Federal prosecutors say shell medical equipment companies submitted billions in fraudulent insurance claims. The case underscores why policyholders and insurers should closely monitor billing activity for signs of fraud.

Dashcam footage and an independent 911 witness helped investigators prove a California driver intentionally caused a collision before filing a fraudulent insurance claim. The driver received jail time, probation, and restitution after being convicted on multiple charges.

Investigators allege five family members used shell construction companies to hide payroll, avoid workers' compensation premiums, and cash millions of dollars in payroll checks through unlicensed money service businesses.

A mechanic's teardown of a Chevrolet Camaro engine recovered after years underwater uncovered signs of prior repairs and prompted questions about whether the vehicle's theft claim and total loss were connected to a possible fraud scheme.

Minnesota regulators say Seguro Medico misled consumers about the scope of their health insurance coverage and violated multiple state insurance laws. The enforcement action follows guilty pleas in a related federal fraud case.

Artificial intelligence is giving fraudsters new ways to manipulate claims, but insurers, TPAs, and defense attorneys are responding with AI-powered detection tools and traditional investigative techniques to identify suspicious evidence.

Police say a reported theft of a 1981 Fiat Spider was fabricated in an attempt to collect insurance proceeds. Investigators used license plate reader data and surveillance video to challenge the claim.

A California wildfire survivor says an unlicensed contractor took an $18,000 payment before abandoning the project. Insurance and fraud experts say similar scams are increasing after natural disasters across the United States.

Licensed insurance agents allegedly used personal information gathered through telemarketing calls to submit life insurance applications without consumers' knowledge. Regulators say the scheme is generating significant losses for insurers and exposing older adults to additional fraud risks.

Iowa investigators allege an insurance agent opened policies using the identities of at least 11 family members without their knowledge, generating more than $36,000 in commissionable premiums. The case includes 23 felony charges and one aggravated misdemeanor.

Two insurers that reimbursed a New Jersey company for an alleged fraud loss are pursuing subrogation against Bank of America. The lawsuit claims the bank processed wire and ACH transfers after employees flagged them as fraudulent.

Utah regulators say a Texas man used false information to obtain more than 1,100 auto insurance policies and collected payments from consumers whose coverage could have been invalid when claims were filed.

Federal prosecutors announced charges against hundreds of defendants in alleged Medicare, Medicaid, wound care, opioid, hospice, and behavioral health fraud schemes. Investigators credited advanced data analytics and coordinated enforcement efforts for identifying the cases.

A federal lawsuit claims hundreds of ineligible individuals were enrolled in Maryland-based health plans through an alleged scheme involving fraudulent residency information and referral networks.

Federal prosecutors allege a Houston-area clinic owner and co-conspirators submitted hundreds of millions of dollars in fraudulent Medicare and Tricare claims tied to medically unnecessary allograft procedures. Investigators say the scheme generated nearly $300 million in government payments and involved kickbacks and patient referrals.