Coalition Against Insurance Fraud

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'Check my Contract': A new initiative to combat insurance fraud in Florida. It’s been two weeks since tornadoes ripped through our area and as clean-up efforts continue, Florida’s Chief Financial Officer Jimmy Patronis is spreading a “buyer beware” message when it comes to home repairs. "It’s unbelievable the type of damage caused by the tornadoes that touched down in this part of the state," said Patronis. Since the storms hit, Patronis has sent members of the Division of Criminal Investigations door-to-door to ensure residents aren’t signing their rights away to potential fraudsters. https://lnkd.in/eSWK_r3b

The Coalition's comments on NCOIL's Transparency in Third Party Litigation Financing Model Act have helped influence the next draft of that model. The National Council of Insurance Legislators (NCOIL) Financial Services & Multi-Lines Issues Committee previously requested comments from interested parties on their draft of an act to address transparency in third party litigation financing. The Coalition, with assistance from its Government Affairs Committee, identified potential loopholes that could be exploited by fraudulent actors and submitted comment that included a suggestion to apply certain protections to both consumer and commercial litigation funders, including prohibiting foreign entities of concern from financing cases. NCOIL's latest iterationdoes incorporate that suggestion from the Coalition Against Insurance Fraud and prohibits consumer litigation funding companies from receiving funding, directly or indirectly financed by foreign entities or persons of concern. In its current form, the model act now makes that prohibition apply to both consumer and commercial litigation funders and is an important step in advancing regulatory improvements and ensuring that a future model act safeguards against unintended consequences from fraudster exploitation. Further discussions are expected at the next NCOIL meeting in November 2024. https://lnkd.in/g9kKERqC

CFO Jimmy Patronis Issues Emergency Rule to Protect Consumers ahead of Hurricane Milton. Today, Chief Financial Officer (CFO) & State Fire Marshal Jimmy Patronis issued an Emergency Rule to enhance transparency in the claims adjusting process for insurance consumers by requiring adjusters to identify and provide detailed explanations for any changes made to damage estimates. This emergency rule allows the Florida Department of Financial Services to hold insurance adjusters who provide contracted services to insurance companies to the same accountability standards that apply to an insurance company’s in-house adjusters by virtue of Senate Bill 7052 (2023). This week, CFO Patronis also issued an Emergency Order lifting restrictions on Insurance Customer Representatives' ability to conduct business outside the office and continuing education requirements. https://lnkd.in/g9udQW62

Coalition attends NJSIA Annual Conference Strategies for preventing fraud in government health policies and insurance fraud caught on camera goes viral All of this and more in this edition of #FraudNewsWeekly #InsuranceFraud https://lnkd.in/gPJXc4mh

Amicus Curiae webinar a huge success Fraudsters on the rise and the Coalition welcomes Heidi Krumenauer All of this and more in today's #FraudNewsWeekly #InsuranceFraud https://lnkd.in/gWWa2VSJ

Fraudsters on the rise: how online scams are hitting insurance customers. Fraud in the insurance industry is evolving into an increasingly serious problem, with fraudsters leveraging online platforms to prey on unsuspecting customers. Recently, Aviva alerted the sector to ongoing fraudulent operations involving a so-called ‘ghost broker’ claiming to be affiliated with the firm. What’s more, Aviva also reported a worrying 39% increase in detected fraudulent claims from 2022 to 2023. “I definitely see a rise in scams. We see it with everything,” Said Ryan Fowler, owner of Insureline Brokers . It’s a trend that has swept across industries, from the CRA scam cases during tax season to sophisticated fraudsters within the insurance sector. And, with affordability becoming a key issue, fraudsters capitalize on offering policies at prices that seem too good to be true, targeting cost-conscious buyers. One significant concern for Fowler and his team is educating consumers about the potential risks of fraud. He cited a personal experience where a client was unsure whether to trust the insurance broker handling their case. https://lnkd.in/gyfuXVcq

Louisiana court rules adjusters have no duty to insured, except in cases of fraud. A Louisiana federal judge has ruled that insurance adjusters generally do not have a legal duty to insured parties unless fraud is involved, dismissing claims against Sedgwick Claims Management Services Inc. U.S. District Judge Brandon S. Long found that Hermes Health Alliance LLC failed to prove a conspiracy by Sedgwick over damage caused by Hurricane Ida. Hermes had sued its insurers and Sedgwick, claiming they weren’t paying enough to repair its property, but the judge ruled that Louisiana law limits the liability of third-party adjusters like Sedgwick. In this case, Hermes didn’t even respond to Sedgwick’s motion to dismiss, leaving the judge with no opposition to consider. While Louisiana law makes adjusters responsible in cases of fraud, this ruling highlights that, under most circumstances, adjusters are not liable for issues between insurers and policyholders.

California Governor vetoes bill aimed at addressing pay gap for the state's insurance fraud detectives Governor Gavin Newsom has vetoed Assembly Bill 2872, a bipartisan measure aimed at addressing the pay gap between fraud detectives at the California Department of Insurance (CDI) and those at other state agencies. While the bill sought to ensure CDI sworn officers received compensation comparable to peace officers at the California Department of Justice, Governor Newsom cited concerns that the bill would bypass the collective bargaining process and limit the state's ability to consider broader factors in salary negotiations. The veto comes despite strong support from industry stakeholders, including a Coalition Against Insurance Fraud letter to the Governor, which emphasized the urgent need for CDI to recruit and retain officers to combat the state's growing insurance fraud problem. The Coalition had noted the nation's $308.6 billion fraud burden and the critical role these investigators play in protecting vulnerable populations. With a 35% vacancy rate in CDI's investigative workforce, the veto is seen as a setback in addressing these staffing challenges. https://lnkd.in/eMeXmBi8

What a success! Over 300 attendees gathered to experience an engaging discussion on one of the most valuable benefits of being a Coalition Against Insurance Fraud member! The program, backed by 10 world-class law firms, delivers incredible value to members by serving as a friend of the court and turning the tide in numerous major cases. With more organizations seeking assistance, the program’s impact continues to grow! A special thanks to Michelle Rafeld (Executive Director), Brent Walker (Director of Government Relations), Dominic Dugo (VP, Fraud Delta Group), Ross Silverman (Katten Law Firm Partner), and Judith French (Director of Ohio DOI) for their contributions in making this Coalition benefit discussion an outstanding success. Long time members and new members alike now have access to an in-depth overview. Congratulations to all involved in making this such a triumph!