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California State Department of Insurance, Fraud Division

The District Attorney's Office is funded by the California State Department of Insurance to investigate and prosecute suspected fraud in both Workers' Compensation and Auto Insurance Claims. Both of these types of crimes are felonies and are punishable by state prison. The District Attorney may investigate these cases independently or with the assistance of the Department of Insurance Investigations Division.

Types of Workers' Compensation insurance fraud cases we investigate include:

APPLICANT FRAUD: typically occurs when a person lies about being injured or when a person gets injured off the job but claims the injury occurred at work. This type of fraud also occurs when a person exaggerates the seriousness of an injury in order to receive a higher dollar benefit or extend the benefit for a longer period of time.

PREMIUM FRAUD: typically occurs when an employer falsely claims a lower number of employees or changes their work classification in order to reduce the amount of their premiums for workers' compensation insurance coverage.

PRACTITIONER FRAUD: typically occurs when a Medical Doctor or Chiropractor bills an insurance company for treatments not actually received by the patient or extends the number of treatments beyond what is necessary in order to collect additional insurance money.

PROVIDER FRAUD: typically occurs when the insurance company misleads prospective clients, collects premiums for insurance coverage not provided, inflates premiums, or fraudulently fails to pay an appropriate claim.

Types of Automobile Insurance fraud cases we investigate include:

FALSE CLAIMS: typically occurs when a person falsely claims a loss that never occurred. This may include such claims as theft or loss of personal property which the claimant has secreted or disposed of for profit.
Where a person falsely reports his or her vehicle as stolen when in fact, they abandoned it after having been involved in an accident while driving under the influence of drugs or alcohol. Where a person falsely claims the details of an accident in order to cover up another crime such as hit and run. Where a person stages a false automobile accident in order to receive payment for damages or faked injury.

INFLATED LOSS CLAIMS: where a person exaggerates the dollar loss or the type and number of items lost or damages to an automobile in order to receive an additional settlement. Where a person exaggerates pain and suffering or his or her inability to work due to an automobile accident in order to receive additional settlement money.

Please contact us if you have been a victim of either of these types of crimes or if you have information regarding these types of fraud, which have been committed in Butte County. Your report will be kept confidential, and will be safely transmitted through a secure server. Upon receipt, our office will investigate, and when possible, prosecute these crimes to the fullest extent of the law.


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