Maryland Insurance Administration issues first-ever civil fraud orders

Jul 24, 2013


The Maryland Insurance Administration (“MIA”) announced today, July 24, 2013, that it has issued its first administrative orders under newly granted authority to pursue civil cases of insurance fraud.  The authority took effect last October following passage of legislation by the 2012 Maryland General Assembly.

Previously, the MIA investigated only criminal fraud cases, which are prosecuted by either the Maryland State Attorney’s Office or the Office of the Attorney General.  Fraud referrals made to the MIA’s Insurance Fraud Division since October 1, 2012 now are also reviewed for civil remedies.

Today’s order were issued in two separate cases:  The first involved a Curtis Bay woman who submitted falsified documents to two insurance companies, saying she had missed eight days of work following a February 2012 automobile accident.  The woman was found to have used her employer’s signature stamp without his knowledge to validate her claim of lost wages.  An investigation led by MIA Assistant Chief Civil Fraud Investigator Joe Smith found that the woman had not missed any days of work as claimed.   As a result, she has been ordered to pay a $2,000 fine and reimburse State Farm Insurance Company for the $644 payment it made to her as a result of her false claim.  Another insurance company involved learned of the false information in time to stop payment on her claim.  

The second case of fraud involved a Mechanicsville man who filed a disability insurance claim with a false date listed for his return to work.  As a result of the false date, the insurance company paid him for time, during which he also received a salary from his employer.  The man has been ordered to repay $1,120.70 to American United Life Insurance Company, along with a $2,000 administrative penalty.

The MIA notes that insurance fraud is a felony in Maryland if it involves $300 or more.  Anyone convicted of the crime faces up to 15 years in prison.  Civil penalties can reach up to $25,000.  Losses from fraudulent claims are passed on to all consumers in the form of higher premiums. 

The Coalition Against Insurance Fraud estimates that theft through insurance fraud reaches at least $80 billion each year.


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