75 convictions secured; total complaints amounted to nearly $14.5 million
By Ross Turner
The SC Attorney General’s office released a report last month analyzing last year’s insurance fraud cases. The report showed that a total of 75 convictions were made in 2010, and defendants were ordered to pay $316, 270 in restitution in both civil and criminal cases. State Attorney General Alan Wilson’s office received 596 complaints of insurance fraud last year and carried over 213 cases from 2009.
Several years ago, we reported a fraud case after receiving a call from a large general contractor. We had worked with this contractor many times before because they sub- contract several of our clients on an ongoing basis. The insurance manager of the general contractor had received a certificate of insurance from a roofer they were using on a job.
The certificate listed The Turner Agency as providing all the insurance coverage through a standard company, but the insurance manager didn’t think the certificate looked right. She called us to verify the coverage and sure enough- we confirmed that it was a forged certificate. The roofer had taken a certificate we issued in that past and put their name in the insured section.
We immediately put together a report and notified both the company that was on the certificate and the South Carolina Insurance Fraud department. Within two days, SLED was knocking on the roofer’s door.
Another roofer we know who pays his worker’s compensation and general liability for one crew knows that this fraud was worth about $ 40,000 – a white collar crime.
The state is doing a great job investigating and prosecuting insurance fraud with the limited funding they have. The Insurance Fraud Division of the SC Attorney General’s office has four attorneys working to defeat insurance fraud in our state.
The state is also working in conjunction with the companies whose investigative units appear to be as aggressive as ever in tracking down fraud. Here are more highlights from the report:
- 2010 cases amounted to nearly $14.5 million in fraud, more than double the dollar amount reported in 2009.
- The largest amount, $11.9 million, was related to auto insurance fraud. The next largest amount, $1.3 million, was related to health and medical insurance fraud.
- Richland County had the largest number of complaints made, while Lexington County had the largest dollar value reported.
- Horry County had two complaints of premium fraud, reported at $181,660.
- Breakdown by region:
- Midlands: 27% (60 cases)
- Lowcountry: 25% (55 cases)
- Piedmont: 24% (52 cases)
- Pee Dee: 24% (53 cases)