The United States Sentencing Commission reported that 86.8% of those convicted by healthcare fraud federally sentenced in fiscal year 2018 had little to no prior criminal records.

The United States Sentencing Commission’s 2018 research provided that the average age of an insurance fraud perpetrator was 49 years at the time of sentencing. Other interesting healthcare insurance fraud statistics that inform on offender demographics follow:

Most medical fraud offenders hail from the following five districts – Southern District of Florida, Eastern District of Michigan, Southern District of Texas, Middle District of Florida, and Eastern District of Louisiana.

The median loss for these offenses was $1,048,375 and include the defrauding of both public and private health care entities, based on the 2018 medical insurance fraud statistics.

South Carolina Insurance Fraud Statistics

86.8% of healthcare fraudsters federally sentenced in fiscal year 2018 had little or no prior criminal history.

In 2018 the Attorney General’s Office of South Carolina received 2,957 complaints of suspected insurance fraud reported by the National Insurance Crime Bureau.

• Those complaints were divided as follows:
• Automobile: 2.151 (73%)
• Personal/Commercial: 447 (15%)
• Workers Compensation: 91 (3%)
• Health/Medical: 101 (3%)
• Premium: 55 (2%)
• Life Insurance: 23 (1%)
• Disability: 5 (<1%)
• Unemployment: 1 (<1%)
• Other: 83 (3%)