Publications

Staged auto accidents are spiking nationwide, with the National Insurance Crime Bureau (NICB) reporting a 23 percent increase from 2023 to 2024 and a staggering 38 percent jump for staged accidents involving commercial vehicles. Speaking on the National Association of Mutual Insurance Companies' (NAMIC) Insurance Unscripted podcast, Coalition Director of Government Relations Brent Walker warned that organized criminal networks are targeting commercial trucks for their higher policy limits, escalating both financial losses and human risk. Walker shared the tragic story of Alice Ross, whose death in a staged crash led to New York’s Alice’s Law. Walker also detailed Operation Sideswipe in Louisiana, where more than 100 staged accidents were tied to an organized ring and a key witness was murdered. The Coalition, NICB, and the International Association of Special Investigation Units (IASIU) are backing the Staged Accident Fraud Prevention Act of 2025, which would make intentionally staging a crash with a commercial vehicle a federal crime punishable by up to 20 years, with longer sentences if injuries occur. NAMIC also supported this still pending federal bill. Walker stressed the importance of antifraud training, early SIU engagement, and intelligence sharing to spot schemes before payouts occur. He also highlighted the Coalition’s successful amicus work protecting state-level good faith immunity laws, critical tools that enable insurers to report suspected fraud without fear of bad faith retaliation.
 

Texas reminds consumers of public adjuster rules. The Texas Department of Insurance (TDI) recently reminded consumers about their rights and responsibilities when hiring a public insurance adjuster, underscoring important issues for both policyholders and fraud fighters. Public adjusters are licensed professionals who can negotiate claims on behalf of consumers, but TDI cautioned homeowners to carefully review contracts, understand fee structures, and verify licensure before signing. Texas law bars public adjusters from acting as contractors on the same claim and prohibits improper solicitation practices, all to protect consumers from fraud and conflicts of interest. 

Colorado expands regulation on insurer use of consumer data to cover major insurance lines with an emphasis on governance and risk management. The Colorado Division of Insurance has finalized the amended Regulation 10-1-1, extending governance and risk management requirements originally designed for life insurers to private passenger automobile and health benefit plan insurers, effective October 15, 2025. The regulation governs the use of external consumer data and information sources (ECDIS), algorithms, and predictive models, requiring robust board-level oversight, documented policies, quantitative testing for unfair discrimination, and annual reporting. Insurers must also ensure accountability for third-party vendors and demonstrate that data-driven tools used for underwriting or claims do not result in consumer harm. For insurance fraud fighters, this regulatory expansion reinforces responsible use of predictive analytics while maintaining the effectiveness of fraud detection programs. In parallel, the NAIC Privacy Protections (H) Working Group continues reviewing potential revisions to its consumer data privacy, focusing on consumer opt-in/opt-out rules for non-affiliated data sharing but ensuring antifraud exemptions remain intact. Together, Colorado’s regulatory framework and the NAIC deliberations reflect a coordinated effort to balance consumer protection with the need for insurers and SIUs to use data and analytics responsibly, including to prevent and detect fraud. The Coalition continues to monitor both developments, advocating for policies that balance consumer protection with the ability to detect and investigate insurance fraud.

Coalition member Verisk, recently 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. Traditional manual investigation and asset location methods are often too slow, resource-intensive and costly, placing a heavy burden on IT, claims and investigative teams. “Insurance fraud and theft continue to grow in sophistication, and we’re committed to equipping the industry with cutting-edge tools to help minimize financial exposure and operational strain,” said Jeff Ryan, chief product officer, Anti-Fraud Analytics at Verisk. “Through seamless integration with ClaimSearch, this launch delivers automated access to previously hard-to-find, critical data points. These insights help empower insurers to identify fraud earlier, recover assets faster and drive more efficient claim outcomes.”

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 to steal people’s hard-earned money. It’s essential to stay vigilant about storm-related scams. Following damage or a loss, you may need to hire a contractor to build or repair your home. Contractors are hired at a cost to build or make repairs following an insurance claim. All contractors who earn over $2,000 a year for their services must be registered with the Iowa Department of Inspections, Appeals, & Licensing. A contractor cannot investigate, appraise, evaluate, give advice, prepare a claim, negotiate, advocate on behalf of, or assist their customer in the adjustment of a claim. This includes advertising to be "claim specialists or analysts," claiming that the contractor can "deal with insurance companies," or in any way increase the claim settlement amount for the policyholder. Consumers have the right to consult a public adjuster to negotiate with their insurance company.

New campaign targets organized crime and auto insurance fraud. Canada’s insurance crime and fraud prevention organization, Équité Association, has launched a new campaign to raise awareness about organized insurance crimes. “Fraud Never Takes a Vacation” is designed to educate and empower Canadians to spot and stop insurance fraud before it strikes, helping to ensure safer roads and more secure communities for everyone. Launched Aug. 13, the campaign’s website includes tips and tools for the public to protect themselves from emerging threats, including: Vin-Fraud, Staged Accidents, Rental Fraud, and more! Équité’s recent First Half of 2025: Auto Theft Trend Report found auto theft involving private passenger vehicles in Canada decreased 19.1% in 2025 H1 compared to the same period in 2024. However, the report also found about 44% of vehicles stolen this year remain unrecovered.

KennCo reminds young drivers and parents to review insurance rules ahead of college term. As students prepare to head to college, KennCo Insurance is issuing a reminder to young drivers and their parents to be aware of key road safety and potential insurance issues. With official data highlighting increased risks for younger motorists, understanding the rules is essential to ensure they are safe and properly insured. Data consistently shows that road users aged 16-24 are the highest-risk group on Irish roads. This risk can be heightened when young people begin driving in new and busy cities and towns, often with unfamiliar traffic layouts and more distractions. Beyond the challenges of driving in a new location, KennCo is highlighting several critical insurance pitfalls that can leave families exposed to significant financial risk with Insurance Fronting: Car Insurance Fronting is when a more experienced driver, usually a parent, is named as the main driver of a car that is primarily being used by a young driver. It is a form of insurance fraud and can lead to a policy being voided.

Investigators with the North Carolina Department of Insurance last week charged Michael Gerard Renna with swindling almost $1 million and attempting to gain another $887,500 from travel insurance companies from 2020 to 2024. The allegations: Renna forged medical documents and altered identification, credit card statements and flight information, then submitted the documents along with claims for travel losses. He was arrested Friday and was being held on $1 million bond in the Johnston County jail ahead of a Monday court appearance, according to the county sheriff’s office. The North Carolina Department of Insurance did not name the travel insurance companies that were defrauded or explain how the scheme was uncovered.

CVS Caremark hit with $289M judgment following whistleblower claim. A lawsuit filed against CVS Health by a whistleblower has resulted in a $289 million judgment, which includes $285 million in actual damages and a $4.9 million civil penalty. The healthcare giant’s pharmacy benefit manager (PBM) vertical, CVS Caremark, was found to have pressured insurance companies to upcode claims submitted to Medicare plans, leaving the federal government on the hook for inflated reimbursement costs. The whistleblower, Sarah Behnke, was an employee at Aetna during some of the incidents, which resulted in her filing a complaint accusing the company of violating provisions of the False Claims Act. The lawsuit was settled for $95M in late June, resolving claims of misconduct that date back to 2010. However, that amount was tripled—per rules within the False Claims Act—by a U.S. District Court in Pennsylvania. In issuing a final judgment on Tuesday, Judge Mitchell Goldberg said evidence presented at trial showed Caremark committed the acts of fraud deliberately, and was “financially motivated” to do so. However, the court only found the PBM liable for two years of overbilling, per terms of the settlement. The initial lawsuit was filed in 2014, meaning CVS did not own Aetna at the time the complaint was filed.

Trouble in the No-Fault System? Allstate and GEICO Hit New York Fraud Schemes. If you think insurance fraud is just a “one-off” scam here and there, think again. Two recently filed lawsuits by powerhouse insurers Allstate and GEICO suggest something much bigger is at play. Patterns of deception. Exploitation. Maybe even cracks in the system itself. The no-fault insurance system, to be precise. Allstate isn’t holding back. On August 13, they slapped a network of New York pharmacies and wholesalers with a lawsuit. The charge? A $1.48 million scam. What they’re saying happened: The pharmacies allegedly submitted bogus claims under New York’s no-fault auto insurance laws. Drugs got billed that shouldn’t have been. Payments rolled out for medications that violated state regulations. Prices were inflated. And, to top it off, Allstate alleges these pharmacies worked a little too closely with prescribers to write up unnecessary scripts.

Los Angeles County fire captain charged with disability fraud. Thomas Merryman is scheduled to be arraigned Sept. 9 on one felony count each of insurance fraud and false personation and two felony counts of forgery, according to the Los Angeles County District Attorney’s Office. The allegations: Merryman fraudulently claimed long-term disability benefits from Colonial Life & Accident Insurance Co. by allegedly submitting forged paperwork and defrauding the insurance company of more than $25,000 involving an alleged fraudulent claim for a work injury while he was not at work, according to the District Attorney’s Office. “Fake disability claims will not be tolerated under my watch, especially by first responders charged with keeping our county safe,” District Attorney Nathan Hochman said in a statement announcing the charges. “False health care claims raise insurance premiums and make it more difficult for people with legitimate work injuries to claim benefits. My message to public servants who abuse the system is clear: We are watching you. Prosecutors and investigators in my office are working closely with the Los Angeles County Fire Department and other agencies to root out fraud.” Merryman could face up to five years in state prison if convicted as charged, according to the District Attorney’s Office.

Insurance fraud in Jasper County: Man used ex-wife’s identity. An unnamed man from Kirbyville, Texas has been arrested for using his ex-wife's information to take out an insurance policy. The allegations: On July 25, the Jasper County Sheriff’s Office received a report of an auto insurance policy being opened fraudulently, a social media post from the Jasper County Sheriff's Office stated. Upon further investigation, it was discovered that the 31-year-old used his ex-wife's information to open an auto insurance policy without her knowledge or permission, leading to a warrant for the man's arrest being issued Wednesday, the Sheriff's Office said.

Two Michigan American men charged with operating chop shop for stolen vehicles. Mohamad El-Hadi, the owner of Hadi’s Cash for Cars, an employee of El-Hadi’s, appeared before the 29th District Court in Wayne. The allegations: El-Hadi allegedly operated a chop shop where at least three vehicles reported stolen were discovered crushed in the company’s tow yard, a news release from Attorney General Dana Nessel’s office states. Investigators say police found at least three stolen vehicles on El-Hadi’s property — a 2009 Kia Sorento, a 2013 Honda Odyssey and a 2017 Buick Encore — all of which were dismantled in the company’s yard. The investigation and arrests were conducted by the Auto Fraud Theft Task Force, which Nessel established in February as part of expanded efforts to combat insurance fraud in response to rising vehicle theft rates.

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