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Fraud Policy Statement

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CenCal actively works with governmental agencies to detect, investigate and prosecute offenders who commit insurance fraud to the fullest extent of the law. We have a team of dedicated Special Investigation Unit (SIU) investigators with direct access to district attorney offices throughout the state. Our commitment to the fight against fraud is really an opportunity to improve things for every insurance buyer and provider. Too many cost dollars are taken up by fraudulent activities that penalize all of us. We invite everybody to join us in this most important venture, and we have made it easy to report suspected fraud throughout our website.

RED FLAG INDICATORS OF AUTO FRAUD

Most claims are legitimate; however, certain red flags in claim files may indicate a need for further investigation. If a claim you are handling contains multiple indicators like those listed below, please review the file with a member of the Special Investigation Unit.

STAGED AND PAPER ACCIDENTS

  • Accident involves obvious liability. Insured rear ended other vehicle or ran a stop sign
  • Loss reported by an attorney’s office. Loss not reported by insured
  • Multiple claimants presenting soft tissue injury claims. 3 or more in one vehicle
  • Insured is difficult to contact or uncooperative
  • Insured readily admits fault for the loss
  • No police report or an over-the-counter police report prepared after the loss. No ambulance or tow truck at scene of the loss
  • Immediate representation by an attorney
  • Represented by a known attorney and/or treating with a known doctor
  • Property damage does not match. The damage is not consistent with loss facts
  • Vehicles involved are salvaged. Vehicles have old damage
  • Vehicle(s) were repaired before they could be inspected
  • Accident involves a phantom vehicle
  • Insured or claimants have a P.O. Box for an address, pager or cell phone, no home telephone number
  • New insurance policy, or vehicle recently added to an existing policy (within 60 days)

Anytime you have a question regarding a suspicious claim, please discuss the claim with a supervisor. We are here to assist you anyway we can.

DETER, DETECT, INVESTIGATE AND PROSECUTE

If you think you might need to report fraud, these links may be of use to you:

California Department of Insurance

Northern California Fraud Investigators Association

National Insurance Crime Bureau

International Association of Special Investigation Units


California Department of Consumer Affairs

Department of Consumer Affairs, Bureau Of Automotive Repair


California State Bar

California Board of Chiropractic Examiners

Medical Board of California

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