Fraud Recovery Group
Proactive Legal Action Against Fraud
Roig Lawyers’ Fraud Recovery Group is built on initiative, precision, and strategy. We help carriers and corporations reduce loss, disrupt repeat offenders, and recover substantial improper payments. We proactively pursue legal action against individuals, medical providers, staged-accident participants, and organized fraud networks engaged in fraud.
We partner with carriers, corporations, and Special Investigation Units (SIU) to move beyond reactive defense and into decisive, affirmative enforcement of policy rights. Our team leverages advanced analytics, investigative technology, and data-driven litigation strategies to recover improper payments, disrupt fraudulent enterprises, and deter future misconduct.
With in-house SIU professionals and former prosecutors on our team, we bring a unique blend of investigative depth, courtroom experience, and regulatory insight. We also coordinate with law enforcement agencies when appropriate to ensure parallel civil and criminal accountability.
Most importantly, we work closely with each client to identify their business objectives and risk tolerance, tailoring our legal strategies to align with their operational goals and long-term fraud prevention initiatives.
Strategic Fraud Litigation
When fraud is uncovered, we move quickly and decisively — not just to defend a claim, but to stop the scheme.
Our goal isn’t a single case victory — it’s dismantling the operation, recovering losses, and eliminating long-term exposure.
Through our Strategic Fraud Recovery Group, we:
- Pursue civil fraud and material misrepresentation actions to invalidate illegitimate claims at their foundation
- Secure declaratory judgments to rescind or void policies obtained through deception
- Recover improperly paid benefits and unjust enrichment damages to return money to our clients
- Leverage Florida and Federal RICO statutes to target staged accidents and organized fraud enterprises
- Assert civil conspiracy and alter-ego claims to expose and reach hidden participants and related entities
- Take action against clinics, billing entities, and participants in unlawful referral and kickback arrangements
We focus on disrupting the economics of fraud — creating deterrence, strengthening future defenses, and reducing systemic risk across your portfolio.
SIU Partnership & Pre-Suit Strategy
Effective Fraud Recovery litigation begins long before a complaint is filed. We are accustomed to integrating with SIU workflows, reporting requirements, and referral protocols. Our attorneys regularly train client SIUs on fraud identification, internal processes, and litigation readiness.
We assist by:
- Conducting Examinations Under Oath (EUOs) to develop critical sworn testimony
- Utilizing billing analytics and technology-driven pattern recognition to identify irregularities
- Mapping corporate structures, ownership overlaps, and interrelated entities
- Developing comprehensive evidentiary records to support rescission, denial, and recovery actions
- Evaluating exposure, collectability, and recovery potential before initiating suit
- Identifying and targeting staged accident networks and organized fraud rings
Our integrated investigative and litigation approach ensures cases are strategically positioned for maximum leverage and recovery.
Regulatory & Statutory Recovery
Insurance fraud frequently implicates statutory and regulatory violations beyond breach of contract. Our attorneys include former prosecutors and SIU professionals experienced in parallel civil–criminal coordination. We evaluate and pursue:
- Florida and Federal RICO claims
- Fraudulent insurance acts under Florida law
- Unjust enrichment and civil conspiracy causes of action
- Referral, fee-splitting, and kickback violations
- Corporate veil-piercing and alter-ego theories
- Coordinated referrals and collaboration with law enforcement when appropriate
Our objective extends beyond resolving a single matter — we aim to disrupt and deter the broader scheme.
Strategic Fraud Prevention & Deterrence
Fraud Recovery is more than recovery — it is a strategic initiative. By taking decisive legal action supported by investigative technology and prosecutorial-level strategy, insurers reinforce compliance expectations and strengthen their claims-handling infrastructure.
Roig Lawyers develops forward-thinking programs that:
- Reduce systemic exposure
- Strengthen internal investigative protocols
- Enhance coordination between legal, SIU, and executive teams
- Support regulatory compliance initiatives
- Protect carrier profitability and brand integrity
Our programs help carriers decrease claim frequency associated with fraud patterns and establish a deterrent reputation in the market.
