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Fake Injuries and Clinics Used in Elaborate Insurance Fraud Scheme

By Ephrat Livni, Esq. | Last updated on

Federal authorities in Grand Rapids, Michigan last month named four people in an indictment alleging an elaborate insurance and healthcare fraud ring. The quartet reportedly set up medical clinics and staged car crashes to defraud insurers, as well as paying people to participate in staged crashes or to make false claims, stating they were patients at the medical clinics.

The scheme went on from January 2014 to May 2015, according to a report in Michigan Live. But the patients did not receive any therapy or medical care for their alleged injuries. The defendants are accused of submitting over 100 fraudulent claims to one insurance company and were paid about $52,000 reportedly.

Staging Car Crashes

Such insurance and healthcare fraud schemes are unfortunately common. Earlier this year, a Utah man was charged with insurance fraud after his 23 car crashes in five years raised suspicions. Although he seemed to be working alone in that case, the fraudulent scheme was similar -- car crashes were common and staged.

Under Michigan law, insurance fraud charges can be filed and prosecuted in federal court as mail fraud, and that is what happened in this case. If they had been charged under Michigan state law, rather than federally, the four defendants would be facing up to ten years in prison and a fine of $50,000 for conspiring to commit a fraudulent insurance act.

Fraud Costs Us All

According to the Coalition Against Insurance Fraud, measuring the impact and cost of insurance fraud nationally, across states and industries, is extremely difficult. There is no one agency that collects data and the Coalition writes, "Insurance fraud data thus are relatively piecemeal, making our understanding of insurance fraud an ongoing work in progress."

Different companies, associations, and government authorities at the state, federal, and local level, all collect data on various aspects of the industry and the losses it suffers. That said, the Coalition does compile, collect and analyze all the disparate data in an effort to make some sense of the total effect of insurance fraud nationally. It estimates that "conservatively" about $80 billion a year is stolen across all lines of insurance.

Really Injured?

If you have been injured in a car accident, talk to a lawyer. Many personal injury attorneys consult for free or a minimal fee and will be happy to assess your case.

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