The job of sniffing out insurance fraud has gotten a lot more exciting lately as states have begun to treat the crime more seriously using undercover agents and wiretaps to collect evidentiary support.

In New York, the milieu of many a mafia flick and the state with the second highest auto insurance premiums in the nation, they are taking an “organized crime approach.” Everyone likes a good mobster movie; and undercover agents faking illnesses to nab corrupt doctors, lawyers and “silent owners” or sneaking into offices after hours to tap phone lines smacks of Scorsese.

Not only that, it’s proving effective. New York Deputy Attorney General Peter Pope told the Associated Press, “If I’m trying to prove the patient in fact didn’t have the symptoms he was being treated for, the only way to do that is to find real patients or send undercovers into the clinic. The biggest investigations and those with the widest reach occurred when we were listening in with court approval.”

The Coalition Against Insurance Fraud reported that many individuals have a lax attitude when it comes to defrauding insurers–one in four Americans say it’s okay for others to make fraudulent claims and one in ten say they would do so if they knew they wouldn’t get caught. So it’s not surprising that insurance fraud is prevalent across all insurance types. According to the National Insurance Crime Bureau (NICB), it costs the industry between $85 and $120 billion annually and each American household $200 to $300 per year.

But beyond the monetary cost, certain stunts endanger lives. A “swoop and squat” in Los Angeles is a “zoom and squat” in Philidelphia, but the MO is the same. One car, packed with passengers, swerves in front of another and hits the brakes to cause a rear-end collision. Then the passengers claim injuries in an attempt to profit from the staged accident.

Unfortunately, this type of scam goes much deeper than this one car full of people. It usually involves a crime ring with professional lawyers and doctors at the top and indigent immigrants hanging on for dear life–and sometimes losing their lives–at the bottom.

Mafia-esque crime rings, wiretaps and secret agents make insurance fraud sound pretty fascinating. However, the majority of fraud–soft fraud–comes in less dramatic forms. According to the Insurance Information Institute (III), common frauds include “padding,” or inflating actual claims; misrepresenting facts on an insurance application; and submitting claims for injuries or damage that never occurred.

But regardless of the degree of the crime, it’s Americans who pay, and pay, and pay…each time they renew their policy.