El Paso Insurance Fraud Attorney

Staged Car Accident Fraud in Texas

Staged car accidents are designed to recover compensation for vehicle damages and losses arising from personal injuries. Common types of staged car accidents include:

• Swoop and squat — In this scenario, 2 or 3 drivers work together to cause an accident. One driver pulls in front of another vehicle while a second driver pulls in front of the first vehicle and suddenly brakes, causing the driver behind to hit the middle vehicle. The last driver is typically at fault for hitting a vehicle from behind.
• Panic stop — Similar to the “swoop and squat,” a driver traveling with a spotter pulls in front of another vehicle. The spotter tells the driver when to brake so that the rear vehicle strikes the first vehicle from behind.
• Fake wave-in — This staged accident occurs when a driver is attempting to merge into a lane and another driver waves them in. As the driver moves into the lane, a rear driver accelerates and hits the vehicle. The rear driver tells police that the other driver was waved in, creating the impression of an improper lane change. 
• Sideswipes — This version of car accident fraud typically occurs at an intersection with a double turn lane when one vehicle swerves into another, and it’s one driver’s word against the other when the police arrive on the accident scene. 
• False witness scams — False witnesses are often involved in stage accidents working in cahoots with the scammer to back his or her version of the accident.
• Exaggerated damage/medical expense scams — One of the most common types of insurance fraud in Texas, this scam involves exaggerating damages or medical expenses to receive additional compensation from an insurer or claiming damage to a vehicle from a previous accident occurred in a more recent one. This scam also might involve exaggerating the amount of money paid to a medical center or a mechanic or misreporting wages to obtain more compensation for lost income.

Insurance Fraud Investigations

It is worth noting that insurance companies typically have special units that investigate auto accident fraud and also work with law enforcement to investigate claims if there is the slightest indication that an accident was staged. There are a variety of methods used to obtain evidence in an insurance fraud investigation to determine whether the claims are true or false, including:

• Surveillance of the supposed injury victim by private investigators  to verify the claim
• Examination of medical reports and medical history
• Searching prior claims and/or accidents
• Insurance coverage analysis
• Identifying and interviewing witnesses
• Analysis of physician’s billing records 
• Background check of the claimant

If the insurer believes you committed auto accident fraud, not only may your claim be denied, you may also face criminal charges. At the Benjamin Law Firm, we have the skills and experience to level the playing field when insurers, law enforcement, and prosecutors work together on auto accident fraud cases. We routinely collaborate with our own network of investigators and work strategically to refute any evidence that may be used against you.  

Homeowners Insurance Fraud in Texas

Some homeowners overestimate values or make less-than-accurate estimates when submitting damage claims wrongly thinking that they are only seeking money that they’ve already paid to the insurer. Nonetheless, this form of fraud causes losses to insurers and affects other homeowners by way of higher insurance premiums. Common types of homeowners insurance fraud include:

• Overstating value — While determining the value of stolen possessions in a home invasion can be difficult, overstating the value of jewelry, artwork, family heirlooms or other personal property is considered insurance fraud under Texas law. 
• Storm damage fraud — Because Texas is prone to hurricanes and floods, storm damage to homes is often overestimated by homeowners. They may also blame damage from non-covered events on storms or intentionally damage their own property to obtain a settlement.
• Staged fires — Homeowners may set fire to their own homes, or pay someone else to stage a fire when facing foreclosure, bankruptcy, or other financial distress. In addition to fraud, homeowners typically face arson charges as well, which can result in a significant prison sentence.
• Inflated claims to avoid deductibles — For homeowners experiencing financial difficulties covering the deductible to make repairs can be a challenge. At times, repairmen may suggest inflating the claim to avoid the expense, while homeowners are unaware of the legal ramifications. In this situation, both parties may face charges of homeowners insurance fraud.
• Orchestrated vandalism — Another common type of homeowners insurance fraud involves offering a portion of the proceeds from an inflated claim to someone who carries out an act of vandalism in exchange for a portion of the claim proceeds.
• Contractor kickbacks — This type of insurance fraud occurs when contractors offer homeowners a “kickback” from the insurance claim in return for using their repair services for repairs. Homeowners who agree to kickback schemes not only face insurance fraud charges but also run the risk of being taken advantage of by contractors who fail to make the needed repairs.

According to the Insurance Information Institute, fraudulent homeowner insurance claims cost insurers $30 billion per year, which forces insurance companies to raise premiums and rates. If you have been accused of homeowners insurance fraud in Texas, the best decision you can make to protect your rights and your future is to consult Benjamin Law Firm. 

Life Insurance Fraud

Life insurance fraud in Texas is typically associated with a faked death, however, it can also involve application fraud, forgery, and phony policy fraud:

• Claims fraud — This type of fraud is often referred to as death fraud which occurs when a policyholder attempts to fake his or her death or the death of a loved one to collect a life insurance benefit. In an extreme (but rare) case, a beneficiary of a life insurance policy may murder the policyholder to obtain a payout. 
• Application fraud — This involves an applicant knowingly providing false or inaccurate information to an insurer in the initial application and during a phone interview with a life insurance agent, including medical records and information from a medical exam. Insurance underwriters rely on this information to determine the applicant’s health rating. If the applicant lies, such as by lying about being a smoker when medical records indicate otherwise, the insurer may deny the application based on misrepresentation which could also result in criminal charges. 
• Forgery — This form of insurance fraud does not involve the insured, but rather other parties unlawfully accessing the policy and changing the policyholder or beneficiaries. Forgery will not only result in claim denials but insurance fraud charges as well.
• Phony policy fraud — In this scenario, scammers impersonate insurance agents to sell fake policies to unsuspecting customers, requesting cash or direct payments.

Given the value of a typical policy, life insurance fraud will likely lead to felony charges, which makes having Benjamin Law Firm on your side crucial. 

Workers’ Compensation Fraud

The Workers’ Compensation Insurance system in Texas is designed to protect employees and employers alike. Workers who sustain a work-related injury or illness receive benefits such as lost wages and medical expenses while employers are protected from personal injury lawsuits. Worker’s Compensation fraud occurs when employers, workers or medical providers attempt to take advantage of the system. The main types of Workers’ Compensation fraud include:

• Policy-related fraud — This occurs when a company that is purchasing Workers’ Compensation Insurance intentionally provides false information to an insurance company to obtain a lower premium. Examples of false information include inaccurately reporting the number of workers, and misclassifying employees as independent contractors.
• Claim-related fraud — This form of Workers’ Compensation fraud occurs when an employee files a false claim for a work-related injury or illness to unlawfully obtain benefits. This type of fraud may involve the worker claiming an offsite injury was work-related or exaggerating the severity of workplace injury to obtain a greater benefit.
• Medical provider fraud — This scheme may involve either a medical provider knowingly attempting to profit from the Workers’ Compensation system by performing unnecessary services on a claimant or medical specialists or pharmacies engaging in fraudulent billing or kickbacks.

Depending on the circumstances, Workers Compensation fraud in Texas may result in misdemeanor or felony charges.