IIHS Confirmed Tesla’s Claims About Reducing Injury Liability Claims with Autopilot

The Insurance Institute for Highway Safety (IIHS) has confirmed Tesla’s claim that its Autopilot and active safety features result in ‘fewer physical damage, injury liability claims.’ However, IIHS also found that the introduction of these features could increase other kinds of claims.

The combined driver assistance features on the 2014–16 Model S lowered the frequency of claims filed under property damage liability (PDL) and bodily injury (BI) liability coverage with the 2012–14 Model S without the technology. However, IIHS didn’t find that they lowered the frequency of collision claims. They also saw increases in MedPay and PIP claims.

Highway Loss Data Institute’s senior vice president, Matt Moore, admits that they would need more data to really understand the effect of Autopilot.

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Filed under auto insurance, Personal Injury Protection, PIP, PIP/No Fault

Pinellas County Sheriff Going After Unlicensed Contractors

Thirty people were arrested in a three-day sting to “flush-out” unlicensed contractors preying on property owners in Pinellas County. The sting produced at least 60 felony and misdemeanor charges against the violators. Operation Flush Out is Sheriff Bob Gualtieri’s third sting since October 2017.

A Tampa Bay Times’ investigation in 2017 revealed how the Pinellas County Construction Licensing Board preferred to punish unlicensed contractors with fines rather than pursue violations in criminal court. Contracting without a license carries a misdemeanor for first-time offenses and a felony the second time.

Pinellas County government took control of the agency on July 1st. Gualtieri launched the Construction Licensing Investigative Unit and trained deputies to investigate contracting crimes. The department’s previous stings in October and February netted more than 45 arrests and dozens of charges.

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Filed under Insurance, Property Insurance

Owner of Medical Billing Company Pleads Guilty to Healthcare Fraud Scheme

According to the report, Billings USA received or created fabricated bills for its clinic customers. The clinics would then bill insurance companies for allowable amounts and create records to back up the charges.  Billings USA collected a 6% fee on the reimbursement from insurers. Palma’s company filed $5.7 million in fraudulent claims to Blue Cross Blue Shield with one clinic and then an additional $5.9 million in fraudulent claims to Blue Cross and Cigna with another clinic.

Mauricio Palma, the owner of medical billing office Billing USA in Miami, pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to eight years in prison. Palma faces $2.1 million in restitution lost $1.8 million in forfeiture.

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Filed under Fraud, Healthcare Fraud, Healthcare Fraud

Florida Medical Professionals Charged in Largest Healthcare Fraud Crackdown In US History

Over 600 medical professionals in 35 states across the U.S. are on the hook for submitting more than $2B in fraudulent claims in what the U.S. attorney’s office is calling the largest healthcare fraud crackdown in the history of the Department of Justice. Of the 601 charged in this crackdown, almost 150 of the accused are from Florida.

Many of the crimes committed in this crackdown are linked to the opioid crisis, but also includes money laundering, check cashing and billings to Medicare.

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Filed under Fraud, Insurance Fraud

Global Blockchain Expected to Grow in the Insurance Market

Insurance companies globally lose more than US$80 billion to fraud every year. A growing number of fraudulent insurance claims, increasing need to have transparent and trustworthy systems, and a focus on reducing the total cost of ownership will most likely drive the growth of the market.  A new study from ReportLinker projects global blockchain will have a compound annual growth rate of 84.9% between 2018 and 2023 ($64.5M to $1.393.8M) in the insurance market. The identity management and fraud detection segment are expected to hold the largest market size during that period.

The insurance sector of the Asia-Pacific (APAC) area is increasing its adoption of blockchain technology now and is expected to grow the fastest.

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Filed under Insurance, Insurance Fraud

Travelers Advocates Current Auto Insurance System for Autonomous Vehicles

Travelers Institute released a white paper expressing their view on autonomous vehicles (AVs) and the role the auto insurance industry should play in addressing the significant policy questions and challenges that will inevitably arise in the future. An insurer that has been around for more than 160 years, Travelers applauds the safety advances of AVs and believes that the current auto system can accommodate AVs and non-AVs.

Click here for the white paper.

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Filed under auto insurance, Autonomous Technology

Florida Insurance Leaders Hope to Rein In AOB Crisis

The Florida insurance industry is hoping to put an end to its AOB crisis with education. Barry Gilway, president, CEO and executive director of Citizens Property Insurance Corp. says the key to slowing Assignment of Benefits (AOB) abuse in Florida is for the insurance industry to link AOB to its impact on the consumer and the premiums they are paying.

Insurance carriers from across the state have seen an increase in litigation due to AOB lawsuits from homeowners who work with unlicensed contractors who file inflated and fake claims on their behalf. According to the Florida Department of Financial Services, AOB lawsuits in Florida have increased from 405 to 28,200 between 2006 and 2016 with South Florida being the worst region for this issue.

Florida insurance industry leaders are hoping for a legislative fix with the new Senate leadership coming in next year.

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Filed under AOB, Property Insurance

Deltona Man Charged With Arson in Insurance Fraud Scheme

Brian Lee Caswell of Deltona was arrested and charged with second-degree arson, arson resulting in injury, burning to defraud an insurer, giving false information to a law enforcement officer and making a false police report.

According to Caswell’s arrest warrant, he had hatched a plan with Alex Spivey of Orlando and Melinda Philbrook of Lady Lake to destroy their truck and collect an insurance payout. Caswell initially claimed the vehicle had been stolen, but later admitted planning the scheme after co-conspirator Spivey caught fire during the arson.

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Filed under auto insurance, Auto Insurance Fraud, Florida, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud

FL Man Poses As NJ Doctor to Submit $1M in Fraud Claims

A Florida man, Yoandi Marrero, has been charged with insurance fraud, theft by deception, attempted theft by deception and identity theft after assuming a New Jersey doctor’s identity to submit more than $1 million in fraudulent medical claims. The services were never rendered and the medical center did not exist.

Marrero was found out when a woman claimed a doctor had billed her insurance for services that were never rendered.

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Filed under Florida, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud

Florida Public Adjuster Sentenced in $14M Insurance Fraud Plot

Corrupt public adjuster Jorge Fausto Espinosa recruited dozens of homeowners via his firm, Nationwide Adjusters, in an insurance fraud plot where he inflated insurance claims to the tune of $14 million.

Espinosa paid marketers to lure homeowners with free kitchens and remodeling jobs if they allowed him to manufacture damage to their homes. He earned around 30% of the insurance payouts he lined up for the homeowners. Espinosa earned payouts of more than $317,000 at times.

Insurers were pushed to pay overblown insurance payouts from claims resulting from rigged fires to water damaged. Espinosa hit at least 14 insurers with more than 50 inflated claims. He was sentenced to 20 years in state prison for racketeering and insurance fraud among many other charges.

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Filed under AOB, Florida, Florida Division of Insurance Fraud, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud, Property Insurance