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Insurance Fraud Prosecutions in Florida

Each year law enforcement detectives with the Division of Insurance Fraud receives and reviews more than 10,000 referrals alleging instances of insurance fraud. Florida's Division of Insurance Fraud was established by the Florida legislature in 1976. It is the law enforcement arm of the Department of Financial Services which investigates these claims.

Definition of Insurance Fraud in Florida

Insurance fraud is defined as any action a person takes with the intention to fraudulently obtain payment from an insurance company or insurer.

More than one thousand of these cases are presented for prosecution each year resulting in thousands of individuals throughout the State of Florida being arrested and facing serious felony charges for the following types of insurance fraud cases:

  • unauthorized insurance entity fraud;
  • non-Medicaid related health care fraud;
  • workers’ compensation premium avoidance and diversions by employers;
  • workers’ compensation claim fraud by employees;
  • insurance premium fraud;
  • crimes associated with claim fraud;
  • viatical application fraud;
  • insurance agent crimes; and
  • escrow funds defalcations held in trust by title insurance firms.

Insurance fraud statistics from the Coalition Against Insurance Fraud (CAIF) in 2008 show that among the different fraud divisions in various states, Florida ranks highly in the following areas:

  • Fourth (4th) in the number of referrals from insurance fraud investigations;
  • Third (3rd) in the number of insurance fraud cases presented for prosecution; and
  • Second (2nd) in the number of arrests for insurance fraud cases.
  • Additionally, insurance fraud statistics in Florida show that according to a study by the Coalition Against Insurance Fraud (CAIF), Florida’s Division of Insurance Fraud leads the United States in the recovery of losses from insurance fraud through restitution that is court ordered. In 2009, the Division of Insurance Fraud prosecuted cases and obtained court orders for restitution that totaled more than $34 million.

    PIP Fraud Investigations in Tampa, FL

    Sammis Law Firm, P.A.
    1005 N. Marion St. Tampa, FL 33602
    Phone: (813) 250-0500 · Fax: (813) 276-1600
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