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Colorado Attorney General

Phil Weiser

Colorado Attorney General

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Insurance Fraud

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:

What is your issue about?

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.

Information about the situation/suspect(s)

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.

Your contact information

Please be prepared to provide your contact information, such as your name, address, phone number, and your email address.

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Important Notice

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. 

  • Colorado Department of Labor and Unemployment

 

Criminal Justice

The Criminal Justice Section investigates and prosecutes on a statewide basis a broad array of matters including but not limited to: securities fraud, insurance fraud, Medicaid fraud, environmental violations, human trafficking, drug trafficking homicides, and multi-jurisdictional organized crime.

This work is accomplished either under the original jurisdiction of the Attorney General’s Office, or in partnership with and at the request of state and federal prosecutors and law enforcement.  Click here to learn more.

Additional Resources

StopFraudColoradoNeed more information?  Please visit our Insurance Fraud Center where we have compiled information about various topics. Please note you will be routed to the Colorado Attorney General’s Consumer Fraud initiative, StopFraudColorado.gov

  • Insurance Fraud Center

 

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Office of the Attorney General
Colorado Department of Law
Ralph L. Carr Judicial Building
1300 Broadway, 10th Floor
Denver, CO 80203

(720) 508-6000

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