Unfortunately, many individuals experience their first encounter with the criminal justice system by using poor judgment in the presentation of their insurance claim and/or while completing their application for insurance.

Many believe that by simply adding a few items to their list of damaged or stolen items, or by omitting past claims history on their insurance application, it is “no big deal”.  The fact is that, in Florida, both actions may constitute insurance fraud and may result in felony criminal charges being filed by the Florida Department of Insurance – Division of Insurance Fraud.

In some situations the policyholder is led down this path by others only to find themselves not only facing the fact that their claim may not be paid but also having to deal with potential criminal charges. The old adage, “if it sounds too good to be true, it probably is” comes to mind.  When seeking assistance or advice, policyholders should deal with only those individuals that are properly licensed and authorized.

The State of Florida requires that insurance companies have a unit or means dedicated to the investigation of suspected insurance fraud.  Florida state statute also requires that any suspected acts of insurance fraud be reported to the Division of Insurance Fraud, which is a State of Florida law enforcement agency.  Tower Hill has a dedicated team of investigators responsible for investigating suspected insurance fraud.  Often, our investigations do not involve policyholders but are focused on unscrupulous individuals who have engaged in fraudulent activity and have taken advantage of an innocent policyholder.

Insurance fraud affects everyone. Most often, the purpose of committing insurance fraud is one of financial gain; however, the impact is often far greater than just the financial impact on the insurance industry and insurance consumers.  For example, arson-for-profit fires have resulted in serious injuries and deaths in those involved in the setting of the fire, including innocent neighbors and responding emergency service personnel.  Staged accidents have also resulted in unexpected injuries and deaths when the “accident” didn’t go as planned.

If you believe that insurance fraud has taken place or is occurring, you may contact Tower Hill via its Toll-Free Fraud Hotline at (866) 265-6590, the State of Florida Insurance Fraud Hotline at (800) 378-0445, or at http://www.myfloridacfo.com/fraud/.

The author, Ernie King, AVP, Tower Hill Special Investigation Unit can be reached at eking@thig.com or at (352) 333-1825.