My sister works in the Providence system of the western U.S. It is run by monkeys whose previous job was having nails hammered into their brains (and I don't mean just the CEOs).

Your bit about the insurers is true, but the extra percentage that is regularly paid by the victim is where the 'variations' happen. And I would not consider them 'criminal geniuses' by any stretch of the imagination; they're just playing the percentages, and most people don't check.