Tempest Investigative Agency
Insurance Fraud Investigations for Insurance Carriers
According to the lasted Federal Bureau of Investigation statistics, "The total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums." You can read more about insurance schemes below or go directly to the website of the Federal Bureau of Investigation.
The insurance industry consists of more than 7,000 companies that collect over $1 trillion in premiums each year. The massive size of the industry contributes significantly to the cost of insurance fraud by providing more opportunities and bigger incentives for committing illegal activities.
Tempest Investigative Agency is ready to do its part to minimize your company's losses - TODAY!
As experienced Palm Beach Insurance Fraud Investigators, we can deliver the evidence needed to establish the validity of insurance claims. From simple insurance investigations to criminal fraud surveillance, you can be assured of accurate, documented information that we gather, prepare, and present in a format usable for the courts. Our background and expertise in surveillance ensures a successful outcome.
Here is where we can help:
- Bodily Injury Claims
- Workers’ Compensation Claims
- Public Liability Accident/Loss
- Scene Investigation
- Automobile Insurance Fraud
- Property Claims Life & Health Claims
- General Liability Disability Investigations
- Product Liability
- Maritime Insurance Fraud
- And More
When you use our services you will receive timely and specific data that is objective and factual with supportive evidence to your requirements.
For answers to your questions, please call or use our CONTACT FORM today for a free consultation. You will get prompt, courteous service. You can also call us at:
(561) 627-7375
Common Schemes (courtesy of fbi.gov)
Premium Diversion
- Premium diversion is the embezzlement of insurance premiums.
- It is the most common type of insurance fraud.
- Generally, an insurance agent fails to send premiums to the underwriter and instead keeps the money for personal use.
- Another common premium diversion scheme involves selling insurance without a license, collecting premiums and then not paying claims.
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Fee Churning
- In fee churning, a series of intermediaries take commissions through reinsurance agreements.
- The initial premium is reduced by repeated commissions until there is no longer money to pay claims.
- The company left to pay the claims is often a business the conspirators have set up to fail.
- When viewed alone, each transaction appears to be legitimate—only after the cumulative effect is considered does fraud emerge.
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Asset Diversion
- Asset diversion is the theft of insurance company assets.
- It occurs almost exclusively in the context of an acquisition or merger of an existing insurance company.
- Asset diversion often involves acquiring control of an insurance company with borrowed funds. After making the purchase, the subject uses the assets of the acquired company to pay off the debt. The remaining assets can then be diverted to the subject.
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Workers’ Compensation Fraud
- Some entities purport to provide workers’ compensation insurance at a reduced cost and then misappropriate premium funds without ever providing insurance.
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Scam Spotlight—Disaster-Related Fraud: Hurricane Katrina
Massive Storm, Massive Cost
- In late August 2005, Hurricane Katrina made landfall along America's Gulf Coast.
- The storm caused approximately $100 billion in economic damages.
- Approximately 1.6 million insurance claims were filed, totaling $34.4 billion in insured losses.
- Of the $80 billion in government funding appropriated for reconstruction, it is estimated that Insurance Fraud may have accounted for as much as $6 billion.
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Disaster Fraud Schemes
- False or exaggerated claims by policyholders.
- Misclassification of flood damage as wind, fire, or theft.
- Claims filed by individuals residing hundreds of miles outside the disaster-zone.
- Bid-rigging by contractors, falsely inflating the cost of repairs.
- Contractors requiring upfront payment for services, then failing to perform the agreed upon repairs.
- Charity fraud scams designed to misappropriate funds donated for disaster relief.
The Government Response
- On September 8, 2005, the Attorney General created the Hurricane Katrina Fraud Task Force (HKTF).
- The HKTF was designed to deter, investigate, and prosecute disaster-related federal crimes.
- The HKTF has a zero-tolerance policy for fraud related to Hurricane Katrina.
- In one Katrina-Related fraud case alone, the FBI received more than 70 indictments and over 60 guilty pleas (as of March 2007).
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Insurance Fraud Resources
For more information about Insurance Fraud or where to report it, contact the following organizations.
Fraud Bureaus Check to see if your state sponsors a fraud bureau that investigates insurance fraud—most states do. You may even be eligible for a reward if you report a scam.
Insurance Companies Go directly to the insurer you think is being defrauded. Some companies have systems in place for reporting fraud. If the company doesn't have a reporting system or fraud hotline, call or write the company headquarters.
National Insurance Crime Bureau (NICB) (800) 835-6422 https://www.nicb.org The NICB is a non-profit organization that partners with insurance companies and law enforcement to help identify, detect, and prosecute insurance criminals. The NICB web site is an excellent source of information.
Coalition Against Insurance Fraud (CAIF) http://www.insurancefraud.org The CAIF is a national alliance of consumer groups, public interest organizations, government agencies, and insurers dedicated to preventing insurance fraud. The CAIF website offers a wealth of information for consumers.
National Association of Insurance Commissioners (NAIC) www.naic.org The NAIC assists state insurance regulators in serving the public interest and achieving regulatory goals. You can find numerous fraud resources on the NAIC website.
Individuals are always encouraged to report Insurance Frauds to their local FBI offices.
For more information, see the FBI's Financial Crimes Report.
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