Definition of backdating insurance coverage

03-Jun-2020 01:54

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.

Current law requires the Fraud Division to investigate various felony provisions of the Penal and Insurance Codes.

Most often, investigations conducted by the Fraud Division involve some aspect of a "Suspected Fraudulent Claim" or other related crimes.

Theft Commercial Carrier - Insured reports baggage/cargo lost by commercial carrier (airline, bus, train, vessel).

Watercraft/Aircraft Theft - Theft or damage to watercraft/aircraft while not on a trailer.

Watercraft/Aircraft Arson - Arson of watercraft/aircraft while not on a trailer.

Misclassification - Misclassifying the type of workers to obtain workers' compensation coverage at a lower premium.

Fraud occurs when someone knowingly lies to obtain a benefit or advantage to which they are not otherwise entitled or someone knowingly denies a benefit that is due and to which someone is entitled.

According to the law, the crime of insurance fraud can be prosecuted when: The Fraud Division is charged with enforcing the provisions of Chapter 12 of the California Insurance Code, commonly referred to as the "Insurance Frauds Prevention Act," California Penal Code, Sections 549-550 and California Labor Code, Section 3700.5.

Paper Collision - Parties conspire to create illusion of legitimate accident using either pre-damaged vehicles or by intentionally and covertly inflicting damage on the suspect's vehicle(s).

Generally, law enforcement is not called to the scene of the accident.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.