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Organized Ring - Collision orchestrated by organized criminal activity involving attorneys, doctors, other medical professionals, office administrators and/or cappers.Medical Provider - Medical provider inflates billing, knowingly submits bills with improper medical codes and misrepresents facts.
(Example: Over-reporting wages as if employees are experienced journeyman with less likelihood of injury and thus allowing for lower premiums or under-reporting payroll to keep premiums lower.) X-Mod Evasion - Misrepresenting claims history by not reporting reportable injuries or by creating shell companies to give the impression of a non or low claims history to obtain workers' compensation coverage at a lower premium. Agricultural/Livestock - Suspicious loss or damage incurred to agricultural products and/or livestock not caused by acts of nature.Trailered Watercraft Arson - Arson of a watercraft while transported on trailer.Other Auto Property - Any other auto-related circumstance not listed above involving the presentation of false documents as proof of insurance. Inflated Billing - Inflated billing by any medical facility, doctor, chiropractor, laboratory, etc.In those instances, the crime of "insurance fraud" is usually pursued as "mail fraud," "criminal racketeering" or other federal offenses.Swoop - "Swoop" vehicle swerves in front of "squat" vehicle causing "squat" vehicle to slam on its brakes, which causes a rear-end collision with the victim's vehicle.Cases investigated by the Fraud Division most often involve criminal acts involving automobile property and personal injury, workers' compensation, health insurance and residential and commercial property claims.
Some examples of the types of insurance fraud that are investigated include: California and federal laws also permit the Fraud Division to pursue its cases federally.Disability - Disability claim submitted against disability insurance policy while claimant on permanent or temporary disability and receiving continual benefits and/or vocational benefits and/or claimant reported working or performing activities exceeding alleged physical limitations.Food Contamination - Foreign object found within food/drink products.Employer Defrauding Employee - Employer committing illegal act against employee(s).Legal Provider - Legal provider inflates billing or materially misrepresents the facts.Back to Automobile Collision Property Faked Damages - Damages to vehicle exaggerated, non-existent, pre-existing or vehicle damaged at a later point in time. Auto Property/Vandalism - Vehicle or motor home vandalism including such items as car rims, stereo equipment and engine parts.