Fraud on the rise...

Posted: Tue Sep 01, 2009 11:10 am Post Subject:

Does it mention anything regarding the factors that make our insurance investigators the best of the lot in the U.S. ?

They all prosecute with no breaks for the sob stories they hear.

Posted: Tue Sep 01, 2009 11:22 am Post Subject:

They are very mythodical, things have to be done a certain way. Also 'time' in some instances brings better results...by that I mean they learn more the longer it goes typcially.

I've been in this biz for 22 years, and I can say hands down, I've never seen as much fraud, (or attempted fraud) as I have in the past year and a half.

Posted: Wed Sep 02, 2009 06:12 am Post Subject:

Hi anon,

I'd like to differ with you at this point..I'd rather support Lori's view maintaining the fact that 'time' is sometimes necessary for yielding better outcomes.

The "speed" with which an insurance investigation is carried on may seem slow with respect to another investigation, wherein the professionals may need to analyze less complicated stuff. Then it wouldn't be right to say that insurance professionals are "slow". A comparative study of successful outcomes would also need to take into account a variety of other factors.

Thanks, ArindamSenIndies

Posted: Mon Apr 05, 2010 04:36 pm Post Subject:

I agree. The only way they are going to pay in any situation is after thorough investigation. I've been a victim in a number of fraud cases (though not related to insurance) and can say that it's only after a great deal of time and consideration that everything can be sorted out accordingly.

Posted: Sun Apr 18, 2010 04:05 am Post Subject:

Insurance fraud is a hidden "tax" on every hard working, premium paying person in America. In California, where I reside, all forms of insurance fraud annually add up to more than $500 per person (including the newest baby being added to the vital records database today). And we have some 39-million people here, so just do the math.

The CA Dept of Insurance (CDI) published figures back in 2003 or 2004, that estimated 47% of all auto insurance claims in Orange County (home to Disneyland & Knott's Berry Farm, and Surf City, USA/Huntington Beach) were believed to be fraudulent. It's no wonder that premiums are as high here as they are. Someone has to pay for it.

The largest medical insurance frauds ever uncovered have happened here, including one estimated to have cost insurance companies in excess of $33-million. Those companies paid for operations performed on people -- with PPO insurance and recruited from all over the United States -- who didn't need them, and were paid to have them (some even received tickets to Disneyland or Knott's as an inducement).

Even Joey Buttafuoco (yes, that Joey Buttafuoco) was busted by CDI and CA Highway Patrol undercover investigators a few years ago for showing the investigators how to "enhance" the collision damage to their vehicles to get more money from the insurance company, and promised to split it with them.

Fraud is not an easy thing to prosecute, because there must be a showing of "intent" to gain an advantage. It requires much investigative work, it often requires information from insiders. It can take months to build a case file sufficiently airtight to nail the SOBs.

Three cheers for the fraud investigators! Public and private.

Posted: Wed Apr 21, 2010 03:29 am Post Subject:

FROM THE CA DEPT OF INSURANCE:

Commissioner Poizner Announces San Jose Mother and Son Arrested, Face Felony Auto Insurance Fraud and Hit and Run Charges

Insurance Commissioner Steve Poizner announced today the arrests of two suspects for automobile insurance fraud. Maria Valle, 40, and her son, Edgar Valle, 20, both of San Jose, were charged with felony insurance fraud and booked at the Santa Clara County Jail on $35,000 bail each. Edgar Valle was also charged with felony hit and run. Maria was arrested on April 14. Edgar was arrested on April 11.

"Fabricating stories to cover up an auto accident is wrong, illegal and will get you a ticket to jail," said Commissioner Poizner. "Think twice before filing a false police report or lying to your insurance company. If you commit auto insurance fraud, you will get caught."

An investigation conducted by the Urban Organized Insurance Fraud Task Force revealed that on October 11, 2008, a single vehicle traffic accident occurred on Jacklin Rd. in Milpitas. Edgar Valle was allegedly driving a vehicle with several passengers inside, that rolled onto its side. One passenger was injured in the accident. Edgar and the passengers allegedly fled the scene of the accident when the police were called. The injured passenger was later detained and questioned by the police. After the accident, Maria Valle allegedly drove from her East San Jose home to Milpitas to pick up Edgar. The next morning, Maria reported her vehicle stolen to the police and filed a stolen vehicle claim with her insurance carrier.

Maria Valle allegedly made material misrepresentations to the Milpitas Police Officer who was investigating the traffic accident, and to her insurance carrier when she filed an insurance claim, by stating that Edgar was at home with her at the time the vehicle was stolen and during the time that her vehicle was involved in the accident. Edgar was also charged with insurance fraud, as well as felony hit and run.

The Urban Organized Automobile Fraud Insurance Task Force is comprised of investigators from the CDI, California Highway Patrol, and Santa Clara County District Attorney's Office.

The case is being prosecuted by the Santa Clara County District Attorney's Office.

Commissioner Poizner oversees sixteen CDI Enforcement Branch regional offices throughout the state. Nearly 2,800 insurance fraud-related arrests have been made by CDI since Commissioner Poizner took office in 2007 - more arrests than have been made during any other three year period, under any previous insurance commissioner.

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The old "my car was stolen" routine is about as stale as the "lucky" husband who had just enough foresight to buy a $500,000 life policy on his wife just a few weeks before she died at the hands of another human being (AKA, the husband).

One such incident happened in Riverside County, CA about 7-8 years ago. A woman and her children were found drowned in the family van at the bottom of a not too deep urban lake. Took the police investigators about 3 minutes to finger the husband. Seems he had debts around town to the tune of $50,000 or $60,000, about the same amount of life insurance he was now beneficiary to on a policy obtained just a couple of weeks earlier. Needless to say, his crime did not pay.

Posted: Fri Jul 02, 2010 02:38 am Post Subject: Thought

Wow thats exactly what I thought too. Times are getting hard people are trying to make money as best as they can even if it means steeling. I do think that this will get worse before it will get better in fact I also think that robbery will rise also. Scary.

Posted: Sat Jul 16, 2011 10:05 am Post Subject:

Times are really getting harder each day. A jobless chunk of our population is already in committing crimes. All of them are going for that big risk to earn quick bucks. There are times we don't even feel how we get dragged in con attempts.