What is insurance fraud?
Insurance fraud can take many forms and is usually prosecuted under Colorado Revised Statute Section 18-5-211. The Attorney General investigates and prosecutes instances of;
- Intentionally providing false statements or false documentation to an insurance company in the claims process
- Staging or causing automobile accidents in order to make a false insurance claim for property damage or injury
- Individuals who create or pass false or fraudulent insurance certificates or misappropriate insurance premium funds.
- While this is not an all-inclusive list, common traits needed to prosecute insurance fraud are establishing the identity of the perpetrator and that the perpetrator had an intent to defraud an individual or an insurance company.
What we are unable to assist with
The Attorney General is unable to prosecute cases where we cannot establish an intent to defraud on the part of the perpetrator. The Colorado Division of Insurance located in the Colorado Department of Regulatory Affairs is responsible for regulating the conduct of insurance companies who do business within the state of Colorado. The role of the criminal prosecution unit at the Attorney General is to solely evaluate, and when appropriate prosecute, criminal conduct. The unit does not have the ability to force insurance companies to pay out on claims, negotiate settlements, or otherwise regulate their actions.
Unscrupulous contractors or individuals can abscond with insurance payouts. Unless the contractor or individual criminally misrepresented themselves during the course of the claim or made criminal misstatements to the insurer, this is potentially a theft that should be referred to local law enforcement rather than to the Attorney General.
Tips on submitting a complaint
The more information you can provide about the situation, the more useful your complaint will be. If possible, be prepared to provide the following information:
Be clear and concise. Briefly describe your issue and what steps you have taken to resolve it. Be sure to include all relevant dates and other details about your experience, including the amount of money lost (if any) and communications you have had with the alleged suspect, witnesses, and involved insurance company or companies.
If available, please be prepared to provide information on the situation you are reporting about, such as suspect name, address, phone number, website, email address, and any other identifying information.
Please be prepared to provide your contact information, such as your name, address, phone number, and your email address.
File a Complaint
The Attorney General’s Office does not have authority to provide legal advice or legal representation to individuals and does not have the authority to investigate or prosecute your individual case.
***ALERT: If you have been a victim of a false or fraudulent unemployment filing in Colorado, you may be a victim of identity theft. As a result, please contact the Colorado Department of Labor and Employment(“CDLE”) as CDLE has authority over unemployment claims in Colorado.