For some who live or work in the Irvine area, a little padding of traveling expenses is not a big deal. It is one of those things that fall in the same gray area as embellishing donations or business overhead on your income tax returns. Everyone does it and nobody minds, right? The truth is, even these “small” things are considered fraud, but the real danger lies in this manner of thinking. Committing these little frauds and getting away with them is a type of conditioning; the success you experience makes it easier to commit bigger frauds.
California’s Dept. of Insurance explains that insurance fraud is one of the more popular forms of fraud, which is committed by people from all walks of life, including those in organized crime, as well as technical and professional business people. Typical means of doing this include overcharging for services or by including services that were never performed to everyday insurance policyholders who want to ensure their deductible is met or who may see their claim as a chance to make some money.
Worker’s compensation is thought to be among the insurance sectors with the most instances of fraud, perhaps because it is open to fraud from many different sources. Claim types range from staged, on-the-job injuries to complicated billing for medical attention that was never received. An employee can file a false claim, as well as medical and legal providers who may be involved. An employer can commit fraud by discouraging employees who have been hurt from filing a claim or by giving false information to its insurance carrier in attempts to lower the cost of premiums.
According to FindLaw, a fraud scheme may be considered either hard or soft fraud. Hard fraud typically includes staging a theft, arson, accident or another type of loss, while soft fraud often refers to acts like inflating the claim (much like padding expenses).
In prosecuting a case of fraud, it must be proven that a defendant knowingly lied or misled the insurer about a claim. Another element to be proven is that the deceit was capable of affecting the claim and its approval.
