Uncovering The Mystery Of 'Cappers': Understanding Insurance Terminology

what is another term for a capper in insurance

In the context of insurance, a capper is a middleman in a fraud scheme. Cappers recruit people to be involved in staged accidents, usually targeting high-value vehicles or senior citizens. They work with lawyers and medical providers, receiving a set fee or a percentage of the take.

The term cap or insurance cap refers to a limit on the amount of coverage provided by an insurance policy. This means that there is a maximum value that the insurance company will pay out for a claim, which can vary depending on the specific coverage and policy details.

Characteristics Values
Definition A capper is a middleman in a fraud scheme.
Role Recruits occupants to be involved in a staged accident.
Arrangement Has an arrangement with a medical provider or lawyer or both, getting either a percentage of the take or a set fee per person.
Story Provides the "story" for the occupants.
Target Usually targets high-dollar cars or business vehicles, as they normally have high-dollar coverage.
Intimidation Can be intimidating if you start asking questions.

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Runners and cappers are the middlemen in a fraud scheme

In a fraud scheme, runners and cappers recruit occupants to be involved in a staged accident. They have an arrangement with either a medical provider or lawyer, or both, and receive either a percentage of the take or a set fee per person. The runner provides the "story" for the occupants, who then load into a car and look for their victim. Usually, a high-dollar car or business vehicle is targeted, as they have high-dollar coverage. Seniors and women are also often targeted. Through various means, an accident ensues, and the occupants head off to treat with the medical provider and sign up with the lawyer for their soft tissue injuries. Sometimes these accidents go awry, and people get hurt or killed.

In California, it is unlawful to knowingly employ runners, cappers, or other persons to procure clients or patients to perform or obtain services or benefits. Runners and cappers who solicit any business for any attorney in any hospital, court, or in any public or private place, on any street or highway, or in any private property, commit a crime. The penalties for violating this law are substantial, including jail time and fines of up to $15,000.

The "chief motive in all insurance crimes is financial profit". Insurance fraud can be classified as hard fraud or soft fraud. Hard fraud occurs when someone deliberately plans or invents a loss, such as a collision, auto theft, or fire that is covered by their insurance policy to claim payment for damages. Soft fraud, which is far more common, consists of policyholders exaggerating otherwise legitimate claims.

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Cappers recruit occupants to be involved in a staged accident

Cappers are the middlemen in insurance fraud schemes. They recruit occupants to be involved in a staged accident and provide them with a story. Cappers work with runners, who are individuals who recruit victims of actual automobile accidents and convince them to visit an attorney. The recruited occupants load into a car and hit the road looking for their victim. Usually, a high-dollar car or a business vehicle (including semi-tractor trailers) is the target, as they normally have high-dollar coverage. They also tend to target seniors as well as women.

The cappers have an arrangement with either a medical provider or lawyer or both, getting either a percentage of the take or a set fee per person. The recruited occupants then deliberately crash into the target vehicle, after which they all head off to treat with the medical provider and sign up with the lawyer for their soft tissue injuries. Sometimes these accidents go awry and people really get hurt or killed.

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The runner provides the story for the occupants

Runners and cappers are the middlemen in a fraud scheme. The runner provides the story for the occupants, who are recruited to be involved in a staged accident. The runner has an arrangement with a medical provider or lawyer, or both, and gets either a percentage of the take or a set fee per person.

The occupants load into a car and hit the road looking for their victim. Usually, a high-dollar car or a business vehicle (including semi-tractor trailers) is the target, as they normally have high-dollar coverage. They also like to target seniors as well as women. If you start asking questions, they can be intimidating. Through various means, an accident ensues and the occupants all head off to treat with the medical provider and sign up with the lawyer for their soft tissue injuries. Or they may simply just sign the sign-in sheets and be on their way. Using another name, they may do it all over again. Sometimes these accidents go awry and people really get hurt or killed.

For example, Alice Ross, a grandmother from Queens, NY, was killed in a staged accident in 2003. She was an innocent victim.

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The occupants target high-dollar cars or business vehicles

A runner or capper is a middleman in an insurance fraud scheme. They recruit occupants to stage an accident, usually targeting high-dollar cars or business vehicles as these have high-dollar coverage. The runner or capper has an arrangement with a medical provider or lawyer, or both, and receives either a percentage of the take or a set fee per person. They provide the story for the occupants, who then load into a car and look for their victim.

In 2003, Alice Ross, a grandmother from Queens, NY, was killed in a staged accident. She was an innocent victim. Two other people, Altagracia Arias of Lwarence, MS, and Jose Luis Lopez Perez of Los Angeles, CA, were also killed in staged accidents, although they were willing participants.

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The occupants also target seniors and women

Runners and cappers are the middlemen in insurance fraud schemes. They recruit occupants to be involved in a staged accident, usually targeting high-dollar cars or business vehicles as they have high-dollar coverage. The cappers also target seniors and women. The cappers have an arrangement with a medical provider or lawyer, or both, and get either a percentage of the take or a set fee per person.

The cappers provide the "story" for the occupants, who then load into a car and hit the road looking for their victim. An accident ensues, and the occupants head off to treat with the medical provider and sign up with the lawyer for their soft tissue injuries. Sometimes, these accidents go awry and people get hurt or killed.

Insurance fraud is a "specific" intent crime. This means a prosecutor must prove that the person involved knowingly committed an act to defraud. The act and intent must come together for it to be considered a crime. Actual monetary loss is not necessary as long as the suspect has committed an act and had the intent to commit the crime.

The majority of life insurance fraud occurs at the application stage, involving applicants misrepresenting their health, their income, and other personal information in order to get a cheaper premium. Identity theft has become an enabling crime that can lead to the amendment of life insurance terms to benefit a fraudster.

The most common perpetrators of healthcare insurance fraud are health care providers. One reason for this is that the historically-prevailing attitude in the medical profession is one of "fidelity to patients". This incentive can lead to fraudulent practices such as billing insurers for treatments that are not covered by the patient's insurance policy. To do this, physicians bill for a different service that the policy covers, rather than the service they rendered.

Another motivation for insurance fraud is a desire for financial gain. Public healthcare programs such as Medicare and Medicaid are especially conducive to fraudulent activities, as they are often run on a fee-for-service structure. Physicians use several fraudulent techniques to achieve this end, including "up-coding" or "upgrading", which involve billing for more expensive treatments than those actually provided, and providing treatments that are not medically necessary.

Frequently asked questions

A capper is a middleman in an insurance fraud scheme. They recruit people to be involved in a staged accident, usually targeting high-value vehicles or senior citizens. The capper has an arrangement with a lawyer or medical provider and gets a set fee or a percentage of the take.

A capper in insurance can also be referred to as a "runner".

Cappers recruit people to stage accidents, usually targeting high-value vehicles or senior citizens. They work with lawyers and medical providers to receive a cut of the profits from insurance claims.

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