved in a vehicle accident on June 14, 2025, and allegedly presented a fraudulent Omni Insurance declaration page to
- [Pennsylvania Auto Insurance Fraud Arrest](https://insurancefraud.org/news_archives/201644/) - On October 1, 2025, detectives of the York County District Attorney's Office filed a criminal complaint charging 48 year old Jennifer R. Thomason of Hanover, PA with Insurance Fraud and Attempted Theft by Deception. According to thecomplaint, on August 6, 2025, Thomason contacted Progressive Insurance and reportedly explained that she hadpulled into her driveway and
- [Whitehall man charged for providing fraudulent insurance activities without a license](https://insurancefraud.org/news_archives/pennsylvania-identity-theft-and-insurance-fraud-arrest/) - The Allegheny County Attorney General’s Office recently announced that a man from Whitehall is facing multiple felony charges for allegedly conducting fraudulent insurance activities without a valid license. Forty-four-year-old Charles Harris has charges of identity theft, insurance fraud, fraudulent business practices and unlicensed activity, and five counts of forgery. These charges stem from allegations that
- [Fugitive arrested in vehicle ‘title-washing’ ring that operated in Berks, Lehigh](https://insurancefraud.org/news_archives/pennsylvania-auto-insurance-fraud-arrest-24/) - The leader of a vehicle title-washing ring that operated in Pennsylvania — including in Berks and Lehigh counties — has been arrested in Mexico, state officials said. Anthony E. Troncoso, 42, was charged in August and remained a fugitive until his recent arrest in Mexico City, Attorney General Dave Sunday said. A grand jury charged
- [GEICO sues pharmacy, healthcare providers over alleged $6 million PIP fraud](https://insurancefraud.org/news_archives/geico-sues-pharmacy-healthcare-providers-over-alleged-6-million-pip-fraud/) - On February 5, 2026, GEICO filed two separate federal lawsuits in New York and Florida, alleging fraud schemes that together extracted more than $6 million from the no-fault insurance system. The twin filings - one targeting a pharmacy, the other a network of healthcare providers - offer a revealing look at how insurers allege fraudsters
- [Pennsylvania sets April 16 deadline for workers' compensation data call](https://insurancefraud.org/news_archives/pennsylvania-sets-april-16-deadline-for-workers-compensation-data-call/) - The Pennsylvania Insurance Department published a notice in the Pennsylvania Bulletin dated Saturday, February 7, 2026 (filed for public inspection February 6, 2026, at 9:00 a.m.) announcing its annual workers’ compensation Special Schedule “W” data call under section 655 of The Insurance Company Law of 1921 (40 P.S. § 815): Insurance companies writing workers’ compensation
- [Suspect in series of San Jose vehicle arsons arrested](https://insurancefraud.org/news_archives/suspect-in-series-of-san-jose-vehicle-arsons-arrested/) - A man suspected of setting multiple vehicles on fire in San Jose last month was arrested, police said on Monday. The San Jose Police Department identified the suspect in a press release as 30-year-old unhoused San Jose resident Jose Rodriguez-Barragan. He is believed to have started about five car fires on January 21 and about
- [AI is helping banks save millions by transforming payment fraud prevention](https://insurancefraud.org/news_archives/ai-is-helping-banks-save-millions-by-transforming-payment-fraud-prevention/) - AI’s double-edged impact on payment fraudThe estimated global financial impact of fraud grew to more than $485 billion in 2023[1] — a staggering number that is expected to grow in years ahead. One catalyst? Fraudsters are using gen AI to rapidly produce convincing deepfakes, synthetic voices and forged documents to run social engineering scams at
- [What Optum found in probe of 14 Medicaid programs possibly vulnerable to fraud](https://insurancefraud.org/news_archives/what-optum-found-in-probe-of-14-medicaid-programs-possibly-vulnerable-to-fraud/) - The State of Minnesota on Friday released the first findings from an investigation by third-party company Optum into potential fraud vulnerabilities in state-run Medicaid programs. Optum was commissioned by Gov. Tim Walz to analyze 14 Medicaid programs at "high-risk" of potential fraud this past October, coming in the years after the $250 million Feeding Our
- [Investigation finds Blackfoot man created 20 fake insurance policies](https://insurancefraud.org/news_archives/investigation-finds-blackfoot-man-created-20-fake-insurance-policies/) - An investigation by the Idaho Department of Insurance led to 11 felony counts of insurance fraud against a Blackfoot man. Reuel Burton Christensen, 54, pleaded not guilty to the charges alleged to have occurred between Nov. 4, 2021, and May 18, 2022, according to court documents. The fraud investigator determined that Christensen created unauthorized insurance
- [DOJ Criminal Fraud Section 2025 Year in Review – Health Care Fraud Is Front and Center](https://insurancefraud.org/news_archives/doj-criminal-fraud-section-2025-year-in-review-health-care-fraud-is-front-and-center/) - On January 22, 2026, the Department of Justice (DOJ or the Department) Criminal Fraud Section issued its 2025 Year in Review summary (YIR Summary). Our more detailed analysis of the full YIR Summary can be found here. DOJ’s Health Care Fraud Unit (the HCF Unit) is focused on “prosecuting complex health care fraud matters and
- [DHS Audit: $1 billion in Medicaid funding vulnerable to fraud](https://insurancefraud.org/news_archives/dhs-audit-1-billion-in-medicaid-funding-vulnerable-to-fraud/) - A third-party audit of the Minnesota Department of Human Services (DHS) identified more than $1 billion in Medicaid funding that may be vulnerable to waste, fraud and abuse. What we know: DHS released the initial findings from an ongoing external audit of how the state is processing Medicaid claims. The audit is being conducted by
- [Tighter Enforcement Driving Rising Auto Insurance Fraud Numbers, Experts Say | Insurify](https://insurancefraud.org/news_archives/tighter-enforcement-driving-rising-auto-insurance-fraud-numbers-experts-say-insurify/) - Insurance fraud cases are increasing nationwide. But the higher number is likely due to stronger enforcement and better detection rather than just more crime, experts say. The Virginia State Police's Stamp Out Fraud program, for example, reported a 72% increase in investigations from 2024 to 2025. This whopping year-over-year jump seems to support insurers' and
- [SLED says Anderson woman used altered Louis Vuitton receipt in false insurance claim](https://insurancefraud.org/news_archives/sled-says-anderson-woman-used-altered-louis-vuitton-receipt-in-false-insurance-claim/) - A 21-year-old woman in Anderson has been charged after the South Carolina Law Enforcement Division says she used an altered Louis Vuitton receipt in a false insurance claim. According to an arrest warrant, on or about March 25, 2025, Timya Rai Davis submitted a false claim for insurance payment to State Farm Fire and Casualty
- [Insurance Company Alleges Fraud Scheme Against Legal Firm and Medical Providers](https://insurancefraud.org/news_archives/insurance-company-alleges-fraud-scheme-against-legal-firm-and-medical-providers/) - Greater New York Mutual Insurance Company has filed a comprehensive lawsuit against multiple defendants, alleging an elaborate fraudulent scheme designed to exploit the insurance system. The complaint was lodged in the United States District Court for the Eastern District of New York on January 27, 2026, targeting entities and individuals including Liakas Law, P.C., Dean
- [Minnesota DHS announces development of enhanced Medicaid prepayment review system](https://insurancefraud.org/news_archives/minnesota-dhs-announces-development-of-enhanced-medicaid-prepayment-review-system/) - In a press conference Friday afternoon, Minnesota Department of Human Services announced it is creating an enhanced prepayment system of processing the state’s Medicaid claims. According to Minnesota DHS Deputy Commissioner and State Medicaid Director John Connolly, this is to prevent and disrupt fraudulent billing in the state. “It’s a complex task that takes a
- [Alabama, NC Public Safety Officers Investigated in ‘Chop Shop,’ Disability Fraud](https://insurancefraud.org/news_archives/alabama-nc-public-safety-officers-investigated-in-chop-shop-disability-fraud/) - Fraud investigations in two Southeastern states have led to the arrest or administrative leave for three public safety officers. In Alabama, two University of Alabama at Birmingham police officers have been placed on leave in connection with an investigation into stolen vehicles, according to local news reports. The investigation is examining the use of National
- [New Jersey Once Again Demonstrates How Nursing Home Enforcement Should Be Done](https://insurancefraud.org/news_archives/new-jersey-once-again-demonstrates-how-nursing-home-enforcement-should-be-done/) - The New Jersey Office of the State Comptroller (OSC) has engaged in a thoughtful, deliberative process to evaluate nursing home care in the state and to remove from nursing home ownership the owners that provide the poorest quality care to residents. In a 2022 report, An Examination of the Lowest-Rated Long Term Care Facilities Participating
- [Attorney General Hanaway Obtains Medicaid Fraud Conviction For Services Not Provided](https://insurancefraud.org/news_archives/attorney-general-hanaway-obtains-medicaid-fraud-conviction-for-services-not-provided/) - Today, Attorney General Catherine Hanaway announced that her Medicaid Fraud Control Unit (MFCU) obtained a Medicaid Fraud conviction against Elizabeth Oker, who received payment after submitting false time records to Medicaid for personal care services she did not actually provide to two Medicaid recipients. “Stealing Medicaid funds alone is egregious, but depriving patients of much-needed
- [Drummond continues fight for Oklahoma homeowners in State Farm response](https://insurancefraud.org/news_archives/drummond-continues-fight-for-oklahoma-homeowners-in-state-farm-response/) - Attorney General Gentner Drummond filed a response yesterday opposing State Farm Fire and Casualty Company’s petition asking the Oklahoma Supreme Court to block his intervention to protect Oklahoma homeowners. The filing includes a letter from Oklahoma Insurance Commissioner Glen Mulready formally requesting Drummond’s continued investigation, intervention and prosecution in Hursh v. State Farm et al.
- [Axle and Experian partner to boost auto fraud detection](https://insurancefraud.org/news_archives/axle-and-experian-partner-to-boost-auto-fraud-detection/) - Axle, a provider of a universal API for insurance data, has announced a strategic collaboration with Experian, a global data and technology leader, to integrate real-time automotive insurance verification into Experian’s Fraud Protect platform. The partnership is designed to strengthen fraud prevention across the automotive retail and lending ecosystem, according to FF News. By embedding
- [Medicare launches pilot program using AI to approve or deny treatment claims](https://insurancefraud.org/news_archives/medicare-launches-pilot-program-using-ai-to-approve-or-deny-treatment-claims/) - Medicare has launched a six-year pilot program that could eventually transform access to health care for some of the millions of people across the U.S. who rely on it for their health insurance coverage. Traditional Medicare is a government-administered insurance plan for people over 65 or with disabilities. About half of the 67 million Americans
- [New York’s runaway $115B Medicaid ‘gravy train’ needs oversight in light of Minnesota fraud, critics charge](https://insurancefraud.org/news_archives/new-yorks-runaway-115b-medicaid-gravy-train-needs-oversight-in-light-of-minnesota-fraud-critics-charge/) - After billions in Medicaid money was stolen by fraudsters in Minnesota, all eyes are on New York — where spending on health programs is set to top $115 billion in 2026. Although New York spends more on Medicaid than Florida and Texas — both with much higher populations — there is no public oversight of
- [Greg Lindberg ordered to pay $526 million to defrauded carriers](https://insurancefraud.org/news_archives/greg-lindberg-ordered-to-pay-526-million-to-defrauded-carriers/) - Former insurance executive Greg Lindberg, who built a conglomerate of more than 100 companies before his empire collapsed amid fraud allegations and a bribery scandal, has been ordered by a North Carolina court to pay $526.2 million to a group of insurers he is accused of defrauding. The judgment from the Wake County Superior Court
- [Kansas City couple sentenced for $38K Medicaid fraud scheme](https://insurancefraud.org/news_archives/kansas-city-couple-sentenced-for-38k-medicaid-fraud-scheme/) - A Kansas City couple will pay nearly $43,000 in restitution after lying about their marriage to steal Medicaid funds meant for in-home care. Court records show that Tarron Boone, 44, and Yvonne Davis-Boone, 35, repeatedly misrepresented their relationship to enroll in Missouri’s Consumer Directed Services program. According to Missouri Attorney General Catherine Hanaway, who announced
- [Lawmakers target insurance fraud loopholes](https://insurancefraud.org/news_archives/lawmakers-target-insurance-fraud-loopholes/) - Insurance fraud costs Washington consumers millions every year — and under current law, many sophisticated schemes can go unpunished. One example: a driver crashes a car, waits a few days, buys insurance and files a claim as if the accident happened after the policy began. Today, that deception may never be charged as a stand-alone
- [Metairie insurance agency charged with fraud](https://insurancefraud.org/news_archives/metairie-insurance-agency-charged-with-fraud/) - A Metairie insurance agency is set to refund over $1.2 million in premium payments after charging customers unlawful excess fees. Alexander Ellsworth and his agency, Ellsworth Corporation is accused of unlawfully quoting construction companies on surety bonds they must have before building. These actions follow a cease-and-desist order and notice of revocation and fine issued
- [Brooklyn Banker Pleads Guilty to Laundering Proceeds of Medicare Fraud for Transnational Criminal Organization](https://insurancefraud.org/news_archives/brooklyn-banker-pleads-guilty-to-laundering-proceeds-of-medicare-fraud-for-transnational-criminal-organization/) - A New York man pleaded guilty today to participating in a scheme to launder more than $8 million in health care fraud proceeds through a U.S. bank on behalf of a transnational criminal organization (TCO). This marks the first time the Health Care Fraud Unit has charged and convicted a former bank employee for conspiring
- [DOJ Announces All-Time High in False Claims Act Recoveries: Healthcare Providers, Government Contractors in the Crosshairs](https://insurancefraud.org/news_archives/doj-announces-all-time-high-in-false-claims-act-recoveries-healthcare-providers-government-contractors-in-the-crosshairs/) - The Department of Justice (DOJ) has announced that False Claims Act (FCA) settlements and judgments exceeded $6.8 billion in fiscal year 2025, marking the largest annual recovery reported in the statute’s history. With a record number of whistleblower qui tam actions and hundreds of new government investigations, FY 2025 was a landmark year for FCA
- [Minnesota to inspect 5,800 Medicaid providers; asking for state workers from other departments to help](https://insurancefraud.org/news_archives/minnesota-to-inspect-5800-medicaid-providers-asking-for-state-workers-from-other-departments-to-help/) - The Minnesota Department of Human Services announced they will begin a “massive statewide push to ensure Medicaid providers in 13 high-risk services have the qualifications required by law.” The Minnesota Department of Human Services is putting out a call across all state agencies asking them to transfer 168 qualified workers to help. They must revalidate
- [NAIC ANNOUNCES 2026 CONSUMER LIAISON REPRESENTATIVES](https://insurancefraud.org/news_archives/naic-announces-2026-consumer-liaison-representatives/) - The following information was released by the National Association of Insurance Commissioners (NAIC): The National Association of Insurance Commissioners (NAIC) recently named 43 consumer liaison representatives for 2026. NAIC Members have long valued the voices of consumer representatives, who provide unique perspectives and insights in the NAIC's proceedings. Regulatory policy work informed by a variety
- [Former NFL Player Convicted for $197M Medicare Fraud](https://insurancefraud.org/news_archives/former-nfl-player-convicted-for-197m-medicare-fraud/) - A federal jury in the Middle District of Florida convicted the owner of a marketing company, and former NFL player, for his role in a yearslong scheme to bilk Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) out of nearly $200 million by selling patient information and sham
- [Man accused of arson after lighting multiple fires at Anchorage Lowe’s](https://insurancefraud.org/news_archives/man-accused-of-arson-after-lighting-multiple-fires-at-anchorage-lowes/) - Anchorage police say a 42-year-old man was arrested after setting multiple fires outside a Lowe’s store on East Tudor Road late Monday, causing thousands of dollars in damage and activating the building’s fire suppression system. According to the Anchorage Police Department, officers were dispatched at about 9:23 p.m. Monday to reports of several small fires
- [Ohio Couple Sentenced for Arson in Profit Scheme to Fraudulently Collect Millions in Insurance Payouts](https://insurancefraud.org/news_archives/ohio-couple-sentenced-for-arson-in-profit-scheme-to-fraudulently-collect-millions-in-insurance-payouts/) - A husband and wife from Willoughby Hills, Ohio, have been sentenced for devising a scheme to collect more than $2 million dollars in insurance money by conspiring to set insured houses on fire. Lonnie White, 48, was sentenced to 53 months (4 years, 4 months) in prison by Chief U.S. District Judge Sara Lioi after
- [Feds allege $3.4 billion Medicare fraud scheme tied to Russian citizen living in Austin](https://insurancefraud.org/news_archives/feds-allege-3-4-billion-medicare-fraud-scheme-tied-to-russian-citizen-living-in-austin/) - Federal authorities say a Texas man helped orchestrate a health care fraud scheme that billed Medicare billions of dollars for medical equipment such as orthotic braces, glucose monitors, urinary catheters and wound dressings that patients often did not need and, in many cases, never received, according to a U.S. District Court criminal complaint uncovered by
- [2 Connecticut men accused of years-long doctor impersonation fraud scheme](https://insurancefraud.org/news_archives/2-connecticut-men-accused-of-years-long-doctor-impersonation-fraud-scheme/) - Two Connecticut men were arrested, including the owner of an East Hartford medical group, after one of his employees allegedly administered services without a license for years to the owner’s knowledge. The owner of Silver Lane Medical Group and Stafford Medical Group, 83-year-old Sultan Quraishi of Glastonbury, and 61-year-old Mohammad Siddiqui of South Windsor, were
- [Ex-Home Affairs employee jailed for funeral insurance fraud](https://insurancefraud.org/news_archives/ex-home-affairs-employee-jailed-for-funeral-insurance-fraud/) - A former Department of Home Affairs employee has been sentenced to an effective five years’ imprisonment for fraud after unlawfully manipulating the National Population Register to submit false funeral insurance claims. Dawn Celeste Pieterson (46) was sentenced on 26 January by the Calvinia Specialised Commercial Crime Court in the Northern Cape. She was convicted on
- [Court-Martial: Kansas airman sentenced for child sex crimes](https://insurancefraud.org/news_archives/court-martial-kansas-airman-sentenced-for-child-sex-crimes/) - A General Court-Martial at McConnell Air Force Base resulted in a conviction on several charges, according to a statement from the base. Senior Airman Randall Moore, 22nd Maintenance Squadron, faced court-martial Jan. 26-Feb. 1 on one charge and two specifications of violating Article 120b of the Uniform Code of Military Justice (UCMJ), sexual abuse of
- [Insurance Fraud Detection Market: Predictive Modeling Driving Market Momentum](https://insurancefraud.org/news_archives/insurance-fraud-detection-market-predictive-modeling-driving-market-momentum/) - Rising fraudulent claims, expanding digital insurance platforms, stricter regulatory requirements, and growing adoption of AI-driven analytics are accelerating demand for advanced, real-time insurance fraud detection solutions. According to IMARC Group's latest research publication, global insurance fraud detection market size reached USD 5.58 Billion in 2024. Looking forward, IMARC Group expects the market to reach USD
- [Rapaport Reappointed as Virginia Workers’ Compensation Commissioner](https://insurancefraud.org/news_archives/rapaport-reappointed-as-virginia-workers-compensation-commissioner/) - The Virginia Workers’ Compensation Commission reappointed Commissioner Robert A. Rapaport to serve an additional six-year term as a commissioner of the Virginia Workers’ Compensation Commission. Rapaport was originally appointed to the commission in 2017. Before his appointment, Rapaport practiced law for 35 years, with a focus on workers’ compensation. His leadership has also extended regionally
- [Lutsen Resort owner Bryce Campbell sues insurer over denied fire claim](https://insurancefraud.org/news_archives/lutsen-resort-owner-bryce-campbell-sues-insurer-over-denied-fire-claim/) - Bryce Campbell and his company, North Shore Resort Co., have filed a lawsuit against insurer, Owners Insurance Co., after it denied a $16.5 million claim following a 2024 fire that destroyed the historic Lutsen Resort lodge. Court records show the lawsuit was filed Jan. 23 in federal court against the Michigan-based insurance company, the same
- [Palm Beach County man pleads guilty to $52M Medicare scheme](https://insurancefraud.org/news_archives/palm-beach-county-man-pleads-guilty-to-52m-medicare-scheme/) - A 38-year-old Palm Beach County man pleaded guilty for his role in a scheme to defraud Medicare by submitting over $52 million in false and fraudulent claims for genetic testing. As part of his plea agreement, Sean Alterman agreed to forfeit his estate and a 2022 Rolls Royce Ghost purchased with money traceable to the
- [Laredo man charged with insurance fraud after false stolen vehicle report](https://insurancefraud.org/news_archives/laredo-man-charged-with-insurance-fraud-after-false-stolen-vehicle-report/) - A Laredo man is facing charges after allegedly filing a false stolen vehicle report. Police say 35-year-old Raymundo Azamar Barba reported his truck stolen at the intersection of Juarez Avenue and Grant Street on Oct. 26, 2025. He told officers he had left a handgun and his children’s social security cards inside the truck. Police
- [Dental office managers plead guilty to Medicaid fraud](https://insurancefraud.org/news_archives/dental-office-managers-plead-guilty-to-medicaid-fraud/) - Two office managers of an Indiana dental office pleaded guilty Jan. 16 to defrauding Medicaid of $365,000, the Chicago Tribune reported. Trystan Arch, 36, and Justyn Arch, 39, previously worked as office managers at Arch Complete Family Dentistry. Justyn Arch, who was also vice president of the practice, managed the Crown Point, Ind., office, while
- [Man charged with arson after Knoxville house fire](https://insurancefraud.org/news_archives/man-charged-with-arson-after-knoxville-house-fire/) - A man is facing a charge of aggravated arson after a house fire in the Beaumont neighborhood of Knoxville, police said Thursday afternoon. Man charged with arson after Knoxville houshttps://www.youtube.com/watch?v=xbTmggDyIiEe fire
- [Oregon Disabling Workers’ Comp Claims Fell in 2024](https://insurancefraud.org/news_archives/oregon-disabling-workers-comp-claims-fell-in-2024/) - Oregon recorded fewer accepted disabling workers’ compensation claims in 2024 even as statewide employment continued to rise, new data from the state’s Department of Consumer and Business Services show. The Oregon Workers’ Compensation Division received 21,749 accepted disabling claims last year, down 1,244 from 2023. Employment grew by 34,800 workers during the same period, keeping
- [Los Angeles hospice fraud reaches billions as Medicare providers scam federal system with fake companies](https://insurancefraud.org/news_archives/los-angeles-hospice-fraud-reaches-billions-as-medicare-providers-scam-federal-system-with-fake-companies/) - Ghost patients, sham companies, offshore owners and corrupt doctors. Auditors and prosecutors say hospice fraud in Los Angeles is off the charts, with providers scamming billions from taxpayers for patients that don't exist, poor care and no care. "Hospice is crazy here," says Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services.
- [TDI Investigations Result in $50M for Fraud Victims](https://insurancefraud.org/news_archives/tdi-investigations-result-in-50m-for-fraud-victims/) - The Texas Department of Insurance (TDI) Fraud Unit this week announced that it contributed to insurance fraud investigations landing $50.9 million in court-ordered restitution in fiscal year 2025. More than 20 TDI investigators working across the state looked into 314 cases of insurance fraud, the department said. After digging into financials and interviewing suspects and
- [South Lubbock house fire leads to arson arrest](https://insurancefraud.org/news_archives/south-lubbock-house-fire-leads-to-arson-arrest/) - A 41-year-old man has been charged with arson after allegedly starting a fire inside a home near 138th & Waco Ave. The Fire Marshal’s Office says a Lubbock County constable was serving an eviction at the residence when the occupant, identified as Roderick Mainda, 41, intentionally started the fire. Lubbock Fire Rescue responded to a
- [Investigators offering reward for information on Youngstown arson](https://insurancefraud.org/news_archives/investigators-offering-reward-for-information-on-youngstown-arson/) - Ohio State Fire Marshal investigators are offering a reward for tips about a Youngstown house fire ruled an arson. According to a release, at around 9 a.m. on Thursday, Youngstown firefighters responded to a house fire at a home in the 2700 block of Griselda Avenue. Firefighters said the front of the home was fully
- [Prosecutors drop charges against contractor in Florida insurance fraud case](https://insurancefraud.org/news_archives/prosecutors-drop-charges-against-contractor-in-florida-insurance-fraud-case/) - When he was arrested on theft and fraud charges in 2023, contractor Ricky McGraw was held up as the poster child for Florida’s crumbling insurance market. McGraw was the “perfect example of the kind of scum” driving up insurance premiums, Florida’s then-Chief Financial Officer Jimmy Patronis said in a news release announcing his arrest. But
- [US health secretary says administration cracking down on health care fraud](https://insurancefraud.org/news_archives/us-health-secretary-says-administration-cracking-down-on-health-care-fraud/) - US Health Secretary Robert F. Kennedy Jr. said Thursday that the Trump administration is intensifying efforts to combat health care fraud and claw back billions of dollars in misused public funds. “We are attacking fraud,” Kennedy said during a Cabinet meeting, pointing to “hundreds of millions of dollars in Medicaid, Medicare fraud in states like
- [4 men arrested, accused of staging crash in Miami: Police](https://insurancefraud.org/news_archives/dairon-palacios/) - Four men are facing charges in connection with what police said was a staged crash in Miami. Dairon Palacios, 18, of West Palm Beach; John Michael Acosta, 21, of Miami; Adriano Prada, 19, of Miami; and Dimas Tomayo, 30, of Hialeah, were arrested on charges including insurance fraud-staged accident, organized scheme to defraud, and providing
- [DOJ Files Lawsuit Against Louisiana Over Alleged Medicare Fraud](https://insurancefraud.org/news_archives/doj-files-lawsuit-against-louisiana-over-alleged-medicare-fraud/) - The Department of Justice (DOJ) has filed a civil complaint under the False Claims Act against Priority Hospital Group (PHG), a Louisiana-based hospital management company, three long-term care hospitals it manages, and a physician, alleging that patients were kept hospitalized longer than medically necessary to increase Medicare reimbursements. Prosecutors also alleged that one facility used
- [Calgary dentist guilty of decade-long insurance fraud handed 3-year sentence](https://insurancefraud.org/news_archives/calgary-dentist-guilty-of-decade-long-insurance-fraud-handed-3-year-sentence/) - Despite an eleventh hour attempt to secure at least a few more weeks of freedom, a Calgary dentist was handed a three-year prison sentence for a decade-long insurance billing fraud. Last year, Alena Smadych pleaded guilty to fraud over $5,000 and admitted to bilking five insurance companies out of nearly $700,000. Before Justice Gord Wong
- [Ashley Moody proposes bill to increase penalties for health care fraud](https://insurancefraud.org/news_archives/ashley-moody-proposes-bill-to-increase-penalties-for-health-care-fraud/) - U.S. Sen. Ashley Moody has introduced a bill to increase penalties for those who engage in health care fraud. Moody’s proposal, the Punishing Health Care Fraudsters Act, is designed to institute harsher fines and prison sentences for those who rip off health care systems and providers. “For too long, the American taxpayer has been abused
- [Doctor Convicted at Trial for Defrauding IRS and Health Care Insurers](https://insurancefraud.org/news_archives/doctor-convicted-at-trial-for-defrauding-irs-and-health-care-insurers/) - A federal jury in Boston, Massachusetts, convicted a medical doctor Tuesday for health care fraud, money laundering, conspiracy to defraud the IRS, and tax evasion. “Over ten years, the defendant hid millions in income from the IRS and defrauded insurers through his medical practice,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s
- [Repeat Health Care Fraud Offender Sentenced for Defrauding New Hampshire Medicaid](https://insurancefraud.org/news_archives/repeat-health-care-fraud-offender-sentenced-for-defrauding-new-hampshire-medicaid/) - A Florida man was sentenced today to one year and one day in prison for causing psychotherapy sessions to be fraudulently billed to New Hampshire Medicaid. According to court documents, Erik X. Alonso, 55, of Miami, Florida, was convicted in 2015 of conspiracy to commit health care fraud and related offenses in the Southern District
- [Man arrested for arson, accused of setting Spring Hill home on fire: HCFR](https://insurancefraud.org/news_archives/man-arrested-for-arson-accused-of-setting-spring-hill-home-on-fire-hcfr/) - A man is behind bars facing an arson charge after investigators say a Spring Hill home was destroyed Saturday after being intentionally set on fire, according to Hernando County Fire Rescue. Shortly before 2:30 p.m., firefighters responded to a report of a house on fire in the 300 block of Peach Tree Drive, HCFR said.
- [Two Women Charged with Health Care Fraud for Allegedly Illegally Providing Medical Services](https://insurancefraud.org/news_archives/two-women-charged-with-health-care-fraud-for-allegedly-illegally-providing-medical-services/) - Acting Attorney General Jennifer Davenport, the Division of Criminal Justice (DCJ), and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that the owner of a health center and one of her employees have been indicted for health care fraud and other related crimes for allegedly illegally performing medical procedures. Esney Davis-Sharpe, 63, of
- [Oregon Mother and Daughter Facing New Charges Related to Forced Labor and Health Care Fraud](https://insurancefraud.org/news_archives/oregon-mother-and-daughter-facing-new-charges-related-to-forced-labor-and-health-care-fraud/) - A grand jury in Oregon yesterday returned a superseding indictment charging a mother and daughter from Tigard, Oregon, with 12-counts of conspiracy to commit health care fraud and forced labor. The indictment alleges that Marie Gertrude Jean Valmont, 67, and Yolandita Marie Andre, 31, coerced the labor and services of three victims, including a minor
- [Willoughby Hills man sentenced for burning 5 homes in insurance fraud](https://insurancefraud.org/news_archives/willoughby-hills-man-sentenced-for-burning-5-homes-in-insurance-fraud/) - A Willoughby Hills man was sentenced to more than four years in prison for burning down five homes in a $2.3 million insurance fraud scheme. Lonnie White, 48, and his wife conspired to buy rental properties, transfer them to someone else and burn them down for the insurance money. U.S. District Judge Sara Lioi on
- [Merchants Insurance Group Files RICO Case to Protect New Yorkers from Widespread Fraud Scheme](https://insurancefraud.org/news_archives/merchants-insurance-group-files-rico-case-to-protect-new-yorkers-from-widespread-fraud-scheme/) - Merchants Insurance Group (Merchants Mutual Insurance Company), headquartered in Buffalo, New York, has filed a federal civil action under the Racketeer Influenced and Corrupt Organizations Act (RICO) to expose and stop an extensive insurance fraud operation targeting New York’s construction industry. The lawsuit, filed on October 20, 2025 by The Willis Law Group, alleges that
- [DOJ will Create a National Fraud Enforcement Division](https://insurancefraud.org/news_archives/doj-will-create-a-national-fraud-enforcement-division/) - This month the White House announced that the United States Department of Justice (DOJ) will establish a new National Fraud Enforcement Division. The White House’s Fact Sheet regarding the initiative reveals a broad scope: bringing criminal and civil actions against “fraud targeting Federal government programs, Federally funded benefits, businesses, nonprofits, and private citizens nationwide.” The
- [Protecting Californians by investigating insurance fraud for 90 years](https://insurancefraud.org/news_archives/protecting-californians-by-investigating-insurance-fraud-for-90-years/) - Working to prevent fraud and support recovery, the California Department of Insurance released an update on consumer protection actions by its Investigation Division. Charged with investigating insurance fraud, unlicensed insurance activity, and misconduct by insurance agents, claims adjusters, and other licensed individuals and entities, the Department is the front-line defense for Californians in the nation’s
- [GEICO sues Florida clinic network alleging $26 million PIP fraud scheme](https://insurancefraud.org/news_archives/geico-sues-florida-clinic-network-alleging-26-million-pip-fraud-scheme/) - GEICO is taking aim at a sprawling network of Florida injury clinics, alleging a more than $26 million PIP fraud operation spanning 14 locations. The auto insurance giant filed a suit on January 22, 2026, in federal court in Miami, accusing the COR Medical Centers chain and telehealth company TeleEMC of running what it describes
- [State alleges Medicaid fraud, seeks $124M in repayments](https://insurancefraud.org/news_archives/state-alleges-medicaid-fraud-seeks-124m-in-repayments/) - A state agency is seeking $124 million in Medicaid repayments from the owners of two New Jersey nursing homes following an investigation into allegations of waste, fraud and abuse at the facilities. New Jersey Acting Comptroller Kevin D. Walsh issued a report in December accusing Daryl Hagler and Kenneth Rozenberg, owners of Hammonton Center and
- [Federal review determines rate of improper payments in Minnesota's Medicaid program is far below national average](https://insurancefraud.org/news_archives/federal-review-determines-rate-of-improper-payments-in-minnesotas-medicaid-program-is-far-below-national-average/) - New federal data released by the U.S. Centers for Medicare & Medicaid Services (CMS) shows the overall rate of improper payment in Minnesota’s Medicaid program is far below national averages. In the review released this week, CMS found an error rate of slightly over 2.1%, compared to a national average of 6.1%. The data for
- [Illinois USPS Employee Indicted for Alleged Workers’ Comp Fraud](https://insurancefraud.org/news_archives/illinois-usps-employee-indicted-for-alleged-workers-comp-fraud/) - A United States Postal Service employee has been indicted on federal fraud charges for allegedly collecting augmented workers’ compensation benefits to which she was not entitled, the U.S. Attorney’s Office, Northern District of Illinois announced last month. Graciela Venegas, 66, began receiving workers’ compensation benefits in 2012 for an injury she sustained in the performance
- [Longtime Alabama Dentist Charged With Insurance Fraud in 2025 Office Explosion](https://insurancefraud.org/news_archives/longtime-alabama-dentist-charged-with-insurance-fraud-in-2025-office-explosion/) - In March of 2025 a well-known dentist’s office exploded in the town of Evergreen, Alabama, near the Florida line. Today, the owner of that office, a dentist described as “very successful” and a “very nice guy,” is in jail, charged with arson and insurance fraud in connection with the explosion and fire. Dr. Douglas P.
- [Traditions Health Agrees to Pay $34M to Resolve False Claims Act Liability Relating to Home Health Services Following Self Disclosure](https://insurancefraud.org/news_archives/traditions-health-agrees-to-pay-34m-to-resolve-false-claims-act-liability-relating-to-home-health-services-following-self-disclosure/) - Traditions Health LLC (Traditions) has agreed to pay $34 million to resolve its civil liability under the False Claims Act for billing medically unnecessary home health claims to Medicare and providing financial benefits to physicians in exchange for referrals. Traditions self-disclosed the conduct at issue to the government. The settlement resolves allegations that, from 2021
- [Plaintiffs Accuse Medical Equipment Providers of Insurance Fraud Scheme](https://insurancefraud.org/news_archives/plaintiffs-accuse-medical-equipment-providers-of-insurance-fraud-scheme/) - A major insurance fraud lawsuit has been filed, aiming to recover over $631,000 allegedly obtained through fraudulent claims. The plaintiffs, Government Employees Insurance Company (GEICO) and its subsidiaries, have brought the case against Altermedic Products Inc., Gezuntmed Products Corp., Mikell Dashevsky, Volodymyr Dovbush, and unnamed defendants in the United States District Court for the Eastern
- [Georgia Chiropractor Convicted Of Healthcare Fraud](https://insurancefraud.org/news_archives/georgia-chiropractor-convicted-of-healthcare-fraud/) - United States Attorney David I. Courcelle announced that STEVEN D. PEYROUX (“PEYROUX”), age 56, of Canton, Georgia, pled guilty on January 15, 2026 to conspiracy to commit healthcare fraud, in violation of 18 U.S.C. §§ 1347 and 1349, in connection with a scheme to bill Medicare millions of dollars for over-the-counter (“OTC”) COVID-19 tests that
- [Attorney General Hanaway Secures Medicaid Fraud Conviction in St. Louis](https://insurancefraud.org/news_archives/attorney-general-hanaway-secures-medicaid-fraud-conviction-in-st-louis/) - Today, Missouri Attorney General Catherine Hanaway announced that Dominique Clark pled guilty to Medicaid Fraud and was sentenced to pay more than $33,000 in restitution. The Attorney General’s Medicaid Fraud Control Unit (MFCU)’s investigation showed that Clark provided care to several Medicaid recipients despite being ineligible to do so due to her criminal history. “Missouri
- [Prison time for healthcare employees in multimillion dollar adult daycare fraud scheme](https://insurancefraud.org/news_archives/prison-time-for-healthcare-employees-in-multimillion-dollar-adult-daycare-fraud-scheme/) - A doctor and clinic employee have been sentenced following their convictions for receiving illegal kickbacks after ordering unnecessary lab tests and prescriptions, announced U.S. Attorney Nicholas J. Ganjei. A federal jury found Dr. Osama Nahas, 70, McAllen, and Isabel Pruneda, 54, Edinburg, guilty March 1, 2024, of conspiracy to commit healthcare fraud, healthcare fraud and
- [California man pleads guilty in $54M radiology and hospice care fraud scheme](https://insurancefraud.org/news_archives/california-man-pleads-guilty-in-54m-radiology-and-hospice-care-fraud-scheme/) - A fraudster has pleaded guilty to charges he took part in a $54 million Medicare scam that involved radiology and other healthcare services. Alex Alexsanian, 48, of Burbank, California, entered a plea to one count of money laundering conspiracy on Jan. 20. He was previously arrested by Golden State authorities in October 2024 for participating
- [Milwaukee health care fraud scheme, woman sentenced to federal prison](https://insurancefraud.org/news_archives/milwaukee-health-care-fraud-scheme-woman-sentenced-to-federal-prison/) - According to the Federal Bureau of Investigation, court documents said 32-year-old Precious Cruse offered kickbacks in the form of free baby items to lure young mothers and pregnant women to her business. She then used the victims' personal information to submit claims to Medicaid for services that were never provided. In September, a federal jury
- [Metro-east man accused of setting insurance agent’s office on fire after dispute](https://insurancefraud.org/news_archives/metro-east-man-accused-of-setting-insurance-agents-office-on-fire-after-dispute/) - An Edwardsville man upset that he would only get about $1,400 if he cashed out a life insurance policy filed by his grandfather has been charged with arson in connection with a fire at an Alton insurance company, federal court records show. Jason Dawson, 38, was indicted on an arson charge on Jan. 6, according
- [Combating Insurance Fraud: Allstate’s Strategy to Remove Profit from Crime](https://insurancefraud.org/news_archives/combating-insurance-fraud-allstates-strategy-to-remove-profit-from-crime/) - Insurance fraud continues to pose a significant challenge to carriers, agents, and underwriters, undermining profitability and distorting risk assessments. The recent insights shared in the article “Allstate Works to Take the Profit Out of the Crime of Fraud” on LinkedIn highlight how Allstate is proactively addressing fraud through innovative detection and prevention strategies. By focusing
- [New York drivers could see lower insurance rates with new fraud prevention plan](https://insurancefraud.org/news_archives/new-york-drivers-could-see-lower-insurance-rates-with-new-fraud-prevention-plan/) - New York Gov. Kathy Hochul is taking action to address the high auto insurance rates in the state, which are among the highest in the nation. Hochul aims to reduce these rates by focusing on insurance fraud prevention. “New Yorkers pay the highest auto insurance rates in the nation, averaging $4,000 a year, $1,500 more
- [Fake Connecticut nurse accused of Medicaid fraud after patient's death appears in court](https://insurancefraud.org/news_archives/fake-connecticut-nurse-accused-of-medicaid-fraud-after-patients-death-appears-in-court/) - A woman charged with Medicaid fraud and first-degree assault of a disabled person after a 2023 patient death led to the discovery that she had no medical license to work as a licensed practical nurse appeared briefly in court Friday. Suzean Langan, 48, of Manchester, never attended school to become an LPN, but worked as
- [Ex–St. Louis alderman convicted of insurance fraud](https://insurancefraud.org/news_archives/ex-st-louis-alderman-convicted-of-insurance-fraud/) - A former St. Louis alderman has been found guilty of insurance fraud for inflating the cost of repairs to a vehicle damaged in an accident. A federal jury deliberated for about eight hours over the course of two days before issuing its verdict Friday in the case against Brandon Bosley. He’ll be sentenced for the
- [Be wary of door-to-door contractors after storms, NC insurance commissioner warns](https://insurancefraud.org/news_archives/be-wary-of-door-to-door-contractors-after-storms-nc-insurance-commissioner-warns/) - North Carolina Insurance Commissioner Mike Causey is warning residents of scammers who come to homeowners after storms and offer on the spot to fix damage -- damage that Causey says may not even exist. Causey is urging people to be cautious of anyone coming to their door offering a free roof inspection. He said this
- [Levittown man sentenced for role in $11 Million insurance scheme](https://insurancefraud.org/news_archives/levittown-man-sentenced-for-role-in-11-million-insurance-scheme/) - A Levittown railroad worker has been sentenced to probation after taking part in a large health care fraud scheme, according to federal prosecutors. David McBrien, 37, of Levittown, pleaded guilty last year to a single count of conspiracy to commit health care fraud before U.S. District Judge Madeline Cox Arleo in Newark, New Jersey, federal
- [WMATA Train Operators Plead Guilty in Health Care Fraud Scheme](https://insurancefraud.org/news_archives/wmata-train-operators-plead-guilty-in-health-care-fraud-scheme/) - Michelle Shropshire, 55, of Waldorf, Md., and Harlisha Jones, 50, of Clinton, Md., and Washington, D.C., pleaded guilty today in U.S. District Court in connection with a health care fraud scheme in which they conspired to obtain fraudulent health care and disability payments totaling nearly $60,000. Shropshire also admitted to spearheading a broader scheme involving
- [Florida nursing assistant convicted in $11.4 million Medicare fraud scheme](https://insurancefraud.org/news_archives/florida-nursing-assistant-convicted-in-11-4-million-medicare-fraud-scheme/) - A federal jury in Fort Lauderdale has convicted Christian "Chris" Cruz, 45, a nursing assistant from Pompano Beach, Florida, for his role in a sweeping $11.4 million health care fraud and wire fraud scheme. The elaborate operation involved shipping thousands of medically unnecessary orthotic braces to Medicare beneficiaries across the country and billing taxpayers for the cost.
- [Former teacher to serve one year in jail for felony insurance theft scheme](https://insurancefraud.org/news_archives/former-teacher-to-serve-one-year-in-jail-for-felony-insurance-theft-scheme/) - Maryland Attorney General Anthony G. Brown announced the sentencing of Kanika Oni Boston, 51, of Washington, D.C., following her convictions for felony theft scheme and felony insurance fraud. The case involved fraudulent insurance payments obtained from Aflac and National Teachers Association Life Insurance while Boston resided in Maryland, and was investigated by the Office of
- [2 former Colorado medical executives indicted in $873M health care fraud scheme](https://insurancefraud.org/news_archives/2-former-colorado-medical-executives-indicted-in-873m-health-care-fraud-scheme/) - A federal grand jury has charged two former executives of a Colorado medical device company with planning to cheat health care programs and investors, and with other types of fraud. The Rhode Island grand jury unsealed the indictment on Wednesday, charging the former chief executive officer and chief operating officer of Zynex, Inc., a Douglas
- [Former St. Louis Alderman Brandon Bosley’s insurance fraud trial begins](https://insurancefraud.org/news_archives/former-st-louis-alderman-brandon-bosleys-insurance-fraud-trial-begins/) - U.S. attorneys and lawyers representing former St. Louis Alderman Brandon Bosley made their opening statements Wednesday in a trial in which he’s accused of defrauding an insurance company on a car claimand then lying to federal agents. The trial revolves around a spring 2021 incident in which Bosley purchased a 2010 Toyota Prius from Mohammed
- [35-year-old man arrested after torching 9 vehicles in the Bywater, New Orleans officials say](https://insurancefraud.org/news_archives/35-year-old-man-arrested-after-torching-9-vehicles-in-the-bywater-new-orleans-officials-say/) - New Orleans police arrested the man accused of setting nine cars on fire in the Bywater neighborhood Monday, New Orleans Mayor Helena Moreno announced Wednesday. Kyle Thomsen, a 35-year-old Bywater resident, was booked into the Orleans Parish jail late Tuesday on four counts of aggravated arson of an inhabited dwelling and nine counts of simple
- [Health Care Executive Pleads Guilty to Kickback Scheme in Vermont](https://insurancefraud.org/news_archives/health-care-executive-pleads-guilty-to-kickback-scheme-in-vermont/) - A Florida businesswoman pleaded guilty today to an information in the District of Vermont for participating in a conspiracy to pay health care kickbacks. According to court documents, Evelyn Herrera, 62, of Loxahatchee, Florida, owned a durable medical equipment company called Merida Medical Supplies Inc. (Merida). After obtaining the identities of individuals residing in Vermont,
- [Seven farmers and a tobacco warehouse manager sentenced for crop insurance fraud scheme](https://insurancefraud.org/news_archives/seven-farmers-and-a-tobacco-warehouse-manager-sentenced-for-crop-insurance-fraud-scheme/) - The following information was released by the U.S. Department of Justice: A Cave City, Ky., farmer,Larry Walden, 69, was sentencedto 52 months' incarceration by U.S. District Judge Karen Caldwell, after pleading guilty to conspiring to commit money laundering, by committing crop insurance fraud. According to his plea agreement, Walden owned and rented farmland in Barren County, on which he
- [Woman convicted of health care fraud, ordered to pay $15.6M](https://insurancefraud.org/news_archives/woman-convicted-of-health-care-fraud-ordered-to-pay-15-6m/) - A federal judge sentenced a Kinston woman to six years in federal prison and ordered her to pay nearly $15.3 million in restitution to North Carolina Medicaid and $373,810 to the Internal Revenue Service. On Aug. 14, Francine Sims Super, 64, of Kinston, pleaded guilty to a health care fraud conspiracy, which included making and
- [How A Nigerian Monarch Was Convicted And Sentenced For $70,000 Medicaid Fraud In US](https://insurancefraud.org/news_archives/how-a-nigerian-monarch-was-convicted-and-sentenced-for-70000-medicaid-fraud-in-us/) - Nigerian traditional ruler Dr. Ekelekamchukwu Alphonsus Ngwadom has been convicted in the United States for Medicaid fraud after charging dozens of minors for therapy sessions they never received. Ekelekamchukwu, 61, is a Psychotherapist and Professor of Psychology and Sociology at University of Mount Olive, North Carolina, USA.He was crowned the king of Mbubu, Amiri Kingdom
- [Clayton man charged with insurance fraud](https://insurancefraud.org/news_archives/clayton-man-charged-with-insurance-fraud/) - North Carolina Insurance Commissioner Mike Causey announced Wednesday the arrest of Nolan Craig Bourgeois Jr., 28, of John Street, Clayton. Bourgeois was charged with insurance fraud, a felony. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Bourgeois of falsely telling United Services Automobile Association Inc. (USAA) that he was not involved in
- [Equifax Introduces Enhanced Synthetic Identity Fraud Detection](https://insurancefraud.org/news_archives/equifax-introduces-enhanced-synthetic-identity-fraud-detection/) - Equifax® (NYSE: EFX) announced the launch of Synthetic Identity Risk, a next-generation fraud detection product that leverages AI capabilities to help businesses identify and prevent synthetic identity fraud, a complex and growing challenge that forces lenders to absorb significant financial loss. This new product leverages sophisticated machine learning algorithms to uncover fraud patterns that traditional methods may miss, detecting and flagging potential fraudulent activity before it impacts
- [CONSUMER ALERT: Carr Warns of Price Gouging and Other Scams in Anticipation of Winter Storms](https://insurancefraud.org/news_archives/consumer-alert-carr-warns-of-price-gouging-and-other-scams-in-anticipation-of-winter-storms/) - Georgia Attorney General Chris Carr is warning Georgians to be on the lookout for possible scams and price gouging in anticipation of the winter storm that is currently expected to impact North Georgia, Metro Atlanta and parts of Central Georgia. “With the possibility of freezing rain and dangerous weather conditions, we urge all Georgians to take the necessary precautions to ensure themselves and
- [Coalition Against Insurance Fraud Names New Insurer Co-Chair, Re-Elects Officers](https://insurancefraud.org/news_archives/coalition-against-insurance-fraud-names-new-insurer-co-chair-re-elects-officers/) - The Coalition Against Insurance Fraud has appointed Steven Piper as insurer co-chair and re-elected John Sokit as treasurer, the organization announced Jan. 15. The Executive Committee and Board of Directors approved the appointments at the coalition’s annual meeting in Arlington, Va. Piper, assistant vice president and global head of special investigations at CNA Insurance, will
- [Governor Hochul Highlights Proposals to Bring Down Costs of Vehicle Insurance Rates and Tackle Fraudulent Claims](https://insurancefraud.org/news_archives/governor-hochul-outlines-several-proposals-to-tackle-fraud-lower-vehicle-insurance-rates/) - Governor Kathy Hochul today highlighted her proposals to bring down costs of vehicle insurance rates and tackle fraudulent claims across New York State. The Governor is taking common-sense steps to battle fraud, limit damages paid out to bad actors and ensure that consumers, not insurance companies, are prioritized. These proposals build on Governor Hochul’s ongoing
- [Washington Senate Passes Bill Granting Insurance Commissioner Restitution and Fining Authority](https://insurancefraud.org/news_archives/washington-senate-passes-bill-granting-insurance-commissioner-restitution-and-fining-authority/) - The Washington state Senate passed legislation Jan. 21 that would grant Insurance Commissioner Patty Kuderer authority to order restitution for policyholders harmed by insurance companies or agents, and establish per-violation fines for property and casualty insurers. The Senate approved SB 5331 by a 29-20 vote. The bill now moves to the House Consumer Protection &
- [Fox Valley police warn AI-created crash videos on social media may lead to misinformation](https://insurancefraud.org/news_archives/fox-valley-police-warn-ai-created-crash-videos-on-social-media-may-lead-to-misinformation/) - Artificial intelligence-generated content is all over social media these days. When scrolling through your feeds, you may come across videos showing vehicles sliding out of control on a snowy highway. But officials warn some of those videos are fake and were created using artificial intelligence. Some include a small disclaimer at the bottom of a
- [Virginia State Police warn of surge in staged crashes and auto insurance fraud](https://insurancefraud.org/news_archives/virginia-state-police-warn-of-surge-in-staged-crashes-and-auto-insurance-fraud/) - Virginia State Police says auto insurance fraud tied to staged crashes and fabricated claims is rising fast, as more individuals attempt to extract quick payouts from insurers. The trend shows up clearly in enforcement data, not anecdotes. First Sgt. Eric Futrell said insurance fraud drains hundreds of millions of dollars nationally each year. In Virginia,
- [Former CEO Tamela Peterson faces healthcare fraud charges in Troy hyperbaric chamber case](https://insurancefraud.org/news_archives/former-ceo-tamela-peterson-faces-healthcare-fraud-charges-in-troy-hyperbaric-chamber-case/) - Tamela Peterson, former CEO linked to the deadly hyperbaric chamber explosion in Troy, now faces charges of health care fraud. She is accused of engaging in false healthcare claims practices, including billing for services not rendered. Peterson owned the Oxford Center locations in Troy and Brighton. View video: https://www.youtube.com/watch?v=Jrh6x6pJe10
- [More fake auto insurance claims are being filed, what state officials want you to do](https://insurancefraud.org/news_archives/more-fake-auto-insurance-claims-are-being-filed-what-state-officials-want-you-to-do/) - Virginia State Police says more people are hoping to make quick cash from insurance companies by faking crashes and insurance claims. First Sergeant Eric Futrell with Virginia State Police told 8News insurance fraud costs Americans hundreds of millions of dollars. Here in Virginia, Futrell said more people are taking advantage of insurance companies by faking
- [Use of AI-Generated Images for Fake Insurance Claims and Other Frauds](https://insurancefraud.org/news_archives/use-of-ai-generated-images-for-fake-insurance-claims-and-other-frauds/) - In 2026, companies and individuals conduct many important transactions using images of objects or documents, rather than the original items themselves. For example, individuals authenticate themselves using photos of their passports; banks process and accept check deposits using images of these checks; employers reimburse employees for expenses submitted with pictures of receipts; and insurers pay
- [Fraudulent health care scheme stopped in Montana](https://insurancefraud.org/news_archives/fraudulent-health-care-scheme-stopped-in-montana/) - The Commissioner of Securities and Insurance Office helped stop a fraudulent multimillion dollar billing scheme by agents preying on Native Americans on reservations, Commissioner James Brown announced this month. In cooperation with health insurers, tribal communities and law enforcement, the investigation secured more than $23.3 million of fraudulently incurred claims through the Affordable Care Act,
- [Kaiser Hit With Record $556M Medicare Fraud Payout — Here’s What It Means for Nurses](https://insurancefraud.org/news_archives/kaiser-hit-with-record-556m-medicare-fraud-payout-heres-what-it-means-for-nurses/) - Affiliates of Kaiser Permanente have agreed to pay $556 million to resolve federal allegations that they violated the False Claims Act (FCA) by submitting unsupported diagnosis codes on Medicare Advantage records that resulted in higher reimbursements, according to the Department of Justice. The settlement, announced January 14, 2026, resolves a lawsuit that accused Kaiser of pressuring its physicians to
- [2 women arrested in Connecticut for allegedly impersonating nurse, administering treatment](https://insurancefraud.org/news_archives/2-women-arrested-in-connecticut-for-allegedly-impersonating-nurse-administering-treatment/) - Two women have been arrested and charged in Connecticut with running a dangerous scheme that defrauded the state’s Medicaid program. Prosecutors say the defendants resorted to identity theft to repeatedly impersonate a licensed nurse and administer treatment to patients. This put numerous victims in harm’s way and even led to a disabled person being assaulted, according to
- [LA County woman charged in 'crash and buy' auto insurance fraud](https://insurancefraud.org/news_archives/la-county-woman-charged-in-crash-and-buy-auto-insurance-fraud/) - Prosecutors have charged a Los Angeles woman with insurance fraud after she allegedly bought insurance coverage following a traffic accident, the LA County District Attorney’s Office told NBC Los Angeles exclusively Monday. Priscilla Lozano was arrested last Thursday after authorities suspected that she committed “crash and buy” fraud from September 2025. Investigators believe Lozano was
- [Hall County RICO Indictment: 9 charged in $1M car title fraud scheme](https://insurancefraud.org/news_archives/hall-county-rico-indictment-9-charged-in-1m-car-title-fraud-scheme/) - Nine people were charged in Hall County following a months-long investigation into a title fraud scheme. The backstory: According to the sheriff's office, investigators with the Special Investigations Unit learned of an ongoing title fraud being committed by Brandy Marie Pitts, 46, of Lavonia, and Susan Faye Palencia, 61, of Homer, in June 2025. Investigators
- [Man Charged With Insurance Fraud After Accident](https://insurancefraud.org/news_archives/man-charged-with-insurance-fraud-after-accident/) - Police have charged a Sarver man, accusing him of a hit-and-run along with committing insurance fraud in Adams Township. On December 24, police were called for a two-vehicle accident on Route 228 in the area of Mars-Valencia Road. According to charging documents, 26-year-old Austin Parison crashed into another vehicle from behind then left the scene.
- [Man sentenced for Mitchell County case of arson and insurance fraud](https://insurancefraud.org/news_archives/man-sentenced-for-mitchell-county-case-of-arson-and-insurance-fraud/) - A North Iowa man has been sentenced for a fiery case of insurance fraud. Zachary Marshall Robbins, 39 of Rockwell, has been ordered to spend three years on supervised probation, pay a $1,025 fine, and complete all recommended mental health treatment. Robbins had been charged with first-degree arson, insurance fraud, and false report of an
- [Sedgwick County man sentenced for insurance fraud](https://insurancefraud.org/news_archives/sedgwick-county-man-sentenced-for-insurance-fraud/) - A Sedgwick County man has received probation for insurance fraud. Marquez Gails, 43, pleaded guilty Friday in Sedgwick County District Court to one felony count of fraudulent insurance act and one felony count of identity theft. He was sentenced to two years of probation with the possibility of two years in prison if he violates the
- [Georgia woman convicted of stealing $5.4 million from state’s Medicaid program](https://insurancefraud.org/news_archives/georgia-woman-convicted-of-stealing-5-4-million-from-states-medicaid-program/) - A middle Georgia woman is behind bars after the Attorney General’s Office said she stole more than $5.4 million. Investigators said Elizabeth Sue Ivester, 63, of Warner Robins, “submitted 77,095 fraudulent claims for a company named Durable Medical Equipment that was never ordered or dispensed.” The AG’s office said the claims totaled over $5 million
- [Two Individuals Plead Guilty to $68 Million Adult Day Care Fraud Scheme](https://insurancefraud.org/news_archives/two-individuals-plead-guilty-to-68-million-adult-day-care-fraud-scheme/) - Two defendants pleaded guilty today to conspiring to defraud Medicaid by paying health care kickbacks for services that were not provided at two Brooklyn social adult day cares and a home health care company. According to court documents, Manal Wasef, 46, and Elaine Antao, 46, both of Brooklyn, were marketers and recruiters for two social
- [Three arrested on Medicaid fraud charges](https://insurancefraud.org/news_archives/three-arrested-on-medicaid-fraud-charges/) - Three state residents have been arrested and charged with submitting fraudulent claims to Medicaid according to state officials. On January 7, 2026 authorities arrested Venice Garner-Moore, Vernon Moore, and Tonya Jackson of Embrace Your Difference, LLC, of North Haven, a business that provides individual and couples counseling, life coaching, groups and workshops. Venice Garner-Moore, 43, of East
- [2 Gastonia women face fraud charges for staging U-Haul crash](https://insurancefraud.org/news_archives/2-gastonia-women-face-fraud-charges-for-staging-u-haul-crash/) - Two Gastonia women have been charged in a staged rental truck crash aimed at defrauding insurers, officials announced Thursday. April Montero, 37, and Deborah Brown face felony counts of insurance fraud and conspiracy to commit fraud. Investigators say the pair staged a U-Haul accident on April 10. Brown was arrested Aug. 13 and held without bond. She
- [Former Adjuster Charged With Creating Then Approving $190K in Fraudulent Claims](https://insurancefraud.org/news_archives/former-adjuster-charged-with-creating-then-approving-190k-in-fraudulent-claims/) - A former New Jersey insurance adjuster has been charged with creating and submitting phony claims, approving them himself, and directing nearly $200,000 in payments to bank accounts he controlled. John Philbin, of Clementon, has been charged with insurance fraud and theft by deception, according to Attorney General Matthew J. Platkin. According to court documents, Philbin
- [Tavern owner pleads guilty to misdemeanor after fire](https://insurancefraud.org/news_archives/tavern-owner-pleads-guilty-to-misdemeanor-after-fire/) - The owner of a Kalida bar who faced multiple felony charges, including aggravated arson and insurance fraud, for a fire at his establishment in March 2024 pleaded guilty Monday in Putnam County Common Pleas Court to a single misdemeanor charge. Jeff Hoyt, 58, was indicted by a grand jury earlier this year on felony counts
- [Rockville Centre man pleads guilty to insurance fraud in workers' comp scheme](https://insurancefraud.org/news_archives/rockville-centre-man-pleads-guilty-to-insurance-fraud-in-workers-comp-scheme/) - A Rockville Centre business owner and his Queens-based iron and erection construction company pleaded guilty to insurance fraud involving a workers' compensation scheme in which more than $600,000 of the company's policy premiums were underpaid, according to Nassau County District Attorney Anne Donnelly. Mahendranauth Khargie, 36, and his business, GC Stud, pleaded guilty on Tuesday, Oct. 21, to insurance fraud, while the company
- [Staffing agency facing fraud, larceny charges after allegedly placing fake CNAs](https://insurancefraud.org/news_archives/staffing-agency-facing-fraud-larceny-charges-after-allegedly-placing-fake-cnas/) - A temporary staffing agency providing nursing home aides and nurses is facing larceny charges after the state alleged it sent uncertified staff to work for nursing home clients. Massachusetts Attorney General Andrea Joy Campbell on Monday announced that a county grand jury had indicted Worcester-based Blooming Staffing Agency and its owner over fraudulent billing. At
- [Nine arrested in $1 million North Georgia title fraud scheme, authorities say](https://insurancefraud.org/news_archives/nine-arrested-in-1-million-north-georgia-title-fraud-scheme-authorities-say/) - Nine suspects have been indicted and arrested following a sweeping title fraud investigation that stretched across North Georgia, authorities revealed this week. The six-month investigation, led by the Hall County Sheriff's Office Special Investigations Unit, uncovered an elaborate scheme in which local car dealers, in collaboration with two business owners, allegedly assisted unlicensed buyers in
- [Attorney General Jeff Jackson Announces Health Care Fraud Sentencing](https://insurancefraud.org/news_archives/attorney-general-jeff-jackson-announces-health-care-fraud-sentencing/) - Today, Attorney General Jeff Jackson announced that Giselle Alexandria Farrell was sentenced to 24 months of supervised probation and ordered to pay $12,916.56 in restitution after pleading guilty to Medicaid provider fraud. “North Carolinians rely on Medicaid for essential health care,” said Attorney General Jeff Jackson. “Families should be able to trust that providers are honest and that
- [Oregon Medicaid insurer’s data breach could lead to insurance fraud](https://insurancefraud.org/news_archives/oregon-medicaid-insurers-data-breach-could-lead-to-insurance-fraud/) - The state’s biggest insurer of health care for low income people notified more than 5,000 of its members last month — two months after a data breach — that their personal information had been “viewed” by unauthorized people and that the information could have been used for insurance fraud. The breach happened in late October
- [Governor Abbott Directs Investigations Into Potential Medicaid Fraud In Texas](https://insurancefraud.org/news_archives/governor-abbott-directs-investigations-into-potential-medicaid-fraud-in-texas/) - Governor Greg Abbott today sent a letter directing the Texas Health and Human Services (HHS) Office of Inspector General and the Texas Health and Human Services Commission (HHSC) to launch investigations into potential Medicaid fraud in Texas to safeguard taxpayer funds, maintain access for eligible Texans, and ensure efficient, high-quality healthcare delivery. "Texas provides critical healthcare services
- [2026 Health Care Fraud Year in Preview](https://insurancefraud.org/news_archives/2026-health-care-fraud-year-in-preview/) - One year into the second Trump administration, we have seen a continuation of some evergreen enforcement priorities as well as new fonts of potential risk and exposure. As in years past, the investigation and prosecution of health care fraud cases remains at the forefront of the federal government’s enforcement activity, though tempered by the government’s
- [Comer Takes New Action in Investigation of Fraud in New York’s Medicaid Programs](https://insurancefraud.org/news_archives/comer-takes-new-action-in-investigation-of-fraud-in-new-yorks-medicaid-programs/) - House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) today is seeking information from the Centers for Medicare and Medicaid Services (CMS) about reports that the State of New York has been failing to abide by current law and properly match federal Medicaid funds. In a letter to CMS Administrator Dr. Mehmet Oz, Chairman Comer seeks a staff briefing on allegations that State has been fraudulently withholding Medicaid funds from local,
- [Allstate scores major win as appeals court revives $4.7 million fraud suit](https://insurancefraud.org/news_archives/allstate-scores-major-win-as-appeals-court-revives-4-7-million-fraud-suit/) - Allstate’s $4.7 million fraud suit against a Houston emergency center is back on, after a federal appeals court revived the case on January 14, 2026. The case, Allstate Indem Co v. Bhagat, arises from Allstate’s allegations that defendants associated with Memorial Heights Emergency Center in Houston carried out a multi‑year scheme to inflate motor‑vehicle injury
- [Fraud, fees among targets for Kansas Insurance Commissioner](https://insurancefraud.org/news_archives/fraud-fees-among-targets-for-kansas-insurance-commissioner/) - Fighting fraud and lowering fees are among the requests Kansas Insurance Commissioner Vicki Schmidt has for lawmakers this session. Schmidt visited Eye on NE Kansas to provide a closer look at her legislative agenda. Among her proposals is creating Insurance Savings Accounts. Schmidt said it would be similar to a Health Savings Account, that allows
- [GEICO sues Brooklyn medical suppliers for alleged $835K insurance fraud](https://insurancefraud.org/news_archives/geico-sues-brooklyn-medical-suppliers-for-alleged-835k-insurance-fraud/) - INSURANCE GIANT GEICO has filed a federal lawsuit accusing two Brooklyn-based companies, Droz Medical Supply Inc. and GB Medical Supply Inc., of orchestrating an $835,000 insurance fraud scheme, with an additional $1.2 million in disputed claims still pending, according to Insurance Business Magazine. Filed Oct. 3 in the Eastern District of New York, the suit alleges that
- [Medicare to Spend $15B on Treatment Linked to Fraud, Patient Harm](https://insurancefraud.org/news_archives/medicare-to-spend-15b-on-treatment-linked-to-fraud-patient-harm/) - Medicare is expected to spend more than $15 billion by year's end on pricey wound care products linked to waste, fraud, and abuse, according to an analysis of data by the National Association of ACOs (NAACOS) and the Institute for Accountable Care. Spending on skin substitutes climbed to $7.7 billion through July, and is projected to reach as
- [Seniors across US suspect Medicare fraud from Delray Beach company](https://insurancefraud.org/news_archives/seniors-across-us-suspect-medicare-fraud-from-delray-beach-company/) - More than two dozen Medicare recipients from across the country have contacted WPTV with reports of fraudulent billing from a Delray Beach company, with claims totaling more than $336,000 for medical equipment they say they never needed or received. Since Chief Investigator Jamie Ostroff first reported on Sunshine Senior Solutions in June, seniors from Ohio to
- [Insurance Commissioner Announces Savings Or Recovery Of More Than $140 Million In 2025](https://insurancefraud.org/news_archives/insurance-commissioner-announces-savings-or-recovery-of-more-than-140-million-in-2025/) - Insurance Commissioner Mike Causey announced that the North Carolina Department of Insurance saved or recovered $142 million for North Carolinians in 2025. The recovered funds include those from insurance fraud restitution, consumer assistance, market monitoring and external reviews, where Department employees helped consumers get needed medical procedures and prescription drugs. Last year, the Department Helped
- [State Farm dodged billions in 2018 settlement, now faces fresh RICO charges in Oklahoma](https://insurancefraud.org/news_archives/state-farm-dodged-billions-in-2018-settlement-now-faces-fresh-rico-charges-in-oklahoma/) - State Farm has been accused of racketeering before; the first time reads like something from The Godfather saga. The story begins in 1997, when State Farm was caught violating its own auto insurance policies by substituting aftermarket parts for bodywork. A 48-state class action lawsuit filed in Illinois resulted in a jury award of $1.1 billion. State Farm appealed.
- [Healthcare fraud enforcement in 2025: A year of aggressive action and expanding risk](https://insurancefraud.org/news_archives/healthcare-fraud-enforcement-in-2025-a-year-of-aggressive-action-and-expanding-risk/) - I. 2025 in context: Enforcement accelerates under a new administration Second, the DOJ's Criminal Division included healthcare fraud as one of its ten priority "high-impact" areas for 2025. This was quickly followed by the largest healthcare fraud takedown in DOJ history, anchored by "Operation Gold Rush,"1 with charges spanning telemedicine, genetic testing, kickbacks and technology-enabled schemes.
- [Walz, Minnesota officials question U.S. Attorney's Office claim that fraud could reach $9 billion](https://insurancefraud.org/news_archives/walz-minnesota-officials-question-u-s-attorneys-office-claim-that-fraud-could-reach-9-billion/) - Federal prosecutors said the total fraud in Minnesota's Medicaid programs could be as much as $9 billion, but DFL Gov. Tim Walz and other state officials disputed the amount of taxpayer money stolen is that high. First Assistant U.S. Attorney Joe Thompson on Thursday, during a news conference about new federal charges, noted that 14 programs deemed
- [Memphis business woman must pay $500k for healthcare and COVID-19 relief fraud](https://insurancefraud.org/news_archives/memphis-business-woman-must-pay-500k-for-healthcare-and-covid-19-relief-fraud/) - A Memphis woman has been sentenced to 14 months in federal prison for healthcare fraud and making false statements in connection with loan applications for the COVID-19 Relief Program. Memphis daycare owner accused of PPP loan, insurance fraud A federal judge also ordered Nakita Cannady, 49, to pay more than $540,000.00 in restitution to the victims,
- [Former Parkville insurance adviser, financial advisor sentenced for insurance fraud, obstruction of justice](https://insurancefraud.org/news_archives/former-parkville-insurance-adviser-financial-advisor-sentenced-for-insurance-fraud-obstruction-of-justice/) - A Baltimore County judge sentenced a former insurance agent and financial advisor to six months in jail on Friday following his conviction for defrauding a client and subsequently attempting to obstruct the legal process with a forged document. Attorney General Anthony G. Brown announced the sentence for Michael C. Okolo, 68, of Parkville. The sentencing follows a
- [Teen arrested, accused of setting cars on fire in Fort Worth neighborhoods](https://insurancefraud.org/news_archives/teen-arrested-accused-of-setting-cars-on-fire-in-fort-worth-neighborhoods/) - A teenager is behind bars, accused of setting multiple cars on fire in neighborhoods in South Fort Worth over the holiday season, investigators say. Police said at least five vehicles were torched across three neighborhoods, beginning early Christmas Eve and continuing through New Year’s Day. "It was going in the air, and it was making
- [Charlotte roofing contractor arrested in insurance fraud sting operation](https://insurancefraud.org/news_archives/charlotte-roofing-contractor-arrested-in-insurance-fraud-sting-operation/) - A Charlotte roofing contractor has been arrested on felony charges after allegedly conspiring to damage a roof and file a fraudulent insurance claim, North Carolina Insurance Commissioner Mike Causey announced Friday. 36-year-old Robert Allen Bentley, a senior project manager with A&M Premier Roofing & Construction, was arrested Dec. 10 and charged with insurance fraud, attempting to obtain property
- [Man arrested for arson, insurance fraud after I-70 car fire near Genesee](https://insurancefraud.org/news_archives/man-arrested-for-arson-insurance-fraud-after-i-70-car-fire-near-genesee/) - A 25-year-old man has been arrested after local investigators determined the Oct. 24 car fire that closed westbound Interstate 70 was a hoax. Elvyn Ramos of Routt County was arrested Dec. 30 on suspicion of third-degree arson, tampering with evidence, insurance fraud and other crimes, the Jeffco Sheriff’s Office stated Jan. 7. JSCO spokesperson Mark Techmeyer explained
- [Owner of Virginia pain clinics sentenced to 45 months for fraud and drug conspiracies](https://insurancefraud.org/news_archives/owner-of-virginia-pain-clinics-sentenced-to-45-months-for-fraud-and-drug-conspiracies/) - The owner of multiple pain clinics throughout Virginia - including Lynchburg, Madison Heights and Christiansburg - was sentenced on Friday to 45 months in federal prison for healthcare fraud and illegal prescription drug conspiracies. 59-year-old John Gregory Barnes, of South Carolina, pleaded guilty in July of 2023 to conspiring to commit healthcare fraud, distributing Suboxone
- [South Carolina Laboratory Pleads Guilty and Agrees to Pay At Least $6.8M to Settle Allegations of Kickbacks to Doctors](https://insurancefraud.org/news_archives/south-carolina-laboratory-pleads-guilty-and-agrees-to-pay-at-least-6-8m-to-settle-allegations-of-kickbacks-to-doctors/) - Clinical laboratory LTD Holding LLC, formerly known as Labtech Diagnostics LLC (Labtech), of Anderson, South Carolina, and its founder and CEO Joseph Labash, of the United Arab Emirates, have agreed to pay at least $6.8 million to the United States to resolve False Claims Act allegations involving illegal kickbacks to doctors. With this settlement, the Department of
- [New Jersey Doctor Charged in 58-Count Indictment with Distributing Opioids in Exchange for Sexual Favors and Defrauding New Jersey Medicaid](https://insurancefraud.org/news_archives/new-jersey-doctor-charged-in-58-count-indictment-with-distributing-opioids-in-exchange-for-sexual-favors-and-defrauding-new-jersey-medicaid/) - A New Jersey doctor was charged in a 58-count indictment with distributing opioids without a legitimate medical purpose, maintaining a drug-involved premises, and defrauding New Jersey Medicaid by billing for visits that never happened, Senior Counsel Philip Lamparello announced today. Ritesh Kalra, 52, of Secaucus, New Jersey, was previously charged by criminal complaint in July
- [OC Superior Court Judge Pleads Guilty to Fraud and Resigns](https://insurancefraud.org/news_archives/oc-superior-court-judge-pleads-guilty-to-fraud-and-resigns/) - OC Superior Court Judge Israel Claustro resigned Wednesday after federal prosecutors announced he agreed to plead guilty to fraud for working with a doctor to defraud the state’s worker’s comp program. In his signed plea agreement, Claustro admitted he worked with Dr. Kevin Tien Do to defraud the state’s Subsequent Injuries Benefits Trust Fund, which
- [Oklahoma Medical Supply Company Owner Indicted for $30M Health Care Fraud Scheme](https://insurancefraud.org/news_archives/oklahoma-medical-supply-company-owner-indicted-for-30m-health-care-fraud-scheme/) - An indictment was unsealed in the Middle District of Florida today charging an Oklahoma chiropractor and medical supply company owner for his role in a conspiracy to submit fraudulent claims to multiple federal health care programs for orthotic braces and other durable medical equipment (DME), and for the theft of government funds intended to support
- [Federal Jury finds Memphis Physician Guilty of Adulterated and Misbranded Medical Devices and Health Care Fraud](https://insurancefraud.org/news_archives/federal-jury-finds-memphis-physician-guilty-of-adulterated-and-misbranded-medical-devices-and-health-care-fraud/) - After a three-and-a-half-week trial and five days of deliberations, a federal jury found Memphis physician Sanjeev Kumar guilty of eighteen counts of adulteration of medical devices, sixteen counts of misbranding medical devices, and six counts of health care fraud. From 2019 to 2024, Kumar submitted and caused his employees to submit fraudulent claims to Medicare
- [Two Health Care Executives Convicted for Exploiting Elderly Medicare Advantage Beneficiaries in $34 Million Fraud Scheme](https://insurancefraud.org/news_archives/two-health-care-executives-convicted-for-exploiting-elderly-medicare-advantage-beneficiaries-in-34-million-fraud-scheme/) - A Miami federal jury convicted two healthcare executives on Dec. 22, 2025 for their roles in a scheme that resulted in the submission of approximately $34 million in false and fraudulent claims to Medicare Advantage plans for medically unnecessary durable medical equipment, including back, knee, shoulder, and ankle braces. According to court documents and evidence
- [Florida Insurance Agency VP Sentenced to 3 Years in Massive ACA Fraud Scheme](https://insurancefraud.org/news_archives/florida-insurance-agency-vp-sentenced-to-3-years-in-massive-aca-fraud-scheme/) - A federal judge sentenced a Pembroke Pines insurance broker to almost three years in prison and millions of dollars in restitution for leading a scheme that fraudulently enrolled thousands of people—many of them homeless—in Affordable Care Act health insurance plans. Dafud Iza, formerly vice president of Fiorella Insurance Agency, in Stuart, pleaded guilty in April to the
- [Baltimore Man Sentenced for Obtaining and Using Vulnerable Victims’ Personal Information in Unemployment Insurance Claims Fraud Scheme](https://insurancefraud.org/news_archives/baltimore-man-sentenced-for-obtaining-and-using-vulnerable-victims-personal-information-in-unemployment-insurance-claims-fraud-scheme/) - U.S. District Judge Julie R. Rubin sentenced Duane Watts, 46, of Baltimore, Maryland, to 54 months in prison, followed by three years of supervised release. The sentence is in connection with Watts’ participation in an unemployment insurance (UI) fraud scheme involving the use of the personal identifying information of multiple victims, including vulnerable victims, to
- [Former Sylvania Twp. police officer sentenced to probation in insurance fraud case involving second wife](https://insurancefraud.org/news_archives/former-sylvania-twp-police-officer-sentenced-to-probation-in-insurance-fraud-case-involving-second-wife/) - A former Sylvania Township police officer been sentenced after claiming his second wife on his health insurance, even though that marriage was not valid. On Jan. 5, 2026, Judge Eric Marks sentenced Robert Austin to five years of probation. The Lucas County Prosecutor’s Office released a statement Wednesday saying Robert Austin agreed to pay nearly
- [Florida Man Arrested on Multiple Felony Fraud Charges in Alleged Insurance Scheme, Records Show](https://insurancefraud.org/news_archives/florida-man-arrested-on-multiple-felony-fraud-charges-in-alleged-insurance-scheme-records-show/) - A Florida man was arrested Wednesday evening following an investigation into an alleged large-scale fraud scheme involving insurance claims and false statements, according to records released by the Florida Department of Financial Services. The suspect, identified by authorities as Isaac Angel Cruz, was taken into custody on multiple felony allegations, including insurance fraud involving amounts between $20,000 and $100,000, making
- [Superior Court Jury Finds Claimant Guilty on All Counts and Now Faces $230,000.00 In Restitution](https://insurancefraud.org/news_archives/superior-court-jury-finds-claimant-guilty-on-all-counts-and-now-faces-230000-00-in-restitution/) - The Special Investigative Unit of RJN Investigations, Inc. was recently notified of the successful prosecution in the case of People of California vs. I. Rivera. In this particular case, the claimant was employed as a full-time Riverside County employee who filed a workers' compensation claim for lower extremity injuries. Despite being provided with extensive medical
- [Inmate charged with insurance fraud in Greenwood County](https://insurancefraud.org/news_archives/inmate-charged-with-insurance-fraud-in-greenwood-county/) - The South Carolina Law Enforcement Division (SLED) have charged an inmate with insurance fraud in Greenwood County. 54-year-old Raymond Kennedy was charged with obtaining property under false pretenses. Kennedy is currently serving a sentence at the Trenton Correction Institution in Edgefield County on an unrelated charge. Officials said Kennedy forged the signature on a policy
- [Woman accused of collecting over $11M in dental insurance fraud pleads no contest in Palm Beach County](https://insurancefraud.org/news_archives/woman-accused-of-collecting-over-11m-in-dental-insurance-fraud-pleads-no-contest-in-palm-beach-county/) - A woman accused of orchestrating a multimillion-dollar dental fraud scheme entered a plea in court. According to court documents in Palm Beach County, Evelyn Cruz, 43, pleaded no contest Tuesday to grand theft and proprietorship by non-dentists. Cruz was sentenced to 28 days in county jail, credited with 28 days' time served in jail, 48
- [CareOregon and Health Share of Oregon Warn of Potential Insurance Fraud After Data Breach](https://insurancefraud.org/news_archives/careoregon-and-health-share-of-oregon-warn-of-potential-insurance-fraud-after-data-breach/) - CareOregon and Health Share of Oregon have notified certain patients about a data breach and potential insurance fraud. Andover Eye Associates has identified a breach of its email environment. CareOregon and Health Share of Oregon CareOregon and Health Share of Oregon have notified certain patients about unauthorized access to some of their protected health information.
- [Suspect in deadly N. Georgia house fire killed in crash following chase with Kentucky State Police](https://insurancefraud.org/news_archives/suspect-in-deadly-n-georgia-house-fire-killed-in-crash-following-chase-with-kentucky-state-police/) - The Dalton Police Department said it is investigating a deadly house fire that was intentionally set. Firefighters were called to the home along Grimes Street in Dalton shortly before 6 a.m. on Saturday. After they put the flames out, they found a woman’s body inside. “After police were already at the scene, a woman called
- [NC Insurance Commissioner Urges President to Not Pardon Greg Lindberg](https://insurancefraud.org/news_archives/nc-insurance-commissioner-urges-president-to-not-pardon-greg-lindberg/) - North Carolina’s insurance commissioner has heard nothing from the White House, three weeks after he sent a letter urging the president to refrain from pardoning twice-convicted insurance entrepreneur Greg Lindberg. “Mr. Lindberg’s criminal conduct was not incidental, technical, or victimless. It was deliberate, sustained, and directly aimed at corrupting a state regulatory system charged with
- [Minnesota freezes provider enrollment for 13 Medicaid programs over fraud risk](https://insurancefraud.org/news_archives/minnesota-freezes-provider-enrollment-for-13-medicaid-programs-over-fraud-risk/) - Minnesota’s Department of Human Services is pausing new provider enrollments in 13 Medicaid-funded services administered by the state as the agency works with the federal government to address fraud concerns in high-risk programs. The agency announced the new step on Thursday. It comes at the order of the federal Centers for Medicare and Medicaid Services,
- [Manning Kass Expands into the Inland Empire with Integration of Smith Law Group](https://insurancefraud.org/news_archives/manning-kass-expands-into-the-inland-empire-with-integration-of-smith-law-group/) - Manning Kass, a nationally recognized law firm, is proud to announce its expansion into the Inland Empire through the integration of Smith Law Group. Establishing a new office located in Riverside, this development enhances the firm’s regional presence and strengthens its ability to serve its clients with both local insight and national resources. Led by
- [Court revives $22.9 million fraud lawsuit alleging lawyer helped deceive GEICO](https://insurancefraud.org/news_archives/court-revives-22-9-million-fraud-lawsuit-alleging-lawyer-helped-deceive-geico/) - A California court has revived a $22.9 million fraud lawsuit alleging an attorney helped clients deceive GEICO with fake injuries and fabricated business losses. The Court of Appeal's decision on January 6 reverses a lower court's dismissal and clarifies a thorny issue in California's Insurance Frauds Prevention Act: when does a fraud complaint rely too heavily on
- [How brokers gamed the ACA marketplace, roiling subsidy debate in Congress](https://insurancefraud.org/news_archives/how-brokers-gamed-the-aca-marketplace-roiling-subsidy-debate-in-congress/) - The Florida insurance brokers offered an enticing deal to unemployed and homeless people: Enroll in a Healthcare.gov health plan they weren’t eligible for in exchange for gift cards, food, alcohol or cash. Theycoached them to lie about their income to qualify for heavily subsidized coverage, according to court documents. Sometimes they enrolled people without their knowledge. A
- [GEICO alleges Florida chiropractors ran $1.37 million PIP billing scheme](https://insurancefraud.org/news_archives/geico-alleges-florida-chiropractors-ran-1-37-million-pip-billing-scheme/) - GEICO is accusing two Florida chiropractic clinics of running a multi‑year PIP billing scheme that it says siphoned more than $1.37 million from the insurer. In a civil action filed on January 5, 2026, in the United States District Court for the Southern District of Florida, West Palm Beach Division, four GEICO companies allege that chiropractor
- [Commissioner Lara and Senator Padilla announce Disaster Recovery Reform Act to speed up recovery for survivors](https://insurancefraud.org/news_archives/commissioner-lara-and-senator-padilla-announce-disaster-recovery-reform-act-to-speed-up-recovery-for-survivors/) - Insurance Commissioner Ricardo Lara and newly-appointed Senate Insurance Committee Chair Steve Padilla announced Senate Bill 876, a comprehensive legislative reform to speed up disaster recovery for homeowners and renters through improved insurance coverage and expanded consumer protections. They are proposing legislation directly responding to wildfire disaster survivors’ call for swifter claims payments and an end to
- [Orange County residents search for fire insurance after company denies renewal](https://insurancefraud.org/news_archives/orange-county-residents-search-for-fire-insurance-after-company-denies-renewal/) - WATCH: Orange County residents search for fire insurance after company denies renewalhttps://www.cbsnews.com/losangeles/video/orange-county-residents-search-for-fire-insurance-after-company-denies-renewal/
- [Fraudster jailed for bogus insurance claims involving stolen Lego sets](https://insurancefraud.org/news_archives/fraudster-jailed-for-bogus-insurance-claims-involving-stolen-lego-sets/) - A man has been jailed for over two years for fake insurance claims including saying that his Lego kits were stolen which were later found on display in his home. From May 2021 to January 2022 Matthew Johnson, 42, submitted fabricated insurance claims to AXA claiming that his stuff was stolen in burglaries at homes in Shetland and Goole. The
- [Ogden man renewed lapsed insurance 10 minutes after crash, charges say](https://insurancefraud.org/news_archives/ogden-man-renewed-lapsed-insurance-10-minutes-after-crash-charges-say/) - An Ogden man is facing a fraud charge accusing him of renewing his lapsed auto insurance policy minutes after he was involved in an accident to secure coverage for the mishap. Danny Elwood Royer, 54, was charged last week in 2nd District Court with insurance fraud, a second-degree felony, stemming from his alleged efforts to
- [Six Additional Defendants Charged, One Defendant Pleads Guilty in Ongoing Fraud Schemes](https://insurancefraud.org/news_archives/six-additional-defendants-charged-one-defendant-pleads-guilty-in-ongoing-fraud-schemes/) - Six additional defendants have been charged federally with participating in schemes to defraud the government in the Autism fraud scheme and the Housing Stabilization Services (HSS) fraud scheme. One defendant charged in the Early Intensive Developmental and Behavioral Intervention (EIDBI) Autism scheme pled guilty today. And this morning, federal agents executed a search warrant relating to
- [4 charged in travel insurance scam, attempting to steal more than $200k, N.J. officials say](https://insurancefraud.org/news_archives/4-charged-in-travel-insurance-scam-attempting-to-steal-more-than-200k-n-j-officials-say/) - Four people were indicted and charged for their roles in an alleged scheme to file fraudulent travel insurance claims and steal hundreds of thousands of dollars from different insurance companies, according to New Jersey Attorney General Matthew Platkin. Agustin Matos, 40, of North Haledon, Kenia Ivonne Vasquez, 44, of the Bronx, New York, and Keyra
- [Doctor indicted for orchestrating $45M botox fraud scheme targeting Medicare](https://insurancefraud.org/news_archives/doctor-indicted-for-orchestrating-45m-botox-fraud-scheme-targeting-medicare/) - A federal grand jury in California returned a superseding indictment charging a doctor for allegedly submitting more than $45 million in false and fraudulent claims to Medicare for Botox injections and for obstructing a criminal investigation by allegedly submitting falsified medical records in response to a grand jury subpoena. According to court documents, Violetta Mailyan,
- [Arizona couple admits in court to faking cancer-curing 'smart chip' device](https://insurancefraud.org/news_archives/arizona-couple-admits-in-court-to-faking-cancer-curing-smart-chip-device/) - She went by Dr. Mary, and her promise was a tantalizing medical breakthrough. At clinics operated in Arizona and several other states, Mary Blakley and her husband, Fred, told patients that for just $300, they could provide a full-body scan that utilized a proprietary "smart chip" to detect a variety of potential illnesses, including cancer. In addition,
- [Attorney General Ford Announces Sentencing of Brothers Behavioral Health and Its Owner](https://insurancefraud.org/news_archives/attorney-general-ford-announces-sentencing-of-brothers-behavioral-health-and-its-owner/) - Today, Nevada Attorney General Aaron D. Ford announced that Las Vegas-based Brothers Behavioral Health LLC and its owner, Isai Anaya-Estrada, were sentenced for fraudulently billing Nevada Medicaid for healthcare services that were not provided to recipients. The fraud occurred between January 2021 and January 2023.District Court Judge Maria Gall sentenced Brothers Behavioral and Anaya-Estrada, who
- [Nine arrested for insurance fraud in Costa Teguise clinic](https://insurancefraud.org/news_archives/nine-arrested-for-insurance-fraud-in-costa-teguise-clinic/) - Guardia Civil have arrested nine people in connection with alleged insurance scams operated by a Costa Teguise clinic. The accused have been charged with continuous fraud, money laundering, and membership of a criminal association. The arrests result from a raid in 2024 in which various documents and electronic devices were found to contain evidence of
- [Kansas Man Sentenced to Probation for Insurance Fraud](https://insurancefraud.org/news_archives/kansas-man-sentenced-to-probation-for-insurance-fraud/) - Kansas Insurance Commissioner Vicki Schmidt this week announced a Sedgwick county man has been sentenced to 18 months of probation for insurance fraud. Shawn Gales, age 37, pleaded guilty on December 18, 2025, in Sedgwick County District Court to one count of Fraudulent Insurance Act, a level 8 Nonperson Felony and one count of Interference
- [Rome Woman Jailed for Insurance Fraud](https://insurancefraud.org/news_archives/rome-woman-jailed-for-insurance-fraud/) - Sabrina Nicole Williams, 43 of Rome, was arrested in Rome after reports said she committed insurance fraud. Reports said that Williams submitted a fraudulent report to American Bankers Insurance Company in order to obtain money. Police added that Williams changed the date and report number from the Rome/Floyd County Fire Department and submitted it to
- [Kansas woman sentenced for insurance fraud](https://insurancefraud.org/news_archives/kansas-woman-sentenced-for-insurance-fraud-2/) - Kansas Attorney General Kris Kobach says 59-year old Tammi Sue Moore Topeka was sentenced to 14 months in prison for submitting a fraudulent insurance claim.Moore pleaded as charged on Nov. 7th, 2025. A judge sentenced Moore to 14 months in prison. According to investigators, Moore submitted an insurance claim alleging she struck a coyote with her vehicle. The
- [Deputy who sued Toronto Raptors president after altercation was convicted of insurance fraud](https://insurancefraud.org/news_archives/deputy-who-sued-toronto-raptors-president-after-altercation-was-convicted-of-insurance-fraud-2/) - Years before he got into an altercation with a Toronto Raptors executive after the team beat the Golden State Warriors in the NBA finals at Oracle Arena, an Alameda County Sheriff’s deputy was arrested and convicted of insurance fraud. The revelations raise new questions about the deputy’s integrity, legal experts say, in a case that
- [Former trucking company owner and convicted murderer sentenced for $9M fraud scheme](https://insurancefraud.org/news_archives/former-trucking-company-owner-and-convicted-murderer-sentenced-for-9m-fraud-scheme-2/) - The former owner of Bill Hall Jr. Trucking recently received a slap on the wrist for a multimillion-dollar workers’ compensation fraud scheme nearly 10 years after she received the lightest possible sentence for killing her husband. Austin, Texas’ 147th District Court sentenced Frances Hall to 10 years deferred adjudication, $150,000 in restitution and ordered to
- [Man sentenced to 15 years in Macon insurance fraud scheme](https://insurancefraud.org/news_archives/man-sentenced-to-15-years-in-macon-insurance-fraud-scheme/) - A Locust Grove man was sentenced to 15 years, three of them in prison, Monday for his part in a nearly $80,000 insurance fraud scheme. Christopher Lorenzo Battle, 41, pleaded guilty to one count of violating Georgia’s Racketeer Influenced and Corrupt Organizations (RICO) Act. As part of his sentence, Battle also must help pay $79,538.71
- [Former Vocational Nurse Sentenced In Insurance Fraud Case](https://insurancefraud.org/news_archives/former-vocational-nurse-sentenced-in-insurance-fraud-case/) - A former vocational nurse working at the California Institution for Men in Chino has been sentenced in a workers’ compensation fraud case in which he falsely claimed an inmate attacked him with a needle. Ndiawar Diop, DOB: 7-15-77, was convicted by a Riverside County jury in June of six felonies – one count each of
- [Michigan pharmacist among four sentenced in Medicare, Medicaid and private insurance fraud case](https://insurancefraud.org/news_archives/michigan-pharmacist-among-four-sentenced-in-medicare-medicaid-and-private-insurance-fraud-case-2/) - A Macomb County pharmacist was among four pharmacy owners sentenced in a federal investigation involving over $13 million in losses to Medicare, Medicaid and Blue Cross Blue Shield of Michigan. The U.S. Department of Justice announced the sentencings Thursday in a press release about the case. "The defendants collectively caused over $13 million of loss
- [Sober-home fraud scheme doctor receives an 8-year term Judge: Dr. Mark Agresti enabled $31.3 million insurance swindle](https://insurancefraud.org/news_archives/sober-home-fraud-scheme-doctor-receives-an-8-year-term-judge-dr-mark-agresti-enabled-31-3-million-insurance-swindle/) - With his wife and 90-year-old mother looking on, a once-respected Palm Beach County psychiatrist was handcuffed and led from a federal courtroom on Friday to begin serving an eight-year prison sentence for exploiting people struggling with addiction. Dr. Mark Agresti's quick transformation from free man to federal prisoner was unusual. Typically, white-collar criminals are allowed
- [Maryland Woman Sentenced for Felony Insurance Fraud](https://insurancefraud.org/news_archives/maryland-woman-sentenced-for-felony-insurance-fraud-2/) - Attorney General Anthony G. Brown announced that Rhonda Keisha Powell of Upper Marlboro was sentenced to 45 days in jail, five years of supervised probation, and ordered to pay $58,373 in restitution after pleading guilty to felony insurance fraud for filing false claims with USAA in 2020 and 2022. Per the news release: “Attorney General
- [Elderly man convicted of $20 million insurance fraud plot](https://insurancefraud.org/news_archives/elderly-man-convicted-of-20-million-insurance-fraud-plot/) - A 77-year-old man was convicted of 19 criminal charges related to a $20 million insurance fraud scheme, officials said. James William Wilson Jr., 77, of Owings Mills, MD, is scheduled to be sentenced on May 1, 2025, and faces a maximum sentence of 20 years in prison for each of his 13 counts of fraud
- [North Texas man sentenced for role in nearly $5M insurance fraud scheme](https://insurancefraud.org/news_archives/north-texas-man-sentenced-for-role-in-nearly-5m-insurance-fraud-scheme/) - A Dallas man was sentenced Thursday for his connection in a nearly $5 million insurance fraud scheme. On Feb. 20, Jordan Ford, 32, was sentenced to 157 months in federal prison and ordered to pay $4,471,338 in restitution following his conviction for a scheme to defraud three insurance companies. According to court documents, Ford and
- [Fraud trial begins for Tyrell Morris, ex-New Orleans 911 call center director](https://insurancefraud.org/news_archives/fraud-trial-begins-for-tyrell-morris-ex-new-orleans-911-call-center-director/) - Tyrell Morris, the former head of the Orleans Parish Communications District, maintained his innocence Monday (Sept. 22) as he went on trial facing four criminal charges. More than a year ago, Morris was indicted by an Orleans Parish grand jury after crashing a city vehicle on his birthday and allegedly trying to cover it up
- [Marin County Man Sentenced for Auto Insurance Fraud, Co-conspirators Also Face Justice](https://insurancefraud.org/news_archives/marin-county-man-sentenced-for-auto-insurance-fraud-co-conspirators-also-face-justice/) - A local Marin County man, Denni Rodas Diaz, has been sentenced to jail time and probation following a conviction for auto insurance fraud. Rodas Diaz, 33, entered a guilty plea to two felony charges under Penal Code section 550(a)(4), which deals with knowingly filing a false insurance claim, according to a statement from the Marin County

## Venues

- [Hilton Long Beach, Long Beach, CA](https://insurancefraud.org/venue/hilton-long-beach-long-beach-ca/)
- [Renaissance Orlando at SeaWorld](https://insurancefraud.org/venue/renaissance-orlando-at-seaworld/)
- [Sheraton New Orleans](https://insurancefraud.org/venue/sheraton-new-orleans/)
- [Hyatt Regency Monterey](https://insurancefraud.org/venue/hyatt-regency-monterey/)
- [Orlando, Fl (Omni Orlando Resort at ChampionsGate)](https://insurancefraud.org/venue/orlando-fl-omni-orlando-resort-at-championsgate/)
- [1012 14th Street NW Washington, DC 20005](https://insurancefraud.org/venue/sample-venue/)
- [Caribe Royale - Orlando, FL](https://insurancefraud.org/venue/caribe-royale-orlando-fl/)
- [Crystal City, VA](https://insurancefraud.org/venue/crystal-city-va/)
- [New Orleans, LA](https://insurancefraud.org/venue/new-orleans-la/)

## Organizers

- [Orlando, FL (Caribe Royale)](https://insurancefraud.org/organizer/orlando-fl-caribe-royale/)
- [Sheraton Pentagon City Hotel - Washington, DC](https://insurancefraud.org/organizer/)

## Categories

- [Blog](https://insurancefraud.org/category/blog/)

## Topics

- [Drug Diversion](https://insurancefraud.org/topics/drug-diversion/)
- [Fraud General](https://insurancefraud.org/topics/fraud-general/)
- [Life Insurance](https://insurancefraud.org/topics/life-insurance/)
- [Public Adjuster](https://insurancefraud.org/topics/public-adjuster/)
- [Public Awareness](https://insurancefraud.org/topics/public-awareness/)
- [Coalition Against Insurance Fraud](https://insurancefraud.org/topics/coalition-against-insurance-fraud/)
- [Legislation](https://insurancefraud.org/topics/legislation/)
- [Workers Comp](https://insurancefraud.org/topics/workers-comp/)
- [Healthcare Fraud](https://insurancefraud.org/topics/healthcare-fraud/)
- [Auto Rate Evasion](https://insurancefraud.org/topics/auto-rate-evasion/)
- [Homeowners Fraud](https://insurancefraud.org/topics/homeowners-fraud/)
- [Insider Fraud](https://insurancefraud.org/topics/insider-fraud/)
- [Commercial Fraud](https://insurancefraud.org/topics/commercial-fraud/)
- [Disability](https://insurancefraud.org/topics/disability/)
- [Liability](https://insurancefraud.org/topics/liability/)
- [Regulatory actions](https://insurancefraud.org/topics/regulatory-actions/)
- [Contractor fraud](https://insurancefraud.org/topics/contractor-fraud/)
- [Medical ID theft](https://insurancefraud.org/topics/medical-id-theft/)
- [Crop insurance](https://insurancefraud.org/topics/crop-insurance/)
- [Unlicensed entities](https://insurancefraud.org/topics/unlicensed-entities/)
- [Auto fraud](https://insurancefraud.org/topics/auto-fraud/)
- [Underwriting](https://insurancefraud.org/topics/underwriting/)
- [Auto - give up](https://insurancefraud.org/topics/auto-give-up/)
- [Insider - insurer](https://insurancefraud.org/topics/insider-insurer/)
- [Homeowners - fake](https://insurancefraud.org/topics/homeowners-fake/)
- [Auto - underwriting](https://insurancefraud.org/topics/auto-underwriting/)
- [Insider - agent](https://insurancefraud.org/topics/insider-agent/)
- [Medical - false claims](https://insurancefraud.org/topics/medical-false-claims/)
- [Work comp - worker](https://insurancefraud.org/topics/work-comp-worker/)
- [Work comp - employer](https://insurancefraud.org/topics/work-comp-employer/)
- [Homeowners - arson](https://insurancefraud.org/topics/homeowners-arson/)
- [Auto - padding/false claim](https://insurancefraud.org/topics/auto-padding-false-claim/)
- [Legislative](https://insurancefraud.org/topics/legislative/)
- [Auto - staged](https://insurancefraud.org/topics/auto-staged/)
- [Liability - false claim](https://insurancefraud.org/topics/liability-false-claim/)
- [Homeowners - padding](https://insurancefraud.org/topics/homeowners-padding/)
- [Technology](https://insurancefraud.org/topics/technology/)
- [To be determined](https://insurancefraud.org/topics/to-be-determined/)
- [Judicial/courts](https://insurancefraud.org/topics/judicial-courts/)
- [Work comp - provider](https://insurancefraud.org/topics/work-comp-provider/)
- [Medicare/Medicaid](https://insurancefraud.org/topics/medicare-medicaid/)
- [Business - arson](https://insurancefraud.org/topics/business-arson/)
- [Business - padding/faking](https://insurancefraud.org/topics/business-padding-faking/)
- [Unlicensed](https://insurancefraud.org/topics/unlicensed/)
- [COVID-19](https://insurancefraud.org/topics/covid-19/)
- [Pet insurance fraud](https://insurancefraud.org/topics/pet-insurance-fraud/)
- [Auto arson](https://insurancefraud.org/topics/auto-arson/)
- [Synthetic Identity Theft](https://insurancefraud.org/topics/synthetic-identity-theft/)
- [Renter's Insurance](https://insurancefraud.org/topics/renters-insurance/)
- [Social Security fraud](https://insurancefraud.org/topics/social-security-fraud/)
- [Third party litigation funding](https://insurancefraud.org/topics/third-party-litigation-funding/)
- [Long-Term Care Insurance](https://insurancefraud.org/topics/long-term-care-insurance/)
- [Elderly Fraud](https://insurancefraud.org/topics/elderly-fraud/)
- [Unemployment Insurance](https://insurancefraud.org/topics/unemployment-insurance/)
- [Title Insurance](https://insurancefraud.org/topics/title-insurance/)

## Features

- [Hall of Shame](https://insurancefraud.org/features/hall-of-shame/)
- [Coalition Quarterly](https://insurancefraud.org/features/coalition-quarterly/) - Coalition Quarterly Updates and a look ahead at key Coalition actions and initiatives. Stay both informed and involved by being in the know.
- [Fraud News Weekly](https://insurancefraud.org/features/fraud-news-weekly/) - Fraud News Weekly Cases, trends, legislation and Coalition updates. Published every Friday.
- [FraudBlog](https://insurancefraud.org/features/fraud-blog/) - FraudBlog Insight and analysis on key trends. Coalition staff and guest experts share their vision on how to better fight fraud.
- [Journal of Insurance Fraud in America](https://insurancefraud.org/features/journal-of-insurance-fraud-in-america/) - Journal of Insurance Fraud in America Leading exerts share the nation’s most in-depth look at anti-fraud trends across all lines of insurance.

## State

- [Alabama](https://insurancefraud.org/state/alabama/)
- [Alaska](https://insurancefraud.org/state/alaska/)
- [Arizona](https://insurancefraud.org/state/arizona/)
- [Arkansas](https://insurancefraud.org/state/arkansas/)
- [California](https://insurancefraud.org/state/california/)
- [Colorado](https://insurancefraud.org/state/colorado/)
- [Connecticut](https://insurancefraud.org/state/connecticut/)
- [Delaware](https://insurancefraud.org/state/delaware/)
- [District of Columbia](https://insurancefraud.org/state/district-of-columbia/)
- [Florida](https://insurancefraud.org/state/florida/)
- [Georgia](https://insurancefraud.org/state/georgia/)
- [Hawaii](https://insurancefraud.org/state/hawaii/)
- [Idaho](https://insurancefraud.org/state/idaho/)
- [Illinois](https://insurancefraud.org/state/illinois/)
- [Indiana](https://insurancefraud.org/state/indiana/)
- [Iowa](https://insurancefraud.org/state/iowa/)
- [Kansas](https://insurancefraud.org/state/kansas/)
- [Kentucky](https://insurancefraud.org/state/kentucky/)
- [Louisiana](https://insurancefraud.org/state/louisiana/)
- [Maine](https://insurancefraud.org/state/maine/)
- [Maryland](https://insurancefraud.org/state/maryland/)
- [Massachusetts](https://insurancefraud.org/state/massachusetts/)
- [Michigan](https://insurancefraud.org/state/michigan/)
- [Minnesota](https://insurancefraud.org/state/minnesota/)
- [Mississippi](https://insurancefraud.org/state/mississippi/)
- [Missouri](https://insurancefraud.org/state/missouri/)
- [Montana](https://insurancefraud.org/state/montana/)
- [Nebraska](https://insurancefraud.org/state/nebraska/)
- [Nevada](https://insurancefraud.org/state/nevada/)
- [New Hampshire](https://insurancefraud.org/state/new-hampshire/)
- [New Jersey](https://insurancefraud.org/state/new-jersey/)
- [New Mexico](https://insurancefraud.org/state/new-mexico/)
- [New York](https://insurancefraud.org/state/new-york/)
- [North Carolina](https://insurancefraud.org/state/north-carolina/)
- [North Dakota](https://insurancefraud.org/state/north-dakota/)
- [Ohio](https://insurancefraud.org/state/ohio/)
- [Oklahoma](https://insurancefraud.org/state/oklahoma/)
- [Oregon](https://insurancefraud.org/state/oregon/)
- [Pennsylvania](https://insurancefraud.org/state/pennsylvania/)
- [Rhode Island](https://insurancefraud.org/state/rhode-island/)
- [South Carolina](https://insurancefraud.org/state/south-carolina/)
- [South Dakota](https://insurancefraud.org/state/south-dakota/)
- [Tennessee](https://insurancefraud.org/state/tennessee/)
- [Texas](https://insurancefraud.org/state/texas/)
- [Utah](https://insurancefraud.org/state/utah/)
- [Vermont](https://insurancefraud.org/state/vermont/)
- [Virginia](https://insurancefraud.org/state/virginia/)
- [Washington](https://insurancefraud.org/state/washington/)
- [West Virginia](https://insurancefraud.org/state/west-virginia/)
- [Wisconsin](https://insurancefraud.org/state/wisconsin/)
- [Wyoming](https://insurancefraud.org/state/wyoming/)
- [Federal](https://insurancefraud.org/state/federal/)

## Statute Areas

- [Anti-Runner Provisions](https://insurancefraud.org/statute_areas/anti-runner-provisions/)
- [Attempted Fraud](https://insurancefraud.org/statute_areas/attempted-fraud/)
- [Claims Fraud](https://insurancefraud.org/statute_areas/claims-fraud/)
- [False Claims Act](https://insurancefraud.org/statute_areas/false-claims-act/)
- [Fraud Bureau](https://insurancefraud.org/statute_areas/fraud-bureau/)
- [Immunity](https://insurancefraud.org/statute_areas/immunity/)
- [Insurance Fraud - Definition](https://insurancefraud.org/statute_areas/insurance-fraud-definition/)
- [Mandatory Restitution](https://insurancefraud.org/statute_areas/mandatory-restitution/)
- [Practitioner Penalites](https://insurancefraud.org/statute_areas/practitioner-penalites/)
- [Premium Fraud](https://insurancefraud.org/statute_areas/premium-fraud/)
- [Range of Criminal Penalties](https://insurancefraud.org/statute_areas/range-of-criminal-penalties/)
- [Range of Civil Penalties](https://insurancefraud.org/statute_areas/range-of-civil-penalties/)
- [Underwriting Fraud](https://insurancefraud.org/statute_areas/underwriting-fraud/)
- [Staged Accidents](https://insurancefraud.org/statute_areas/staged-accidents/)

## Requirement Types

- [Fraud Warning](https://insurancefraud.org/requirement_types/fraud-warning/)
- [Mandatory Reporting](https://insurancefraud.org/requirement_types/mandatory-reporting/)
- [Fraud Plan](https://insurancefraud.org/requirement_types/fraud-plan/)
- [SIU Education](https://insurancefraud.org/requirement_types/siu-education/)
- [SIU Requirement](https://insurancefraud.org/requirement_types/siu-requirement/)
- [Annual Reporting](https://insurancefraud.org/requirement_types/annual-reporting/)

## Categories

- [Conviction](https://insurancefraud.org/news_categories/conviction/)
- [Arrest](https://insurancefraud.org/news_categories/arrest/)

## Categories

- [Consumer Privacy](https://insurancefraud.org/current_legislation_categories/consumer-privacy/)
- [Public Adjusters](https://insurancefraud.org/current_legislation_categories/public-adjusters/)
- [Counterfeit Airbags](https://insurancefraud.org/current_legislation_categories/counterfeit-airbags/)
- [Identity Theft](https://insurancefraud.org/current_legislation_categories/identity-theft/)
- [Immunity](https://insurancefraud.org/current_legislation_categories/immunity/)
- [Assignment of Benefits](https://insurancefraud.org/current_legislation_categories/assignment-of-benefits/)
- [Workers Compensation](https://insurancefraud.org/current_legislation_categories/workers-compensation/)
- [Data Privacy](https://insurancefraud.org/current_legislation_categories/data-privacy/)
- [Fraud Act Updates](https://insurancefraud.org/current_legislation_categories/fraud-act-updates/)
- [Fraud Bureau Authority](https://insurancefraud.org/current_legislation_categories/fraud-bureau-authority/)
- [Insurance Fraud Penalties](https://insurancefraud.org/current_legislation_categories/insurance-fraud-penalties/)
- [Auto Damage Estimates](https://insurancefraud.org/current_legislation_categories/auto-damage-estimates/)
- [Auto Damage Appraisals](https://insurancefraud.org/current_legislation_categories/auto-damage-appraisals/)
- [Medical Fraud](https://insurancefraud.org/current_legislation_categories/medical-fraud/)
- [Towing](https://insurancefraud.org/current_legislation_categories/towing/)
- [Policy Misrepresentations](https://insurancefraud.org/current_legislation_categories/policy-misrepresentations/)
- [Runners](https://insurancefraud.org/current_legislation_categories/runners/)
- [Staged Accidents](https://insurancefraud.org/current_legislation_categories/staged-accidents/)
- [Fraud Warnings](https://insurancefraud.org/current_legislation_categories/fraud-warnings/)
- [Insurance Fraud Prevention Act](https://insurancefraud.org/current_legislation_categories/insurance-fraud-prevention-act/)
- [Fraud Reporting](https://insurancefraud.org/current_legislation_categories/fraud-reporting/)
- [Disaster Claims](https://insurancefraud.org/current_legislation_categories/disaster-claims/)
- [Telematics](https://insurancefraud.org/current_legislation_categories/telematics/)
- [Insurer Practices](https://insurancefraud.org/current_legislation_categories/insurer-practices/)
- [Health Insurance](https://insurancefraud.org/current_legislation_categories/health-insurance/)
- [Vehicle Photo Inspections](https://insurancefraud.org/current_legislation_categories/vehicle-photo-inspections/)
- [Assignment of Benefits - Property](https://insurancefraud.org/current_legislation_categories/assignment-of-benefits-property/)
- [Artificial Intelligence](https://insurancefraud.org/current_legislation_categories/artificial-intelligence/)
- [Dental Fraud](https://insurancefraud.org/current_legislation_categories/dental-fraud/)
- [Bail Bond Antifraud Regulations](https://insurancefraud.org/current_legislation_categories/bail-bond-antifraud-regulations/)