The Schemes

• Total Vehicle Destruction - In this scheme the vehicle owner orchestrates the destruction of the vehicle to collect insurance money. The "stolen" vehicle is often found burned in a secluded area, submerged in a lake or, in some extreme cases, buried underground.
  
  
• Hit and Run - In this case, the perpetrator uses a damaged vehicle and claims to be a victim of a hit and run or an animal collision. Police are often called to the scene to verify the damage.
  
  
• Paper Accidents - As the name suggests, paper accidents occur only on paper. An owner fabricates an accident report to collect insurance money for a vehicle with preexisting damage.
  
  
• Salvage Switch - A salvage vehicle is purchased for its title and vehicle identification number. The salvage vehicle's title and vehicle identification numbers are used to conceal the identity of a stolen vehicle of the same make and model.
  
  
• Cover-Ups - Staged collisions are meant to "cover-up" existing damage caused by the insured. Sometimes, real rental cars are used as the "at-fault" vehicle.
  
  
• Duplicate claims - Accident claims are filed on the same vehicle through different insurance companies.
  
  
• Risky Repairs - Shops that offer to "bury" your deductible or inflate the damage estimate when you take your car in for repairs aren't doing you any favors. These shops may only hide the damaged parts instead of repairing them. "Risky Repairs" schemes such as this are frequently uncovered during the insurance company's follow-up inspection.
  
  

Medical Mills
Medical mills are organized criminal enterprises that attempt to defraud insurers and their policyholders through unethical and fraudulent health care billing practices. These mills consist of dishonest medical professionals who oftentimes conspire with unscrupulous lawyers, recruiters and patients.

Typical fraud-related injuries involve soft-tissue sprains and strains like backaches, whiplash and headaches. Injuries are often subjective and difficult to verify. Medical patients rarely spend any time in the hospital.

Types of Medical Mills

• Fraudulent Physician - In this rare type of medical mill, everything from the doctor to the bills to the office itself is a fraud. Since patients with bogus injuries are often recruited, these offices contain little or no medical supplies and actual treatment is rarely prescribed.
  
  
• Double-Dipping Doctor - This type of medical mill does provide medical services, though the methods of treatment are often questionable, excessive, redundant and unnecessary. Patients are occasionally overcharged for services or, in some extreme cases, billed for services never rendered. Bogus claims for treatment are then submitted to insurers for payment.
  
  
• Inflated Billing - The most common type of provider fraud often goes unnoticed by the patient. The health care provider often provides quality treatment and service; however, on occasion the bills are purposely inflated. Also when a provider purposely miscodes and inflates bills in order to get more money from the insurer.
  
  

The Criminals

• Unscrupulous Medical Providers - Dishonest medical providers often inflate bills or give unnecessary treatment in an attempt to collect extensive insurance reimbursements. Participants often include chiropractors, physicians, pharmacists and their office managers.
  
  
• Unscrupulous Legal Providers - Dishonest attorneys purposely funnel patients to corrupt doctors or knowingly represent accident victims who are filing padded claims. Participants often include personal injury attorneys, legal clerks and law office managers.
  
  
• Cappers or Runners - Third party middlemen who recruit insurance fraud perpetrators and befriend legitimate accident victims for medical mills through promises of big money payoffs.
  
  
• Insurance Fraud Perpetrators - Pseudo patients who often fake or exaggerate injuries in the first place, oftentimes claiming soft tissue sprains and strains that are hard to disprove and do not appear on x-rays.
  
  

See Also:
Staged Vehicle Collisions
Vehicle Theft Fraud
Bodily Injury Insurance Fraud
Collision Repair Fraud