Welcome to the Division of Insurance Fraud

Serving and safeguarding the public and businesses operating in the State of Florida against acts of insurance fraud

Recent News

August 7, 2009 - The Crime Intelligence Analyst Unit of the Division of Insurance Fraud recently conducted a study of the impact of the economy and it's impact on insurance fraud in the state of Florida, across the nation and even globally. The results of their research and analysis is provided in the attached report.  Read More	August 1, 2009 - The Division of Insurance Fraud concluded its Strategic Plan Meeting on May 28, 2009. Prior to our meeting, we conducted a rigorous analysis of the Division's outputs over the past several fiscal years. The Division utilized the services of Dr. Scott Helzer, Florida State University, to facilitate the process of the meeting. The Division of Insurance Fraud's Strategic Plan 2009 will serve as a high-level road map, with strategic goals and objectives that address the mission of the Division. Its main goal is to once again be ranked the number one Fraud Division in the Nation.  Read More	February 25, 2009 - Division of Insurance Fraud receives prestigious accreditation from the Commission for Florida Law Enforcement Accreditation.  The accreditation for the Division of Insurance Fraud is a highly prized, 260-standard recognition of law enforcement professional excellence, a critical component of the CFO’s duty as the agency head of the Florida Department of Financial Services.  Read More

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About the Division

Established by the legislature in 1976, The Division of Insurance Fraud is the law enforcement arm of the Department of Financial Services and is responsible for investigating insurance fraud; crimes associated with claim fraud, insurance premium fraud, workers’ compensation claim fraud, workers’ compensation premium avoidance and diversions, insurer insolvency fraud, unauthorized insurance entity fraud and insurance agent crimes. The law enforcement detectives of the Division of Insurance Fraud also investigate viatical application fraud, defalcations of escrow funds held in trust by title insurance firms, and non-Medicaid related health care fraud.

According to a 2007-2008 report from the Coalition Against Insurance Fraud (CAIF), Florida’s Division of Insurance Fraud leads the nation in the recovery of insurance fraud related losses through court ordered restitution. In Fiscal Year 2008/2009, cases presented for prosecution by The Division of Insurance Fraud resulted in more than $34 million in court ordered restitution. According to the Coalition's 2007-2008 statistics, Florida ranks in the top four (4) among all states’ fraud divisions and bureaus in key measurements of success:

• 2nd in the number of arrests
• 3rd in the number of cases presented for prosecution
• 4th in the number of referrals

Florida’s Division of Insurance Fraud continues to lead the fight against insurance fraud under the leadership of Colonel Vicki Cutcliffe. During Fiscal Year 2008/2009, investigative efforts by The Division of Insurance Fraud resulted in 982 cases presented for prosecution, 834 arrests, and 532 convictions. Also during Fiscal Year 2008/2009, The Division of Insurance Fraud received and reviewed 12,084 insurance fraud referrals and opened 1,971 cases for investigation.

Insurance fraud is not a victimless crime! It is estimated that insurance fraud costs the US $80 billion dollars or more a year. Those costs get passed down to you, the consumer. The CAIF estimates that cost to be approximately $950 per family. Reporting insurance fraud is easy and just a click away.

What is Insurance Fraud?

Any action taken by an individual with the intent to fraudulently obtain payment from an insurer is considered insurance fraud.

Top 5 DIF Referral (Tip) Types - 4th Quarter - Fiscal Year 08/09

Insurance Consumer Tips

Use Caution!

• When receiving phone calls after an accident. It could be someone trying to involve you in a fraud scheme.
• If a life insurance sales pitch comes at a time when there is no apparent need to change insurance coverage, such as a marriage, a new child, or similar life change.
• If an agent offers to replace your old life insurance policy, which has a high cash value, with a new 'better' one. Carefully review the premium schedule, benefits and restrictions on benefits, such as pre-existing conditions

Always!

• Make sure you receive a written policy within sixty (60) days after you have paid your first premium.
• Compare prices and options before purchasing insurance, especially if a price being offered is substantially lower than others.
• Make sure you receive and review your detailed billings for all services.
• When buying or renewing insurance coverage, check with the Office of Insurance Regulation to make sure you are dealing with a licensed agent and a licensed insurance company.
• Protect your insurance identification numbers as you would a credit card number.

Never!

• Write a premium check to an agent. Checks should be written to the insurance company or insurance agency.
• Never sign blank insurance forms.