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Calif. Couple’s Fake Knee Injury Plot Exposed; Leads to Convictions

The effective collaboration between claims, SIU and Calif. prosecutors not only exposed two fraud perpetrators but also led to their prosecution and conviction.

By Barry Zalma | Updated on November 27, 2012

(Editor’s Note: The following article was contributed by Barry Zalma, Esq., CFE, who has been practicing insurance law in California for more than 40 years.)

As claims professionals well know, insurance fraud is rampant in the United States. Experts have estimated the crime robs the industry of between $80 billion and $300 billion each year. Yet, no one knows the true amount because so many fraudulent insurance claims succeed. Those that do result in a prosecution and conviction are rare. People convicted of insurance fraud are usually amazed at the conviction and will invariably attempt to avoid the conviction by seeking reversal in the appellate courts. The fact that they have funds to pursue an appeal is evidence of how successful and profitable insurance fraud can be.  

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