1 Geoffrey R. Branch, Operations Major Florida Department of Financial Services Division of Insurance Fraud Ph: 954 - 958 - 5444 [email protected] Department of Financial Services DIVISION OF INSURANCE FRAUD
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Geoffrey R. Branch, Operations MajorFlorida Department of Financial ServicesDivision of Insurance FraudPh: [email protected]
Department of Financial Services
DIVISION OF INSURANCE FRAUD
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Created in 1976
Charged with investigating any and all insurance fraud in Florida:
AutoHealthPropertyLifeWorkers’ Compensation
Accredited by the Commission for Florida Law Enforcement Accreditation (CFA) in February 2009
DIVISION OF INSURANCE FRAUD
DIF’s Structure
148 sworn law enforcement positions 112 detectives
Supported by 41 non-sworn positions Crime Intelligence Analysts Administrative Secretaries and other professional support occupations
Organization Office of Professional Standards and
Planning Fraud Operations Bureau of Workers’ Compensation Fraud Bureau of Criminal Intelligence & Analytical
Support
Personnel allocation Five regions 11 statewide field offices 23 squads
Filing Complaints
http://www.myfloridacfo.com/fraud/
Initial submission should be done through web site
No need for sending supporting documentation until requested
Nothing prevents you from contacting DIF to review referral either before or after submission
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Filing Complaints http://www.myfloridacfo.com/fraud/
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What to Expect
Acknowledgement letter
Tip routing
Supervisory review
Case assignment
Investigative process
Filing decision
Prosecution
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Types of Arrests FY 7/01/13 TO 3/31/14 Total of 1,111
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PIP Fraud WC Fraud Fraud - All
Other
Licensee
Fraud
Vehicle
Fraud
Homeowners
Fraud
Application
Fraud
423 367 141 53 46 33 48
PIP Fraud, 423, 38%
WC Fraud, 367, 33%
Fraud - All Other, 141, 13%
Licensee Fraud, 53, 5%
Vehicle Fraud, 46, 4%
Homeowners Fraud, 33, 3%
Application Fraud, 48, 4%
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Common Scams during disaster
1. Auto/Vessel2. Property3. Business
•Unscrupulous Public Adjuster/Contractor Scams•Unlicensed activity•Theft of payments•Use of inferior materials•Poor quality work•Caused/increased damage•Billing for services not rendered•Double billing•Organized scams
• At times with assistance/knowledge of property owner who realizes damage is not fully covered
DIF Responses
Joint operations – public awareness Agent and Agency
Workers’ Compensation Compliance
Local authorities/licensing
ESF 16 Responses
Insurance Villages
Fraud investigations
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Public Adjusters Recruiting Scheme
Public adjuster hires “runners” familiar with the area.
“Runner” solicits homeowners with little or no damage to file claims.
Entice homeowners with promises of large insurance settlements if they increase the damage to their homes.
Inflated claim brings higher fees for PA.FSS 626.854 PA Defined; Prohibitions
FSS627.707 Policyholder may not accept rebate
State issued orders to protect consumers
Emergency rules relating to Public Adjusters.
Consumer protection rules issued by the CFO / OIR.
Limits PA fees to 10% of the claim (20% otherwise not related to State of Emergency)
Prohibits PA’s from collecting up-front fees.
Establishes a 14-day contract rescission period.
Prohibits PA from entering into a contract on a residential total loss.
Public Adjusters Historically
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Andrew 1992 – 91
Opal 1995 – 170
Charley, Frances, Ivan and Jeanne 2004 – 1,180
Peaked in 2008 – 2,515 Resident
and 407 non- resident PA’s
Where we are today……
As of April 8, 2014:
Individuals currently holding Public Adjuster
licenses in Florida total 1,606 (vs. 2,515 in
2008)
1,219 of which have active appointments
There are 321 non-resident Public Adjuster in addition to the above, of which 206 hold active appointments
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Initiatives Focus on “Facilitators”
Partnerships
Technology
Re-alignment of resources
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Florida Property and Casualty Insurance Fraud Task Force
•275 plus members•Quarterly meetings at Lake Mary•Open to all
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Department of Financial Services
DIVISION OF INSURANCE FRAUD