Protecting Californians by investigating insurance fraud for 90 years

Working to prevent fraud and support recovery, the California Department of Insurance released an update on consumer protection actions by its Investigation Division. Charged with investigating insurance fraud, unlicensed insurance activity, and misconduct by insurance agents, claims adjusters, and other licensed individuals and entities, the department is the front-line defense for Californians in the nation's largest insurance market — both during disasters and in everyday insurance transactions.

"Our investigators work every day to hold insurance fraudsters and bad actors accountable, protecting consumers and ensuring integrity across California's insurance marketplace," said Insurance Commissioner Ricardo Lara. "Whether during disasters or in everyday insurance transactions, the Department of Insurance helps policyholders access their benefits and ensures they are protected when they need it most."

Results that protect consumers

The department's investigative work protects consumers year-round, including during disasters when policyholders may be especially vulnerable. After disasters, investigators take action against any licensees who may be targeting victims. Following the Eaton Fire, a department investigation into a bad acting licensed adjuster, resulted in a $10,000 fine, license surrender, and a 10-year industry ban. Investigators are out in the community after disasters, educating consumers about their rights and helping to deter potential fraud by those who prey on survivors.

During wildfire recovery efforts in Pacific Palisades, Topanga and Malibu, investigators helped safely transport claims adjusters into restricted areas to expedite insurance payments to survivors, which today total over $22.4 billion. Over several operational days, adjusters from seven insurance companies accessed approximately 318 properties, advancing more than 160 insurance claims.

Beyond disaster response, the department continues to stop fraud and protect consumers through both criminal and administrative actions, including:

Premium finance fraud

Prosecuted a former Northridge-based insurance agent sentenced to 50 months in federal prison for more than $3.7 million in fraudulent premiums.

Life insurance fraud

Dismantled a scheme involving former agents who allegedly misrepresented policy terms and falsified agent information to collect over $1.4 million in unearned commissions.

Unauthorized insurance activity

Issued cease and desist orders against an entity illegally operating as a health insurance company, and secured a $150,000 settlement with a licensed title company for illegal rebates and conflicts of interest.

90 years of enforcement and consumer protection

This year the Department of Insurance Investigation Division is recognizing 90 years of protecting consumers through criminal investigations, regulatory enforcement, and oversight of California's insurance marketplace. The milestone not only reflects the Department's long-standing enforcement work, but also serves as a reminder that the Department of Insurance is a resource for Californians who need help, have questions, or suspect insurance fraud.

As it enters its tenth decade, the Department's Investigation Division continues its mission to protect consumers, stop fraud, and maintain the integrity of California's insurance marketplace, building on 90 years of enforcement, oversight, and service to Californians statewide.

Consumers play a vital role in stopping fraud. Many high-impact investigations begin with tips from the public, which help the Department identify misconduct and hold bad actors accountable. Reporting suspected insurance fraud protects individual policyholders and strengthens the entire insurance marketplace. Consumers can report fraud or verify a license at insurance.ca.gov or by calling (800) 927-4357.