fraudulent claims News

Former Texas Hospital CEO Pleads Guilty to Insurance Fraud Scheme

The former CEO of Palo Pinto General Hospital in Palo Pinto, Texas, has pleaded guilty to defrauding three major insurance providers – BlueCross BlueShield of Texas, CIGNA Texas, and United Healthcare – out of millions of dollars, U.S. Attorney for …

Shift Technology Raises $60M to Expand Use of AI for Fraudulent Claims Detection

Shift Technology has raised $60 million in new venture financing, money that will help grow the reach of its artificial intelligence and big data technology designed to help carriers detect fraud during the claims process. Plans call for using the …

Two Brothers in New Jersey Sentenced for Roles in Accident Insurance Scheme

Two brothers who organized a scheme to recruit motor vehicle accident victims as patients for chiropractic facilities they controlled have been sentenced to more than six years in state prison. The sentences imposed last month also require that 54-year-old Anhuar …

Mass. Court Finds Defendant Guilty of Insurance Fraud in Car Accident Case

The Massachusetts Appeals Court has affirmed a lower court’s decision to charge the defendant in a case involving a Boston car accident with motor vehicle insurance fraud. However, the Appeals Court reversed the lower court’s decision to also charge the …

Connecticut Man Faces Prison for Role in Over 50 Staged Accidents

A Connecticut man has pleaded guilty to his role in a scheme that involved staging car crashes to defraud automobile insurance companies. Connecticut U.S. Attorney Deirdre M. Daly said Frandy Dugue, of Norwich, Conn., pleaded guilty Tuesday to one count …

New Jersey Woman Gets 3 Years for False Stolen-Car Claim

A Newark, New Jersey, woman who falsely reported her car had been stolen so she could get an insurance settlement is now headed to state prison. State authorities say 58-year-old Janette Bautista received a three-year term. She had pleaded guilty …

New Jersey Couple, Son Accused of Torching $139K Bentley for Insurance

Authorities announced that a Hudson County, New Jersey, couple, along with their adult son and the manager of a car dealership, have been charged with conspiracy, insurance fraud, and other offenses for allegedly falsifying a car loan application to buy …

Insurers Could Find an Early-Mover Advantage from Telematics: Fitch

The motor insurance industry faces a significant shake-up from two waves of technological innovation – the growth of telematics and the development of driverless cars, according to Fitch. Over the short term, telematics will have a bigger impact on the …

UK’s Aviva Beefs Up Fraud Screening in Commercial Motor Business

Aviva detected fraud in almost 2,200 commercial motor policies in 2015, using various anti-fraud tools, the London-based insurer revealed. But the company is taking its fight against fraud to a new level — by screening all commercial motor policies at …

N.J. Man Sentenced for Insurance Fraud Over Damage Done to Car

A Newark, New Jersey, man who committed insurance fraud is now headed to prison. New Jersey state authorities say Derrick Smith recently received a three-year sentence. Smith sought more than $15,000 from his insurer for damage done to his car …