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Glossary

 

Arson For Profit

An owner, or someone hired by an owner, deliberately burns a business, home or vehicle to collect insurance money.

 

Disaster Fraud

Disaster victims claim more damages than actually occurred, or they collect money to repair damaged property, but never complete the work.

 

Drive Down

A driver waves on another driver, indicating it’s okay to proceed, and then intentionally hits the passing car.

 

Embezzlement

Theft of premium dollars intended for payment of coverage.

 

Exaggerated Claims

Overstating or padding an insurance claim to make up for the deductible.

 

Falsifying Theft Reports

Falsely reporting items stolen or exaggerating the value of items taken in a burglary to collect insurance money.

 

Food Contamination

Foreign object placed within food/drink products.

 

Hidden Repairs

An auto body shop owner offers to “hide” the deductible or inflate the extent of damage.

 

Hit and Run

Using a pre-damaged vehicle, criminals claim they were in an accident and can’t identify the other driver, often calling police to verify.

 

Medical Fraud

Medical Mills/Padded Bills:  Unethical health care providers working in concert with scheming patients, or in the name of unwitting patients, create fictitious accident-related injuries to collect on fraudulent disability, workers’ compensation or personal injury claims.  The health care providers often bill insurers for multiple office visits and tests that never take place.

Medicaid or Medicare:  False or exaggerated claims submitted for patients whose insurance coverage is through state or federal agencies.

 

Misclassification

Misclassifying the type of workers to obtain workers’ compensation coverage at a lower premium.

 

Multiple Policies

A property or vehicle owner illegally buys numerous insurance policies for one property or vehicle and then damages or destroys it, collecting on all policies.

 

Owner/Lessee Give-up

A vehicle owner/lessee gives the vehicle to another person voluntarily and then falsely claims to the insurance company it was stolen.

 

Paper Accident

An owner fabricates an accident by making false police and insurance reports.

 

Policy Misrepresentation

A vehicle owner uses a friend’s or relative’s address and misrepresents where the vehicle is kept and how far he drives to work to obtain a lower premium.

 

Sideswipe

A driver in the inside lane of a dual left turn in a busy intersection drifts into the outer lane, intentionally forcing a collision.

 

Slip and Fall

An individual reports he/she was injured after falling on commercial property.   The fall was staged or fabricated, and there never was an injury, or it was slight.  These con artists often target small businesses or franchise operations and can work with unethical attorneys.

 

Swoop and Squat

A vehicle is suddenly passed by another vehicle which “swoops” in front of it.  This causes the vehicle in front to stop abruptly, or “squat,” and the vehicle behind is unable to avoid colliding with the rear end of the vehicle.  The swoop car will never be seen again and the squat car driver submits vehicle damage and personal injury claims to the insurer.  Often times, multiple occupants in the squat car will fabricate bodily injuries, as well.

 

Under Reported Wages

Misrepresenting payroll to obtain workers’ compensation coverage at a lower premium.

 

Workers’ Compensation

An employee falsely claims a work-related injury or exaggerates the extent of a minor injury to collect workers’ compensation benefits.

 

X-Mod Evasion

Misrepresenting claims history by not reporting 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.