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Tag: insurance fraud


Regulatory / Legal

New York Fund Receives $7.75 Million After Workers’ Compensation Fraud Prosecution

December 18, 2023

Via: Insurance Journal

Law enforcement officials announced the final sentencing in their prosecution of an $18 million workers’ compensation fraud case and the return of $7.75 million to the New York State Insurance Fund (NYSIF). Manhattan District Attorney Alvin Bragg, Jr. on Friday […]


Cyber Risks, Risk Management

Is ChatGPT an insurance fraudster’s best friend?

October 12, 2023

Via: Insurance Business

The use of artificial intelligence (AI) to facilitate fraud insurance claims has grown over the past decade, especially as AI has become more sophisticated. But the entry of generative AI could drive insurance fraud to levels yet unseen, a digital […]


News, Regulatory / Legal

Vesttoo seeks to recover $200m+ from co-founders Bertele & Lifshitz

September 18, 2023

Via: Artemis BM

Under-fire Israeli insurtech Vesttoo, which is at the heart of a letter of credit (LOC) fraud scandal, is now claiming hundreds of millions of dollars back from its two ousted co-founders, as well as persons that worked to source investors, […]


News

Arrests Made in California “Family and Friend” Auto Insurance Fraud Ring

August 17, 2023

Via: Insurance Journal

An alleged “family and friend” organized auto insurance fraud ring in California was seemingly broken up by the Urban Automobile Insurance Fraud Task Force when seven people were arrested on Wednesday in connection to the case. In total, 23 individuals […]


News

Kentucky Tobacco Crop Insurance Fraud Ring Results in Two More Guilty Pleas

June 5, 2023

Via: Insurance Journal

A Kentucky farmer and his sister-in-law have pleaded guilty to a multi-year scheme to defraud the Federal Crop Insurance Corp. and companies the FCIC reinsures. ARMTech Insurance Services, now part of AgriSompo North America, paid out on some of the […]


News

Fraudulent Filings in Massachusetts Could Be Distorting U.S. Jobless Claims Reports

May 18, 2023

Via: Insurance Journal

Fraudulent filings for state unemployment insurance aid in Massachusetts could be distorting U.S. weekly unemployment claims data, economists warned on Wednesday, making it harder to get a clear picture of the labor market in the short-term. A surge in applications […]


Regulatory / Legal

Accountant Charged With $10 Million in Construction Workers’ Compensation Fraud

May 9, 2023

Via: Insurance Journal

Manhattan District Attorney Alvin Bragg, Jr. announced two indictments of a certified public accountant for defrauding the New York State Insurance Fund (NYSIF) of more than $10 million in workers’ compensation insurance premium payments. Accountant Steve Lyon Lyon was charged […]


Regulatory / Legal

Law firm, partners fined $2 million for “massive insurance fraud scheme”

May 3, 2023

Via: Insurance Business

Louisiana Insurance Commissioner Jim Donelon has fined Texas law firm McLenny Moseley & Associates (MMA) and associated partners $2 million for hurricane-related insurance fraud involving at least 850 Louisiana homeowners and policyholders. “The illegal insurance scheme perpetrated by McClenny Moseley […]


Regulatory / Legal

New York Surgeon Gets 36 Months in Jail for Role in $30M Trip-and-Fall Scam

March 27, 2023

Via: Insurance Journal

A New York-licensed pain management doctor has been sentenced to 36 months in prison for his participation in a scheme to obtain fraudulent insurance reimbursements and other compensation from fraudulent trip-and-fall accidents. Damian Williams, U.S. Attorney for the Southern District […]


Regulatory / Legal

Florida Insurance Agent Who Used $5M in Premiums for Safari, Condos Gets 14 Years

March 23, 2023

Via: Insurance Journal

More than 18 months after he pleaded guilty to absconding with almost $5 million in premiums, a Florida insurance agent has been sentenced to 14 years in prison. John M. Thomas, 52, the former owner of Thomas Insurance agency in […]


Regulatory / Legal

New York Jury Convicts Lawyer, Doctor in $31M Trip-and-Fall Insurance Fraud

December 19, 2022

Via: Insurance Journal

A New York attorney and surgeon were convicted by a Manhattan jury of six counts of fraud for participation in an illegal scheme that included false insurance claims and unnecessary surgeries for alleged injuries from staged trips and falls, a […]


Regulatory / Legal

Spouses plead guilty in $1 million insurance scam

November 29, 2022

Via: Insurance Business

A former Amtrak employee has pleaded guilty to conspiring with her husband to steal almost $1 million in COVID-19-related unemployment insurance benefits and for dishonestly obtaining more than $63,000 in sickness benefits. Lizette Berrios Lathon, 45, of Moreno Valley, Calif., […]


Risk Management, Trends

Insurance fraud costs $308.6bn annually, coalition reports

November 28, 2022

Via: Reinsurance News

The Coalition Against Insurance Fraud has released a report estimating that annually, insurance fraud costs the US $308.6 billion. In 1995, the Coalition estimated this number at $80 billion, though at the time, only the property & casualty insurance line […]


Regulatory / Legal

Houston Business to Pay $300K For Workers’ Comp Insurance Fraud

November 15, 2022

Via: Insurance Journal

The Texas Department of Insurance Division of Workers’ Compensation (DWC) announced that a Travis County district court judge convicted Sehgal & Sons Enterprises (Ultra Business Services Inc.) of first-degree felony in a scheme to defraud Texas Mutual Insurance Company (Texas […]


Regulatory / Legal

Navy veteran pleads guilty in $2 million insurance scam

October 31, 2022

Via: Insurance Business

A US Navy veteran has pleaded guilty to charges related to an insurance fraud scheme that bilked a program that compensates service members who suffer serious and debilitating injuries while on active duty. Christopher Toups, who at the time of […]


Regulatory / Legal

Massive insurance fraudster hit with new state grand jury indictments

June 29, 2022

Via: Insurance Business

New South Carolina grand jury indictments have been filed against controversial insurance fraud attorney Alex Murdaugh and his alleged accomplice Curtis Eddie Smith. Murdaugh, 54, is currently in jail on a $7 million bond following more than 70 criminal charges […]


Regulatory / Legal

‘Well-to-Do’ Investment Firm Head Charged in $300,000 South Florida Insurance Fraud

June 23, 2022

Via: Insurance Journal

The head of a small, South Florida investment firm has been charged with insurance fraud after he submitted a $300,000 roof-leak claim to his insurer, American International Group, along with allegedly fake photos of mold and other damage to his […]


Regulatory / Legal

Twenty-three people charged in massive life insurance scam

June 6, 2022

Via: Insurance Business

A federal grand jury in Chicago has charged 23 people with participating in an insurance fraud scheme that allegedly bilked 10 life insurance carriers out of at least $26 million in benefits. The defendants allegedly submitted fraudulent applications in order […]


Regulatory / Legal

Ex-Ohio Insurance Agent Arrested for Defrauding Customers

June 3, 2022

Via: Insurance Journal

A former Ohio insurance agent was arrested June 2 on federal charges alleging he defrauded dozens of victims in the Cincinnati and Dayton area and fraudulently obtained two COVID Paycheck Protections Program loans. Seneca Birchmore, 44, of Cincinnati, lost his […]


Financial, Risk Management

Fraudulent disaster claims cost P&C insurers extra $4.6bn to $9.2bn

May 18, 2022

Via: Artemis BM

Fraud, litigation, claims inflation, social inflation, loss adjustment expenses, there seems a multitude of reasons for natural disaster insurance claims to become amplified and for higher loss costs to ultimately flow to providers of reinsurance capital, including ILS funds and […]