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- Insurance Fraud Unit
Insurance Fraud Unit
The Napa County District Attorney’s Office Insurance Fraud Unit is charged with enforcing the provisions of Chapter 12 of the California Insurance Code, commonly referred to as the “Insurance Frauds Prevention Act,” California Penal Code, Sections 549-550 and California Labor Code, Section 3700.5. Current law allows the Fraud Unit to investigate various felony and misdemeanor provisions of the Penal and Insurance Codes. Frequently, investigations conducted by the Fraud Unit involve some aspect of a “Suspected Fraudulent Claim.”
Importance of Awareness & Citizen Protection
The following information and useful links are intended to raise awareness of the different types of insurance fraud, how to identify and protect yourself from insurance fraud, and who to contact if you've witnessed or been the victim of suspected insurance fraud.
What is Insurance Fraud?
Fraud occurs when someone knowingly lies to obtain some benefit or advantage to which they are not otherwise entitled or someone knowingly denies some benefit that is due and to which someone is entitled. Depending on the specific issues involved, an alleged wrongful act may be handled as an administrative action by the California Department of Insurance (CDI) or may be investigated as a criminal matter by the CDI, local district attorney’s office, or other law enforcement agency.
What Types of Insurance Fraud Does the District Attorney’s Office handle?
Automobile Insurance Fraud
Automobile insurance fraud is one of the most widespread and lucrative fraud problems in the United States. The effects of automobile insurance fraud are significant for both the insurance companies and ultimately the consumer with increased insurance costs (National Insurance Crime Bureau estimates that $200-$300 per year is added to each individual insurance premium). Additionally, some of these automobile insurance schemes come with substantial physical risks to the law abiding citizens of our community. The Napa County District Attorney’s Office in partnership with the California Department of Insurance actively investigates allegations of automobile insurance fraud. By educating and informing the public of this problem, we strive to minimize the impact of this type of fraud in our community.
Read the helpful document, Automobile Insurance Fraud: What you need to know (PDF).
Workers' Compensation Insurance Fraud
Workers’ compensation fraud is a serious community and statewide issue, which impacts industry, employers, the medical profession, insurance companies, employees, and local businesses. $10 billion in workers’ compensation claims are filed each year in the state of California. It is estimated that 10% to 30% of those claims are fraudulent, costing California consumers $5 billion per year. The District Attorney’s Office is committed to serve our community by pursuing criminal cases related to workers’ compensation insurance fraud. By doing so, Napa County will continue to be a place where employers and employees are treated in accordance with the law, and honest businesses can compete fairly.
Whether you are a citizen, a legal resident, or an undocumented alien regularly employed, or a day laborer receiving cash, you may be entitled to workers’ compensation benefits if you are injured on the job. Workers’ compensation is a benefit provided to employees who are injured on the job. Employees must provide this compensation either by obtaining workers’ compensation insurance coverage or by certifying to the State of California that they are self-insured. It is illegal for an employer to operate without workers’ compensation coverage for their workers. (California Labor Code Section 3700.5)