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Insurance Fraud
Our insurance fraud attorneys regularly team with SIU, Claims and Auditing Departments to investigate and litigate claims involving suspected insurance fraud. We are involved in all aspects of the claim process: investigating the claim, taking examinations under oath and providing coverage opinions; defending the denial of fraudulent claims and any related Bad Faith actions; initiating litigation to recover amounts paid out on fraudulent claims; filing declaratory judgment actions to prevent payment on such claims and defending any related arbitration matters; and developing and implementing insurance fraud initiatives to deter the filing of additional fraudulent claims. We work with our clients to develop solutions to the problems they face in a manner that allows them to quantify the impact and results of their anti-fraud activities.
Insurance fraud occurs across various lines of coverage and at different times in the process. Examples are underwriting/rate evasion fraud at policy inception, fabricated losses and post-loss claim enhancement. Our attorneys have experience investigating and litigating claims involving application and premium fraud, staged accident and theft rings, medical provider eligibility and billing for services not rendered, business interruption losses, property damage, surety/fidelity bonds, and claims of employment discrimination. Some of the key issues our attorneys have addressed in litigation in state and federal courts include:
- Discovery of hidden payroll in computer business records
- Recovery of unpaid insurance premiums
- Dismissal on summary judgment of Bad Faith Claims related to policy cancellation
- Staged motor vehicle accident rings
- Unlicensed medical providers
- Medical provider billing fraud
- Staged vehicle thefts
- Identity fraud and eligibility
- Fraudulent employment discrimination claims
For more information about the Global Insurance Services Group at Goldberg Segalla LLP, please contact one of the practice group Co-Chairs:
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