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Insurance Fraud Whistleblowers

INSURANCE FRAUD WHISTLEBLOWERS UNDER INSURANCE CODE 1871.7

The Insurance Frauds Prevention Act, Insurance Code § 1871.7, allows an individual with personal knowledge of insurance fraud to bring a lawsuit for the State of California for insurance fraud. Importantly, you do not have to have been injured directly.

An insurance whistleblower’s case brought under Insurance Code §1871.7 is more expansive than other cases under parallel qui tam statutes, particularly because the fraud does not need to be committed against the government. In other words, it is irrelevant if the State of California suffered an injury or loss. What it does mean is that you can bring a lawsuit if a private insurance company sustained a loss. For example, your automobile insurance or health insurance policy. Insurance Code § 1871.7 does not protect the policyholder if the insurer commits fraud against them. The reason that Section 1871.7 was enacted is because that when fraud is committed against insurance companies it also harms the people of California by increasing insurance costs.

Insurance fraud can happen with all types of insurance, including, health insurance, for medical expenses; life and casualty insurance, for financial loss with an accident or death; workers’ compensation, for work-related injuries; disability insurance, for disabilites, injuries or illnesses; life insurance, if there is a death; auto insurance, for car accidents; and property insurance, for property damage or loss claims. Examples of types of insurance fraud that may qualify under the California insurance whistleblower award program:

  • False billing claims,
  • Billing for services not performed,
  • Over Billing or billing for more extensive services than actually occurred,
  • Treatment performed by a person that is not licensed,
  • Misrepresenting the number of employees to minimize workers’ compensation,
  • Faking a death for life insurance,
  • Staging car accidents or faking injuries to collect auto insurance,
  • Lying about property being destroyed for property insurance;
  • Submitting the same claims multiple times.

WHAT CAN YOU DO TO REMEDY INSURANCE FRAUD IN CALIFORNIA?

If you are aware of insurance fraud that might qualify as fraud under the California Insurance fraud whistleblower law you should contact the attorneys at the Evans Law Firm for a free and confidential consultation. Insurance fraud whistleblowers can reward successful whistleblowers/ relators with a generous award of up to 50% of any recovery obtained, plus attorney’s fees and costs. The law also provides for penalties between $5,000 and $10,000 for each illegal act, and treble damages for any amount paid under a fraudulent insurance claim.

Evans Law Firm, Inc. handles cases that involve insurance and banking fraud, whistleblower and qui tam claims, consumer fraud class actions, annuity fraud, and financial and physical elder abuse. If you believe you have personal knowledge of insurance fraud, contact Evans Law Firm, Inc. at (415) 441-8669 or info@evanslaw.com for a free and confidential consultation.

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