Not all people injured in accidents are victims. Some of them are predators, getting paid to take a hit.
"The organized crime rings that are involved in automobile losses that involve the medical side ... are perpetrating what we call 'staged accidents,'" said National Crime Insurance Bureau Special Agent Mike Gallagher.
He said he has seen this type of fraud played out in many different ways. Among the most common is what's known as the the "swoop and squat."
"(A driver) will come around, pull in front of the (driver) that's in front, slam on their brakes just for a second and take off. The person that's directly in front of you that's part of that organization slams on their brakes and holds them so that you hit them," Gallagher said.
The perpetrators don't just plan how, they also plan who they will target -- mainly mothers with multiple kids in the car or older drivers.
"The reason for this is the intimidation factor. They can control the scene with an elderly person and they can also do that with a young mother because she's going to be more concerned with her children than anything else," Gallagher said.
Commercial and high-end vehicles are also common prey because they generally have a higher insurance cap.
Conversely, the criminal's car is generally on it's last leg, often referred to as a battle wagon.
"The people that are in that car, they usually load it. You'll have a driver, a passenger, maybe even a third person up front, and you definitely put as many people as you can hold in the back. All of them ... immediately file medical injury claims," Gallagher said.
Another common scenario is the paper case, which is essentially a claim for an accident that never occurred.
The overwhelming majority of questionable medical claims come from Houston, a city that filed more of them during the last three years than the next nine largest cities in the state combined.
San Antonio ranks third in state for the number of questionable claims per city.