NICB announces Q3 increase in questionable claims by 7 percent

insurance fraudThe National Insurance Crime Bureau (NICB) has released its third quarter 2011 results from its referral reason analysis of questionable claims (QC).

This report investigates six different types of claim referral reason categories. They are: workers’ compensation, casualty, property, commercial, vehicle, and miscellaneous. It compared the results among the third quarters of every year from 2009 to 2011.

Questionable claims are those that are made to member insurance companies of NICB which must be referred to the bureau for closer review and potential investigation as a result of certain red flags which are signals that fraud could exist. There can be up to seven different reasons for referral for any individual claim.

Throughout 2009’s first three quarters, there had been a total number of QC referrals of 62,341 to the NICB. Throughout the same span the following year, that figure rose to 70,295. By the end of the third quarter in 2011, there were 74,944. When compared with last year, there was an overall increase of QC referrals of 7 percent in 2011, and there was an increase of 20 percent when compared to 2009’s figures.

There was a rise in the QC referrals for casualty and workers’ compensation policies, but there were decreases among commercial and property policies. Claims for vehicle policies remained about the same, although there was a spike in the specific “hail damage” referral reason of 103 percent from 2010 to the same time in 2011.

The NICB is the top not-for profit organization in the United States that holds the single purpose of identifying, stopping, and preventing vehicle theft and insurance fraud.

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