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Month: April 2018

PIP fraud still rampant

As the Florida legislature considers changes to Florida’s no-fault insurance system, sentencing has begun in one of the most intricate PIP fraud conspiracies in recent years. A total of $23 million dollars in fraudulent PIP claims was racked up over seven years.

The case places in the public eye some details about how PIP fraud operates, which is educational. Without giving away too many details on how to uncover auto insurance fraud it highlights the severity of the problem and why all claims have to be diligently inspected.

The ring

The first sentences have been handed down in the ring that perpetrated the fraud for so many years. It was large, covering many different professions and defrauding several insurance carriers.

Auto accident victims were recruited by tow truck drivers and chiropractic clinics. They were referred to lawyers who filed personal injury claims. The entire scam, which was elaborate and carefully constructed, involved thousands of accident victims who were routed through this criminal enterprise.

How it was stopped

The Florida Department of Insurance Fraud noticed a pattern of billing at the very top end of PIP coverage from several chiropractic clinics. This started an investigation that involved many law enforcement entities at the local, state, and federal level.

The key takeaway is that insurance fraud information such as this is available and can be used by insurance companies which suspect fraud. Rarely are criminal enterprises as large as this one, but all of them involve patterns of fraudulent billing.

This is one of many things which need to be examined in the proves of uncovering PIP fraud. It takes experience to know what to look for in these investigations.

Far too common

As important as it is that large fraud rings like this are broken, smaller ones are operating all the time. Any insurance agency that suspects fraud needs to have it thoroughly investigated as part of any pre-trial preparation when a claim is denied.

There are many tell-tale signs, and all were present in this case. While it was big enough to gain attention, far too often smaller criminal enterprises get away with fraud.