Suspected Fraud Referrals
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- Roland Hodges
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1 Suspected Fraud Referrals CASE TYPE FY 10/11 FY 11/12 FY 12/13 % increase/ decrease Personal Injury Protection % Workers Compensation % Vehicle % Application % Licensee % Homeowners % Healthcare % Commercial % Banking and Securities % Duplicate Entry % Disability % Arson for Profit % Financial Investigation % Non-Insurance Fraud % Other Agency Assistance % Life Insurance % Identity Theft % Unauthorized Entity % Warranty % Information Only % Marine % Title Fraud % My Safe Florida Home % Bonds % Referrals 12,084 12,820 13,452 15,141 15,447 FY 2008/2009 FY 2009/2010 FY 2010/2011 FY 2011/2012 FY 2012/2013
2 Presentations CASE TYPE FY 10/11 FY 11/12 FY 12/13 % increase/ decrease Personal Injury Protection % Workers' Compensation % Licensee % Vehicle % Homeowners % Healthcare % Disabilty % Application % Commercial % Other Agency Assistance % Marine % Arson for Profit % Financial % Banking and Securities % Warranty n/a Identity Theft % Life Insurance % Title Fraud % My Safe Florida Home % Unauthorized Entity % Presentations 1,670 1,234 1,214 1, FY 2008/2009 FY 2009/2010 FY 2010/2011 FY 2011/2012 FY 2012/2013
3 Arrests CASE TYPE FY 10/11 FY 11/12 FY 12/13 % increase/ decrease Personal Injury Protection % Workers' Compensation % Licensee % Vehicle % Other Agency Assist % Healthcare % Homeowners % Disability % Application % Commercial % Banking and Securities % Financial % Arson for Profit % Life Insurance % Marine % Warranty Identity Theft % Title Fraud % Unauthorized % Bonds My Safe Florida Home Arrests 1,571 1, , FY 2008/2009 FY 2009/2010 FY 2010/2011 FY 2011/2012 FY 2012/2013
4 Convictions CASE TYPE FY 10/11 FY 11/12 FY 12/13 % increase/ decrease Personal Injury Protection % Workers' Compensation % Licensee % Vehicle % Healthcare % Homeowners % Disability % Commercial % Application % Other Agency Assistance % Financial Investigation % Banking and Securities % Life Insurance % Title % Arson for Profit % Identity % Marine % Unauthorized Entity % Warranty Bonds My Safe Florida Home Convictions 1, FY 2008/2009 FY 2009/2010 FY 2010/2011 FY 2011/2012 FY 2012/2013
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9 Suspected Fraud Referrals Personal Injury Protection Workers Compensation Vehicle Application Licensee Homeowners Healthcare Commercial Banking and Securities Duplicate Entry Disability Arson for Profit Financial Investigation Non-Insurance Fraud Other Agency Assistance Life Insurance Identity Theft Unauthorized Entity Warranty Information Only Marine Title Fraud My Safe Florida Home Bonds Homeowners, 765 Licensee, 905 Application, 1,227 Healthcare, 536 Vehicle, 1,390 Workers Compensation, 1,733 Personal Injury Protection, 7,346
10 Presentations Personal Injury Protection Workers' Compensation Licensee Vehicle Homeowners Healthcare Disabilty Disabilty, 38 Healthcare, 39 Homeowners, 50 Vehicle, 58 Application Commercial Other Agency Assistance Licensee, 86 Personal Injury Protection, 802 Marine Arson for Profit Financial Workers' Compensation, 475 Banking and Securities Warranty Identity Theft Life Insurance Title Fraud My Safe Florida Home Unauthorized Entity
11 Arrests Personal Injury Protection Workers' Compensation Licensee Vehicle Other Agency Assist Healthcare Homeowners Disability Application Commercial Banking and Securities Other Agency Assist, 56 Vehicle, 57 Licensee, 141 Disability, 35 Homeowners, 41 Healthcare, 43 Personal Injury Protection, 651 Financial Arson for Profit Life Insurance Marine Warranty Workers' Compensation, 418 Identity Theft Title Fraud Unauthorized Bonds My Safe Florida Home
12 Convictions Personal Injury Protection Workers' Compensation Licensee Vehicle Healthcare Homeowners Disability Commercial Homeowners, 26 Healthcare, 43 Disability, 26 Application Other Agency Assistance Financial Investigation Banking and Securities Vehicle, 44 Licensee, 138 Personal Injury Protection, 442 Life Insurance Title Arson for Profit Identity Marine Workers' Compensation, 259 Unauthorized Entity Warranty Bonds My Safe Florida Home
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17 STAT PACK From 7/1/2012 To 6/30/ :59:59 PM ADMINISTRATIVE Presented for EXTRA DUTIES PERFORMED % 0.00% 0.00% 0.00% 0.00% 0.00% APPLICATION FRAUD Presented for BY CLAIMANT COMMERCIAL CREDIT LIFE DISABILITY FINANCIAL HEALTH HOMEOWNER/SINKHOLE HOMEOWNERS HOMEOWNERS/SINKHOLE HOMEOWNER-SINKHOLE LIFE VEHICLE VESSEL % 3.89% 3.41% 2.04% 2.16% 1.76% ARSON FOR PROFIT Presented for COMMERCIAL HOME VEHICLE VESSEL % 0.58% 0.62% 0.60% 0.70% 0.37% AVIATION FRAUD Presented for FICTITIOUS CLAIM
18 % 0.00% 0.00% 0.00% 0.00% 0.00% BANKING AND SECURITIES Presented for BANK FRAUD FINANCE FRAUD MORTGAGE FRAUD SECURITIES FRAUD % 0.54% 0.66% 0.24% 1.46% 0.56% COMMERCIAL Presented for AGRICULTURE/LIVESTOCK FICTITIOUS CERTIFICATE OF INS FICTITIOUS CLAIM OR DAMAGE FICTITIOUS LIABILITY CLAIM INFLATED CLAIM SLIP & FALL % 1.65% 2.37% 1.56% 1.72% 2.32% DISABILITY FRAUD Presented for FICTITIOUS CLAIM WORKING WHILE COLLECTING % 1.69% 1.94% 2.28% 2.23% 2.41% DUPLICATE ENTRIES Presented for DUPLICATE % 0.00% 0.00% 0.00% 0.00% 0.00% FINANCIAL INVESTIGATION Presented for FINANCIAL MORTGAGE FRAUD
19 % 0.79% 1.56% 0.42% 0.89% 1.20% HEALTHCARE Presented for BY PATIENT BY PROVIDER DENTAL HEALTHCARE FRAUD DENTAL HEALTHCARE FRD BY CLAIMANT DISABILITY EMPLOYER POCKETING PREMIUMS FICTITIOUS INSURANCE CARD FICTITIOUS PROVIDER OTHER MEDICAL PROVIDER PATIENT BROKERING PRESCRIPTION FRAUD SERVICES BY UNLICENSED PERSON % 2.40% 4.12% 2.34% 2.74% 3.99% HOMEOWNERS Presented for COOKING/KITCHEN FIRE FICTITIOUS CLAIM OR DAMAGE FICTITIOUS LIABILITY CLAIM FORGERY BY HOMEOWNER FORGERY BY OTHER FORGERY BY PUBLIC ADJUSTER INFLATED CLAIM PLUMBING/TRENCHING SINKHOLE WATER EXTRACTION % 4.88% 4.73% 2.99% 2.61% 2.41% IDENTITY THEFT Presented for
20 BY ENTITY BY PERSON % 0.17% 0.19% 0.18% 0.19% 0.28% INFORMATION ONLY Presented for INFORMATION INFORMATION ONLY % 0.04% 0.00% 0.00% 0.00% 0.00% LICENSEE FRAUD Presented for ADJUSTER ADJUSTER-BROKEN PIPE ADJUSTER-BROKEN TILE AGENCY AGENT ANNUITY BAIL BOND AGENT CARRIER FICTITIOUS CLAIM OR DAMAGE HEALTH MAINTENANCE ORG Public Adjuster PUBLIC ADJUSTER/SINKHOLE PUBLIC ADJUSTER-BROKEN PIPE PUBLIC ADJUSTER-BROKEN TILE PUBLIC ADJUSTER-KITCHEN FIRE SERVICE WARRANTY COMPANY THIRD PARTY ADMINISTRATOR TITLE INSURANCE UNLICENSED AGENT OR ADJUSTER UNLICENSED CONTRACTOR VIATICAL BROKER VIATICAL PROVIDER
21 5.86% 6.53% 7.20% 5.15% 8.98% 12.79% LIFE INSURANCE FRAUD Presented for BENEFICIARY FORGERY CREDIT LIFE LIFE AND ANNUITIES MURDER FOR PROFIT QUESTIONABLE DEATH % 0.33% 0.38% 0.12% 0.38% 0.46% MARINE FRAUD Presented for FICTITIOUS CLAIM INFLATED CLAIM % 0.33% 0.14% 0.90% 0.25% 0.19% MY SAFE FLORIDA HOME Presented for CONTRACTOR HOME INSPECTOR HOMEOWNER WIND RESISTANT IMPROVEMENTS % 0.08% 0.09% 0.00% 0.00% 0.00% NON-INSURANCE FRAUD Presented for INTRA-AGENCY RESPONSE LETTER NO ACTION % 0.04% 0.05% 0.00% 0.00% 0.00% OTHER AGENCY ASSISTANCE Presented for AGENT ASSISTANCE UNLICENSED CONTRACTOR
22 0.25% 1.69% 1.89% 0.96% 3.56% 1.67% PERSONAL INJURY PROTECTION Presented for BY ATTORNEY BY CLAIMANT BY PROVIDER FICTITIOUS CLAIM OR DAMAGE FICTITIOUS INSURANCE CARD ILLEGAL POSSESSION OF ACCIDENT REPORT JUMP IN LOST WAGES PAPER ACCIDENT PATIENT BROKERING SOLICITATION STAGED ACCIDENT UNLICENSED ACTIVITY % 30.72% 30.07% 48.02% 41.44% 40.96% RISK MANAGEMENT Presented for GOVERNMENT EMPLOYEE % 0.04% 0.05% 0.06% 0.06% 0.00% TITLE FRAUD Presented for HOME PROPERTY VEHICLE % 0.12% 0.09% 0.06% 0.13% 0.37% UNAUTHORIZED ENTITIES FRAUD Presented for HEALTH LIFE AND ANNUITIES MARINE
23 PROPERTY/CASUALTY PROVIDER VEHICLE VEHICLE FRAUD % 0.04% 0.09% 0.00% 0.06% 0.09% ACCESSORIES BODY SHOP BY CLAIMANT BY PROVIDER DAMAGE TO VEHICLE DITCHING FAILURE TO RETURN (THEFT) JUMP IN VEHICLE WARRANTY FRAUD % 6.57% 6.96% 3.47% 3.63% 4.08% CELL PHONE HOME VEHICLE WORKERS' COMPENSATION % 0.08% 0.05% 0.24% 0.25% 0.09% Presented for Presented for Presented for AGENT PREMIUM BY ATTORNEY BY EMPLOYEE CLAIMANT BY EMPLOYER BY PROVIDER COMMERCIAL EMPLOYEE PAYROLL DEDUCTION EMPLOYER PREMIUM
24 FICTITIOUS CERTIFICATE OF EXEMPTION FICTITIOUS CERTIFICATE OF INSURANCE ID THEFT OF NUMBER OR NAME LEASING COMPANY MONEY SERVICE BUSINESS UNLICENSED CONTRACTOR VIOLATION OF STOP WORK ORDER WORKING WITHOUT COVERAGE % 36.79% 33.33% 28.38% 26.54% 24.00% Grand Total /18/2013 4:30:53 PM Page 1 of 1
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