Insurance Fraud

The Insurance Fraud Unit handles workers’ compensation fraud, automobile insurance fraud, and organized automobile fraud cases. If you suspect insurance fraud, please report it to our unit for investigation.


(p) 916.874.8903
(f) 916.321.2219
Insurance Fraud Hotline: 916.874.4698
Click here for a COMPLAINT FORM

Workers’ Compensation Fraud

Fraud can occur at any time during the life of a workers’ compensation claim, from the initial filing of the claim, to statements to the employer, a doctor or other medical care person, a claim representative, physical therapist, or anyone else involved in the administration of the claim and the determination of available benefits.  Fraud can occur even if the initial injury was legitimate and the filing of a claim warranted. Some common examples of workers’ compensation fraud include:

  • fabricating an injury

  • claiming a non-work injury as work-related

  • continuing to claim being injured when not

  • exaggerating physical disabilities or limitations

  • employer falsifying statements to deny a claim

  • medical provider deliberately “over treating” on a case

Learn more here

Automobile Insurance Fraud

The insurance industry estimates that auto fraud scams cost consumers anywhere from $15 billion to $20 billion annually. The Insurance Research Council estimates that, nationwide, one-third of all bodily injury claims for auto accidents contain some fraud. Automobile insurance fraud takes many forms, such as:

  • Padding of insurance claims

  • Staged or phantom accidents

  • Organized auto theft rings

  • Automobile arson (Organized Automobile Fraud Interdiction Program)

  • Chop-shops

  • Medical provider and/or auto body billing fraud

  • Attorney embezzlement of insurance company settlement funds

  • Insurance broker billing schemes and insurance company personnel conspiring with other individuals to defraud their own employers

Learn more here

The Insurance Fraud Unit recommends the following agencies that may be of further assistance:

Department of Insurance Fraud Division

Department of Insurance Suspected Fraudulent Claims Forms

National Insurance Crime Bureau