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Iowa Insurance Agent Charged in Alleged Identity Theft and Insurance Fraud Scheme

Iowa Insurance Agent Charged in Alleged Identity Theft and Insurance Fraud Scheme

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.
July 6 Fraud Insurance Industry Legislation & Regulation Iowa

Insurers Allege Bank of America Processed More Than $1 Million in Flagged Fraud Transfers

Insurers Allege Bank of America Processed More Than $1 Million in Flagged Fraud Transfers

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.
July 6 Fraud Litigation Subrogation Technology New Jersey

Texas Man Charged in Utah Ghost Broker Scheme Involving 1,100 Fraudulent Auto Insurance Policies

Texas Man Charged in Utah Ghost Broker Scheme Involving 1,100 Fraudulent Auto Insurance Policies

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.
June 24 Auto Fraud Insurance Industry Legislation & Regulation Litigation Texas Utah

Health Care Fraud Crackdown Targets $6.5 Billion in Alleged False Claims

Health Care Fraud Crackdown Targets $6.5 Billion in Alleged False Claims

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.
June 23 Fraud Legislation & Regulation Life & Health Risk Management Technology

CareFirst Files RICO Lawsuit Over Alleged $50 Million Health Insurance Fraud

CareFirst Files RICO Lawsuit Over Alleged $50 Million Health Insurance Fraud

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.
June 23 Fraud Insurance Industry Life & Health Litigation Maryland

Houston-Area Clinic Owner Accused in $906 Million Medicare and Tricare Fraud Scheme

Houston-Area Clinic Owner Accused in $906 Million Medicare and Tricare Fraud Scheme

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.
June 22 Fraud Insurance Industry Legislation & Regulation Life & Health California Hawaii Nevada Texas

AI-Powered Health Insurance Fraud Forces Carriers to Strengthen Defenses

AI-Powered Health Insurance Fraud Forces Carriers to Strengthen Defenses

Health insurers are investing in voice authentication, deepfake detection, and advanced analytics as criminals use AI-generated records, synthetic identities, and automated calls to exploit healthcare systems.
June 22 Fraud Insurance Industry Life & Health Risk Management Technology

Pennsylvania Supreme Court Allows Physician Referrals to Pharmacies They Own

Pennsylvania Supreme Court Allows Physician Referrals to Pharmacies They Own

A Pennsylvania Supreme Court ruling found that the state's workers' compensation self-referral law does not apply to pharmacies, allowing physicians to refer injured workers to pharmacies in which they have a financial interest. The decision could fuel ongoing disputes over prescription drug costs and billing practices.
June 19 Fraud Insurance Industry Legislation & Regulation Workers' Compensation Pennsylvania

McBee Dynasty Star Faces 2027 Trial Over Alleged Fraudulent Asset Transfers

McBee Dynasty Star Faces 2027 Trial Over Alleged Fraudulent Asset Transfers

Federal prosecutors allege reality television personality and convicted crop insurance fraud defendant Steve McBee transferred valuable business interests to his sons while under investigation. The family disputes the claims and argues the transfers followed long-established trust practices.
June 19 Fraud Insurance Industry Litigation Risk Management Missouri Nebraska South Dakota

NICB Warns of Contractor Fraud Following Illinois Tornado Surge as Storm Losses Rise

NICB Warns of Contractor Fraud Following Illinois Tornado Surge as Storm Losses Rise

Illinois has recorded 140 tornadoes in 2026, prompting the National Insurance Crime Bureau to warn residents about contractor fraud schemes that often emerge after major disasters. The alert comes as severe convective storm losses continue to generate tens of billions in insured claims annually.
June 19 Catastrophe Fraud Litigation Property Risk Management Illinois

Project Jetsetter Exposes International Auto Insurance Fraud Network in Canada

Project Jetsetter Exposes International Auto Insurance Fraud Network in Canada

A multi-year investigation uncovered organized criminal groups linked to staged collisions, vehicle financing fraud, and false insurance claims that generated millions in losses and drove up costs for insurers and policyholders.
June 8 Auto Fraud Insurance Industry Legislation & Regulation Technology

NICB Warns Contractor Fraud Is Rising Nationwide After Natural Disasters

NICB Warns Contractor Fraud Is Rising Nationwide After Natural Disasters

As communities recover from tornadoes, floods, wildfires, and other disasters, NICB says contractor fraud schemes are becoming more sophisticated, with roofing scams, inflated mitigation claims, and assignment of benefits abuse among the most common threats.
June 8 Catastrophe Fraud Insurance Industry Property Risk Management

Meta Fraud Exposure Raises New Liability Questions for Insurers

Meta Fraud Exposure Raises New Liability Questions for Insurers

New fraud data from Lloyds Bank and recent U.S. court rulings are increasing scrutiny of Meta's role in online scams, creating new questions about liability, insurance coverage, cyber risk, and potential subrogation opportunities.
June 8 Fraud Insurance Industry Legislation & Regulation Litigation Risk Management

FICO: Insurers Must Shift From Reactive Fraud Detection to Connected Intelligence

FICO: Insurers Must Shift From Reactive Fraud Detection to Connected Intelligence

New FICO report argues that fragmented data systems are leaving insurers vulnerable to organized fraud networks and calls for real-time, enterprise-wide fraud intelligence.
June 8 Fraud Insurance Industry Technology

Texas Police Chief’s Staged Vehicle Theft Insurance Fraud Conviction Upheld on Appeal

Texas Police Chief’s Staged Vehicle Theft Insurance Fraud Conviction Upheld on Appeal

A federal appeals court found sufficient evidence that a Texas police chief conspired to burn his wife's SUV, report it stolen, and collect insurance proceeds. The case highlights multiple fraud indicators that claims investigators identified before any confession emerged.
June 5 Auto Fraud Insurance Industry Litigation Risk Management Texas
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