Former FBI Agent Unpacks How a Massive Health Insurance Scam Took Root in Pennsylvania and Spread Nationwide
A federal investigation into a sweeping health insurance fraud scheme that began in Reading, Pennsylvania, highlights how scammers stole millions from thousands of victims nationwide.
May 20, 2025
Fraud
Insurance Industry
Life & Health
Litigation
Pennsylvania
Pennsylvania Shuts Down Unlicensed Insurance Telemarketing Scheme with Nationwide Reach
A multiyear investigation by the Pennsylvania Insurance Department led to the indictment of four businessmen and two companies for defrauding consumers across the U.S.
May 20, 2025
Fraud
Insurance Industry
Legislation & Regulation
Life & Health
Pennsylvania
West Virginia Man Charged After Illegally Using Over $20K in Deceased Relative’s Workers’ Comp Payments
A Salt Rock resident faces multiple felony charges after admitting to using more than $20,000 in workers’ comp benefits sent in error to his deceased relative’s account.
May 20, 2025
Fraud
Insurance Industry
Litigation
Workers' Compensation
West Virginia
How Insurers Can Tackle Tech, Process and Organizational Debt to Drive Innovation
Insurers face more than just outdated technology — process and organizational debt also hold them back. Tackling all three is key to modernization and customer value.
May 19, 2025
Education & Training
Insurance Industry
Risk Management
Technology
Insurers Scramble for Disaster Data After NOAA Halts Updates
With NOAA’s disaster data program discontinued after 2024, insurance companies face major challenges in modeling risk, pricing policies, and ensuring climate resilience.
May 13, 2025
Catastrophe
Insurance Industry
Property
Risk Management
California
How Property and Casualty Insurers Can Combat Fraud with AI-Driven Multimodal Technology
AI-powered multimodal tech is helping property and casualty insurers detect fraud more accurately across the claims cycle, potentially saving billions and lowering premium costs.
May 13, 2025
Fraud
Insurance Industry
Property
Technology
Escrow Officer Sentenced to Prison for Orchestrating $350K Title Fraud Scheme in Texas
A McAllen, Texas escrow officer was sentenced to 24 months in prison for wire fraud after falsifying real estate documents and defrauding lenders and buyers of over $350,000.
May 13, 2025
Fraud
Insurance Industry
Litigation
Property
Texas
Amtrak Health Plan Defrauded of $12 Million by Over 100 Employees and Medical Providers
Over 100 Amtrak employees joined forces with medical providers in a fraudulent health insurance scheme that cost the company more than $12 million, a new report finds.
May 12, 2025
Fraud
Insurance Industry
Legislation & Regulation
Risk Management
Connecticut
Delaware
District Of Columbia
Maryland
New Jersey
Florida Appeals Court Backs Insurer’s Right to Enforce Repair Option in Homeowner Dispute
A recent Florida appellate ruling reinforces insurers’ authority to enforce managed repair clauses, highlighting the importance of policy clarity in property claim disputes.
May 12, 2025
Insurance Industry
Legislation & Regulation
Litigation
Property
Florida
Why Data Exfiltration Has Replaced Ransomware as the Top Cyber Threat
As ransomware attacks evolve, data theft has overtaken system encryption as the primary threat, driving up cyber insurance claims and shifting insurer response strategies.
May 12, 2025
Insurance Industry
Litigation
Risk Management
Technology
Insurers Prioritize Claims Over Underwriting in Anti-Fraud Tech Use
While most U.S. insurers use technology to detect claims fraud, fewer are leveraging these tools for underwriting or internal fraud, a new survey reveals.
May 12, 2025
Fraud
Insurance Industry
Technology
Underwriting
Billing Frustrations Spark Honest Dialogue Between Carriers and Defense Counsel
CLM’s Litigation Management Task Force is tackling billing friction, talent recruitment, and tech adoption with candid conversations aimed at reshaping defense counsel compensation.
May 9, 2025
Education & Training
Insurance Industry
Litigation
Technology
NOAA Ends Billion-Dollar Disaster Tracking Program Citing Budget Cuts and Staffing Issues
NOAA will stop updating its billion-dollar weather disaster database, a move that limits public access to vital cost-tracking of extreme weather events.
May 8, 2025
Catastrophe
Insurance Industry
Property
Risk Management
California
Allstate Becomes One of the First Major Insurers to Explore Quantum Computing Through Chicago Quantum Exchange
Allstate partners with the Chicago Quantum Exchange to explore how quantum computing could transform risk analysis, fraud detection, and customer service in insurance.
May 8, 2025
Fraud
Insurance Industry
Risk Management
Technology
Illinois
Indiana
Wisconsin
Kansas Storm Claims Top $612 Million as Insurers Report Widespread Losses
In 2024, Kansas insurers paid over $612 million for nearly 57,000 storm-related claims, with Johnson County topping the list and Greeley County seeing the least.
May 8, 2025
Catastrophe
Insurance Industry
Property
Risk Management
Kansas
