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.

 

FIFEC was held from June 5-7 in Orlando. A record-setting number of attendees (over 1,000) were there to learn more about attacking insurance fraud.

 

 

 

 

 

 

 

 

 

 

 

 

About the Division

The Department of Financial Services is headed by the Chief Financial Officer. The Division of Insurance Fraud (DIF) is the law enforcement arm under the Department and is responsible for investigating all various types of insurance fraud. In January 2012, Director Dan Anderson, was appointed by the Chief Financial Officer over the Division of Insurance Fraud. He is assisted by Deputy Director Jack Kelley. The Division of Insurance Fraud has six regions located throughout the state of Florida, each commanded by a law enforcement captain; and 23 squads, each supervised by a lieutenant. Additionally, the Division consists of 150 sworn officers and 46 civilian support staff members.

Insurance Fraud is not a victimless crime. It is estimated that insurance fraud costs the United States $80 billion dollars or more a year, which are ultimately passed down to consumers. The Coalition Against Insurance Fraud (CAIF) estimates this fraud to cost approximately $950 per family. Since taking office, CFO Atwater has made it a top priority to fight this insidious fraud. He believes it to be one of the biggest cost drivers for escalating auto insurance rates that are increasingly burdening Florida's consumers and families. Proudly, the Division of Insurance Fraud has served as a national leader in the fight against insurance fraud, continuously ranking in the top five among all states’ fraud bureaus and divisions.

Last year, DIF responded to many thousands of suspected fraud referrals, over half of which were Personal Injury Protection (PIP) Fraud. In fiscal year 2011/2012, the Division showed a 15 percent increase in the number of referrals. The various types of insurance fraud the Division investigates include:

• PIP Fraud
• Workers' Compensation Fraud (includes claimant and premium avoidance)
• Vehicle Fraud
• Application Fraud
• Licensee Fraud (includes insurance agents and public adjusters)
• Homeowner's Fraud
• Healthcare Fraud
• Unauthorized Entity Fraud

 

Top 5 DIF Referral (Tip) Types

2nd Quarter Fiscal Year 12/13

 

For the third quarter of Fiscal Year 2013, over 400 arrests; 2nd highest quarter ever

 

For the previous rating period of October 1, 2011 to September 30, 2012, the Division of Insurance Fraud:

• made 1,337 total arrests. This exceeds the 1,228 that were made during the record setting Fiscal Year (FY). With the end of November where DIF made over 148 arrests (the 3rd most arrests DIF has ever made in a month);
• made 1,003 presentations (125.5 per month) in the last eight months of the previous rating period;
• made 1,326 presentations for the previous rating period. This exceeds the record 1,242 presentations made during the FY. The increase in presentations (and ensuring that they were quality presentations) played a large part in the increase in arrests. We now are averaging almost one arrest per one presentation, which is where we need to be (quality and quantity);
• made 526 PIP arrests. 378 of those arrests were made in the last eight months of the rating period. DIF “shut down” a significant number of PIP Clinics (over 60) during the rating period and we continue to do so.

 

For the current fiscal year (FY) of July 1, 2012 to June 30th, 2013, the Division of Insurance Fraud:

• made 157 arrests in October 2012. This is now the 2nd most arrests DIF has ever made in a month (trailing only last April’s totals);
• through the end of April (first ten months of FY) made well over 1,200 arrests, exceeding last year's record of 1,228;
• made well over 1,300 presentations, exceeding last year's record ;
• DIF has made well over 1,800 arrests in the last 14 months;
• DIF Detectives are averaging more arrests per Detective on board, than they have ever averaged;
• arrested over 250 “enablers.” These are a class of criminals that we now track where the insurance fraud could not have happened without their vital role being played.

 

We have established new or bettered partnerships the Broward Sheriff’s Office (BSO), the Palm Beach Sheriff’s Office (PBSO), the Florida Highway Patrol, the Jacksonville Sheriff’s Office and DIF will continue to develop more. We have continued to educate many about our mission and we have additional joint operations upcoming with other law enforcement agencies.

DIF continues to arrest very significant violators in Operation Dirty Money in the arena of Worker’s Comp Fraud. We have arrested over 40 violators in this extremely successful operation in that we have charged more than 290 million in insurance fraud (avoidance of Worker’s Comp Premium Insurance). To date, we have seized over $3.6 million in assets in our partnership with the Broward and Palm Beach County Sheriff's Offices. The majority of those assets seized have come since July, 1, 2012. This operation has multi-state and international aspects to it and DIF has coordinated the efforts of many agencies involved.

• Thirty-one shell companies (actively investigated) through which $290,000,000.00 worth of fraudulent transactions were identified and charged;
• Eleven (11) targeted Money Service Businesses (MSBs), 10 of which were the subject of search warrants (16 total including all branches), from which $3,635,039.98 has been siezed for forfeiture;
• Nine (9) MSB owners have been criminally charged;
• Ten (10) facilitators have been criminally charged for controlling the above-mentioned shell companies;
• Fifteen (15) shell company owners have been criminally charged.

There is much, much more to come.

 

One of the division's desired outcomes is to double our annual budget in a year ($30 million at a minimum) in restitution requested and court ordered restitution. During this fiscal year (through 10 months), over $39 million was requested and over $110 million was ordered.

DIF continues to be a leader in running the Property and Casualty and Worker’s Comp Task Forces and plays a stronger role than ever. DIF plays a very strong role in the Florida Insurance Fraud Education Committee (FIFEC) and it is stronger now than ever. The constant interaction with the Insurance Industry pays a lot of dividends. DIF has concentrated efforts on investigations where the elderly have been victimized and will continue to do so.

In October, DIF published its Annual Report and we have received a lot of positive comments from the Insurance Industry, FIFEC, other law enforcement agencies and insurance fraud divisions from other states.

Insurance fraud is not a victimless crime. Reporting insurance fraud is easy and just a click away.