Bienvenido a la División de Fraude de Seguros

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

Sobre la División

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 the Coalición contra el Fraude de Seguros (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 2007/2008, cases presented for prosecution by The Division of Insurance Fraud resulted in $94 million in court ordered restitution which is 5.5 times greater than the operating budget allocated for the Division. Additionally, according to the Coalition, 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

Under the leadership of Colonel Vicki Cutcliffe, Florida’s Division of Insurance Fraud continues to be a perennial leader in the fight against insurance fraud. During Fiscal Year 2007/2008, investigative efforts by The Division of Insurance Fraud resulted in 873 cases presented for prosecution, 816 arrests, and 663 convictions. Also during Fiscal Year 2007/2008, The Division of Insurance Fraud received and reviewed 9,916 insurance fraud referrals and opened 1,742 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 Types of Insurance Fraud In Florida By Number of Referrals

For 3rd Quarter 2008 (updated quarterly)

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 Division 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.