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Insurance Fraud / Auto Theft Unit

Purpose
Contact Us / Report Insurance Fraud
Disaster Fraud
What Can You Do?
Annual Report
Red Flags of Insurance Fraud
Other Links


Purpose

The Insurance Fraud Unit is responsible for investigating referrals of suspected fraudulent insurance acts; assisting federal and local law enforcement in the investigation of fraudulent insurance acts; cooperating with local prosecutors and the attorney general's office in the prosecution of fraudulent insurance acts; and promoting awareness of insurance fraud throughout the state.


Contact Us / Report Insurance Fraud

If you have any knowledge of a fraudulent scheme, report the activity to the Louisiana State Police by:

E-mail:

Phone: (225) 925-3701 or (225) 925-3702

Fax: (225) 925-3769

Mail:
Louisiana State Police
Bureau of Investigation
Insurance Fraud Unit
7919 Independence Blvd, Box A-19
Baton Rouge, LA 70806

Baton Rouge Field Office - 225.925.3850

New Orleans Field Office - 504.471.2716

Lafayette Field Office - 337.262.2051

Alexandria Field Office - 318.484.2190 (x 108)

Shreveport Field Office - 318.862.9913

Monroe Field Office - 318.362.4588

For questions concerning physical inspection certifications please contact administrative coordinator Helena Graham at 225.925.3536



Disaster Fraud


What Can You Do?

  • Be aware of staged accidents, such as intentional sideswiping or cars that cut in front of other vehicles, forcing collisions due to quick stops.
  • Be aware of individuals that try to get you to leave the scene of an accident without calling police or obtaining a police report.
  • Be aware that some individuals report damage as vandalism in an attempt to cover deliberate or previous damage to one's own property.
  • Be aware of individuals making a false stolen vehicle claim to cover previous damage to a vehicle or to dispose of the vehicle.
  • Be aware of individuals that inflate genuine claims to cover a policy deductible.
  • Be aware of attempts to convince you that "everybody is getting rich" so you may as well try to get additional money also.
  • Be aware of the possibility that someone may set a small fire in their home to obtain a new paint or remodeling job.
  • Be aware of individuals that fake an on-the-job injury to stay off work after healing to collect Workers' Compensation benefits.

Annual Report


Red Flags of Insurance Fraud

Worker's Compensation Premium Fraud - occurs when an employer provides false information in order to obtain a lower insurance rating.

Red Flags:

  • The employee's injuries are not consistent with the employee's job classification or the nature of the business.
  • The employee states that his/her employer is other than what is listed on the claim form.
  • The employee disputes information supplied by the employer on the first report of injury.
  • The employee disputes the average weekly wage due additional income (i.e., cash, per diem, and/or 1099 income).
  • There are cross-outs and erasures on the injury forms.
  • The employer refuses to cooperate in the claims investigation; refuses to provide employee with claim form.
  • Employer's witnesses to the accident are generally management personnel.
  • The employer is routinely cited for safety violations.
  • Employer paying medical bills and not reporting injuries.

Worker's Compensation Fraud - occurs when an employee files an inflated or false injury claim in order to receive benefits or increase benefits.

Red Flags:

  • Employee is disgruntled, soon-to-retire, or facing imminent firing or layoff.
  • Employee takes more time off than the claimed injury seems to warrant.
  • Employee is new on the job.
  • Employee is experiencing financial difficulties and/or domestic problems prior to submission of claim.
  • Employee is unusually familiar with workers' compensation claim handling procedures and laws.
  • Employee has several other family members also receiving workers' compensation benefits or other "social insurance" benefits, i.e. unemployment.
  • Surveillance or "tip" indicates that the totally disabled worker is currently employed elsewhere.
  • Employee comes to office for delivery of benefit checks, avoids use of US Mail.
  • Employee cancels or fails to keep appointment, or refuses a diagnostic procedure to confirm an injury.
  • Social Security number provided does not belong to employee.
  • Employee refuses or cannot produce solid or correct identification.

Staged Accident Fraud - occurs when a person intentionally causes or is involved in an accident, or walks in and reports an accident in order to receive compensation for false or intentional damages and injuries.

Red Flags:

  • Claimant has prior accidents of similar circumstances.
  • Claimant has multiple past claims with same attorney.
  • Claimant is unemployed.
  • Lack of familiar or personal relationships between occupants of claimant vehicle.
  • Inconsistencies in multiple claimants' versions of seating in vehicle, why claimants were in vehicle, and destination of claimants.
  • Claimant demonstrates familiarity with claims process and claim evaluation.
  • Presence of an overly enthusiastic witness at the accident scene.
  • Claimant has recently purchased vehicle, and/or insurance.
  • Victim is usually female or elderly.

Property Fraud - the falsification or inflation of a claim for the loss of personal property in order to obtain a larger settlement.

Red Flags:

  • Insured is overly pushy for a quick settlement.
  • Insured handles all business in person, thus avoiding the use of the mail.
  • Losses are incompatible with insured's resident, occupation and/or income.
  • Losses include a large amount of cash.
  • Insured is willing to accept an inordinately small settlement rather than document all claims losses.
  • Buildings and/or contents were up for sale at the time of the loss.
  • Suspiciously coincidental absence of family pet at the time of fire.
  • Building and/or business was recently purchased.
  • Building is in deteriorating condition and/or lacks proper maintenance.
  • Fire scene investigation reveals absence of items of sentimental value; e.g. family Bible, family photos, trophies.
  • No police report or an over-the-counter report in situations where police would normally investigate.
  • Insured's loss inventory differs significantly from police department's crime report.

Disaster Fraud - occurs in the aftermath of a disaster when the insured claims false or inflated claims on intentionally caused or pre-existing damage.

Red Flags:

  • Insured declares extensive losses without physical evidence, photographs or documented receipts.
  • Items claimed to not match claimant's lifestyle, decor, house, occupation or income.
  • Lack of carpet indentation from alleged large furniture or appliances.
  • Insured is overly pushy for quick settlement.
  • Investigation reveals absence of family photographs, heirlooms or items of sentimental value.
  • Affected area was not evacuated.
  • No other homes were damaged or destroyed in the affected area.
  • Insured claims items were new.
  • Insured can't properly describe items as to function or features.
  • Insured property was not located in major damaged area.
  • Property was in poor condition prior to loss.
  • Insured cannot produce damaged item(s) for viewing.
  • Insured claims unrepaired damage from a previous disaster.

Securities / Promissory Notes Fraud - the marketing and selling of investment opportunities that do not qualify with the regulations set forth by or have not been registered with the Office of Financial Institutions.

Red Flags:

  • Unbelievable interest rate offered on investment. If it seems "to good to be true". . . it probably is.
  • An agent or other representative urges you to pay with cash.
  • A salesperson urges you to cash in your certificates of deposit (despite the interest penalty) and put the money into investments, annuities, or life insurance policies.

Vehicle Theft Fraud - occurs when the owner of a vehicle disposes of or fraudulently reports their vehicle stolen in an attempt secure a settlement.

Red Flags:

  • Insured has lived at current address less than six months, or been with current employer less than six months.
  • Insured does not have a telephone or is difficult to contact.
  • Insured is unemployed.
  • Insured claims expensive contents in vehicle at the time of theft.
  • Insured is behind in loan payments on vehicle and/or other financial obligations.
  • Insured has a previous history of vehicle theft claims.
  • Vehicle was recently purchased.
  • Vehicle has a history of mechanical problems or is a "gas guzzler".
  • Vehicle has incorrect VIN, or VIN is different than VIN appearing on the title.
  • Vehicle is recovered with seized engine or blown transmission.
  • Vehicle is recovered stripped, burned, or has severe collision damage within a short duration of the time after loss allegedly occurred.
  • Loss occurs within one month of issue or expiration of the policy.
  • Coverage was obtained via walk-in business to agent.
  • Coverage is for minimum liability with full comprehensive coverage on late model and/or expensive vehicle.
  • Police report has not been made by insured or has been delayed.
  • License plate does not match vehicle and/or is not registered to insured.
  • Salvage yard or repair garage takes unusual interest in claim.

Other Links