Insurance Fraud: The Crime We All Pay For

Why We All Need To Work At Identifying Fraud

Insurance fraud occurs every day in every city and state. If insurance fraud was a legitimate business, it would be a Fortune 500 Company. According to the Coalition Against Insurance Fraud, insurance fraud costs Americans at least $80 billion a year, or nearly $950 for each family. In California alone the cost of insurance fraud has reached a staggering $15 billion per year. Businesses lose millions in income annually because fraud increases their costs for employee health coverage and business insurance, while reducing the productivity of the workforce. Insurance premiums stay high because companies must pass the significant cost of insurance fraud to policyholders.

Athens Special Investigations Unit, a step toward dealing with the issues

Athens has made fighting fraud a priority by creating a special fraud fighting unit. The Athens Special Investigations Unit (SIU) educates employees, consumers and customers to be alert for fraud, how to identify potential fraudulent claims, and what to do about suspicious claims once identified. Involving the SIU in the strategic planning of the suspicious claims at an early stage allows for an efficient and cost effective resolution. The Athens SIU acts as a liaison with the Department of Insurance and the proper prosecutorial agency to ensure compliance with all regulations as required. Early intervention, proper planning and the use of investigative resources results in the rapid identification of suspicious claims. This in turn translates into cost savings for Athens customers.

How Athens Administrators can help

Continuing our commitment to partnering with our clients to provide superior services, Athens Administrators has teamed up with a well respected industry leading investigation company, Frasco Investigative Services, to create the Athens SIU.

Athens SIU

  • Knowledge of Workers Compensation claims functions
  • Knowledge of Property & Casualty claims functions
  • Fraud Awareness Training
  • Fraud Audits
  • Fraud Awareness Posters
  • Fraud Hotline – (888) 363-1942
  • Knowledge of and compliance with DOI Regulations
  • Submits cases to the Department of the Insurance and the appropriate District Attorney’s Office for Criminal Prosecution

Additional Resources for Information about Insurance Fraud
CA Dept. of Insurance Annual Report – See Pages 129-256
Coalition Against Insurance Fraud