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Glossary |
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Arson For Profit |
An owner, or someone hired by an owner,
deliberately burns a business, home or vehicle to collect insurance money. |
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Disaster Fraud |
Disaster victims claim more damages than actually
occurred, or they collect money to repair damaged property, but never
complete the work. |
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Drive Down |
A driver waves on another driver, indicating it’s okay to proceed, and then intentionally hits the
passing car. |
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Embezzlement |
Theft of premium dollars intended for payment of
coverage. |
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Exaggerated Claims |
Overstating or padding an insurance claim to make
up for the deductible. |
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Falsifying Theft Reports |
Falsely reporting items stolen or exaggerating the
value of items taken in a burglary to collect insurance money. |
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Food Contamination |
Foreign object placed within food/drink products. |
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Hidden Repairs |
An auto body shop owner offers to “hide” the
deductible or inflate the extent of damage. |
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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. |
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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. |
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Misclassification |
Misclassifying the type of workers to obtain workers’
compensation coverage at a lower premium. |
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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. |
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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. |
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Paper Accident |
An owner fabricates an accident by making false
police and insurance reports. |
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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. |
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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. |
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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. |
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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. |
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Under Reported Wages |
Misrepresenting payroll to obtain workers’
compensation coverage at a lower premium. |
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Workers’ Compensation |
An employee falsely claims a work-related injury or
exaggerates the extent of a minor injury to collect workers’ compensation
benefits. |
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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. |
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