Fraud Division Overview
Fraud Division Mission
"To protect the public and prevent economic loss through the detection, investigation, and arrest of insurance fraud offenders."
To achieve this mission, the Fraud Division is staffed by over 266 dedicated staff serving in the Enforcement Branch headquarters and nine regional offices throughout the State. Established in 1979, the Fraud Division is the largest law enforcement unit within the Enforcement Branch of the California Department of Insurance and is composed of four separate insurance fraud programs:
- Automobile Insurance Fraud
- Workers' Compensation Fraud
- Property, Life and Casualty Fraud
- Disability and Healthcare Fraud
Within these programs, detectives investigate crimes related to section 550 of the Penal Code, the California Insurance Code and other related crimes discovered during the investigation, such as conspiracy, human trafficking, grand theft and automobile theft statutes.
As sworn peace officers, Fraud Division detectives are the leading experts in the field of insurance fraud. They are trained in criminal investigations and provide assistance as well as training for consumers, the insurance industry, and allied law enforcement agencies. They conduct investigations, surveillance, undercover operations, and interview witnesses and suspects. Detectives also write and execute search and arrest warrants, as well as testify in court. Fraud Division detectives may be assigned to various local law enforcement task forces such as auto theft, computer forensics, underground economy, pharmaceutical fraud, and disaster fraud. Fraud Division detectives are also tasked with identifying emerging trends in insurance fraud in order to protect California consumers. The Fraud Division's ability to identify emerging trends, their training programs, and their business practices have been emulated by others, and have garnered the Division a national reputation.
Unlike most California state agencies whose budgets are derived from the general fund, the Fraud Division's funding is primarily secured from assessments on employers and on insurance policies issued in the State.
In addition, Fraud Division detectives collaborate with local, state and federal allied law enforcement agencies on criminal investigations. This pooling of resources and expertise has identified strategies to aggressively investigate and deter fraudulent behavior.
Fraud Division History
The Fraud Division has established a method for insurers, Third Party Administrators (TPA's), and self insureds to report suspected insurance fraud. It is important to know that notification of insurance fraud may be made anonymously.