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Fraud affects us ALL as Individuals, Business Owners and Insurance Carriers.



At Blue Eye Investigations we are determined in combating FRAUD!  We are well aware of the risks you face everyday and we are committed to using all of our resources on your behalf to protect your assets from the scams so often employed.


Almost as long a there has been insurance, there have been people who have tried to defraud insurance companies.  Not only do these people cost us money, but they also put innocent people in danger.  Police and insurance investigators are more watchful than ever, looking for possibly fraudulent cases.

 

The following outlines different kinds of fraud committed and some of the more recognizable fraud schemes.


Staged Vehicle Collisions - In staged vehicle collisions, rings of con artists team up with dishonest doctors, lawyers and repair shop operators to create automobile accidents involving unsuspecting motorists.  Bogus witnesses are positioned near the collision to support the criminal's account and contradict the innocent driver's testimony.  The accident results in lawsuits and phony medical insurance claims.

 

Favorite targets for staged collisions are fully insured drivers not accompanied by passengers who could serve as witnesses.  Luxury cars are often targeted because they offer the promise of extensive insurance coverage.

 

The Schemes:

 

  • Swoop and Squat - An unsuspecting driver follows two vehicles driven by a pair of perpetrators.  The first vehicle, the swoop vehicle, suddenly cuts in front, stops or slows down in front of the second squat vehicle, forcing it to abruptly stop to avoid a collision.  The innocent driver of the third vehicle has little or no time to react and a collision between the squat car and the innocent motorist occurs.  The rear-end collision leaves the unsuspecting motorist at fault.

 

  • Drive Down - This scheme takes place when an unsuspecting driver tries to merge into traffic.  The perpetrator yields and waves to the innocent driver to proceed with the merge.  As the innocent driver merges, the suspect driver intentionally smashes into the victim and denies to waving to the innocent driver.

 

  • Side Swipe - With a side swipe, perpetrators target innocent drivers in a dual left turn lane of a busy intersection.  If an unsuspecting victim in the inner lane drifts into the outer lane, the perpetrators intentionally cause a collision.

Vehicle Theft Fraud - Some perpetrators report their vehicles stolen in an attempt to collect insurance money.  Others try to dispose of their vehicles because they cannot afford their car payments.

 

The Schemes:

 

  • Owner Give-Up - Theft claims are filed for vehicles that are sold without paperwork, abandoned, impounded or hidden until after a claim goes through.

 

  • 30-Day Special - Often orchestrated by owners whose vehicles need extensive repairs, they will report the vehicle stolen and hide it for 30 days, just long enough for the insurance company to settle the claim.  Once the claim is paid, the vehicle is often found abandoned.

 

  • Export Fraud - A vehicle is purchased or rented, insured and then shipped to an overseas conspirator.  Once the conspirator sells the vehicle, the perpetrator reports it stolen.  The insurance company covers the loss, while the fraud ring profits from the sale of the vehicle overseas for two to three times its value.


 


  • Phantom Vehicles - This scheme occurs when an individual creates a phony title or registration to secure insurance on a non-existent vehicle.  The insured will later report the vehicle stolen before filing a fraudulent insurance claim.

Other Vehicle Claims Fraud

 

The Schemes:

 

  • Total Vehicle Destruction - In this scheme the vehicle owner orchestrates the destruction of the vehicle to collect insurance money.  The "stolen" vehicle is often found burned in a secluded area, submerged in a lake or, in some extreme cases, buried underground.

 

  • Hit and Run - In this case, the perpetrator uses a damaged vehicle and claims to be a victim of a hit and run or an animal collision.  Police are often called to the scene to verify the damage.

 

  • Paper Accidents - As the name suggests, paper accidents occur only on paper.  An owner fabricates an accident report to collect insurance money from for a vehicle with preexisting damage.

Medical Mills - A medical mill consists of medical professionals - at times working with legal professionals and recruiters - who rip off patients and insurance companies through unethical and fraudulent billing practices.


 

Typical fraud-related injuries involve soft-tissue sprains and strains like backaches, whiplash and headaches. Injuries are often subjective and difficult to verify.  Medical patients rarely spend any time in the hospital.

 

The Criminals:

 

  • Unscrupulous Medical Providers - Dishonest medical providers often inflate bills or give unnecessary treatment in an attempt to collect extensive insurance reimbursements.  Participants often include chiropractors, physicians, pharmacists and their office managers.

 

  • Unscrupulous Legal Providers - Dishonest attorneys purposely funnel patients to corrupt doctors or knowingly represent accident victims who are filing padded claims.  Participants often include personal injury attorneys, legal clerks and law office managers.

 

  • Cappers or Runners - Third party middlemen who recruit insurance fraud perpetrators and befriend legitimate accident victims for medical mills.

 

  • Insurance Fraud Perpetrators - Pseudo patients who often fake or exaggerate injuries before visiting a medical mill.

 

Types of Medical Mills:

 

  • Fraudulent Physician - In this rare type of medical mill, everything from the doctor to the bills to the office itself is a fraud.  Since patients with bogus injuries are often recruited, these offices contain little or no medical supplies and actual treatment is rarely prescribed.

 

  • Double-Dipping Doctor - This type of medical mill does provide medical services, though the methods of treatment are often questionable, excessive or redundant.  Patients are occasionally overcharged for services or, in some extreme cases, billed for services never rendered.

 

  • Creative Accountants - The most common type of provider fraud often goes unnoticed by the patient.  The health care provider often provides quality treatment and service; however, on occasion the bills are purposely inflated.

Bodily Injury Insurance Fraud - Bodily injury fraud occurs when someone purposely fakes or exaggerates an injury to collect insurance benefits.

 

Common Bodily Injury Schemes:

 

  • Slip and Fall - Slip and fall scams are among the most widely practiced types of insurance fraud.  The claimant or his/her attorney threatens litigation against a person, organization or business from a bogus injury sustained when the victim fell on the innocent party's property.  Ultimately, the innocent party's insurance company pays for the bogus accident.

 

  • The Fake Break - Some con artists will take advantage of a new or existing injury to make a bogus claim.

 

  • The Yank Down - Perpetrators purposely pull display items or store merchandise on top of themselves and then file an injury claim resulting from the "fallen object."

 

  • The Big Trip - Here the perpetrator takes advantage of a broken or obstructed sidewalk or stairway to make a bogus claim.

 

  • The Chew and Sue - This scam involves claims against "dangerous" food products.  The schemer will claim that ill-prepared food caused physical injury and then submit a bodily injury claim.