NICB announces Q3 increase in questionable claims by 7 percent

The 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…

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Florida faces significant costs resulting from fraudulent no-fault claims

According to the Property Casualty Insurers Association of America (PCI), the imperfections of Florida’s no-fault car insurance system are causing abuse that is system-wide, and the number of fraudulent claims is larger than it has been at any other time. This national association issued a special report on the no-fault auto coverage in the state which showed that the resulting costs from the false claims have meant that drivers are paying over $800 billion more than they would otherwise be required. According to a senior vice president at PCI, Paul…

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Allstate sues 10 New York area defendants for $5 million in insurance fraud

Allstate Insurance Company has filed a lawsuit against 10 defendants in the New York area in order to help to recover $5 million in fraudulent insurance claims. This is the company’s fourth lawsuit of this nature this year. The complaint includes specific mention of five medical professional corporations, a physician, one corporation, and three individuals who are not physicians. Thirty one fraud lawsuits worth over $170 million in damages have been filed by Allstate in the state of New York since 2003. New York state is a hotbed of insurance…

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California District Attorneys awarded million in grants to fight insurance fraud

California’s Department of Insurance is issuing over $3 million in grants to the state’s District Attorneys in an effort to battle the spread of fraudulent disability and health claims. The state has been wracked with fraud for several years, a fact that Insurance Commissioner Dave Jones has labored to rectify. According to Jones, the grants will be used to fun investigations and prosecutions as the state government looks to crack down on insurance fraud. Jones hopes that the move will also dissuade individuals from committing fraud, knowing that District Attorneys…

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FEMA requests money back from disaster victims

FEMA, the Federal Emergency Management Agency, admits disaster payments to unqualified applicants were largely their own fault. As a consequence of employees who did not completely understand eligibility rules made accounting errors, thousands of people were paid disaster relief money between 2005 and 2009; now they’re getting a bill from FEMA, wanting their money back. Victims of floods, tornadoes, wildfires and earthquakes that received help from FEMA as far back as 2005; may be getting a bill from FEMA. After discovering that there had been improper payments made, FEMA began looking into…

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Are no-fault insurance laws creating fertile ground for fraudlent claims activity?

Florida legislators are facing pressure to make changes to the state’s no-fault auto insurance laws. Several insurers want to see changes that would help reduce the amount of fraudulent claims they are receiving. State law requires that drivers have personal injury protection coverage that would help them pay medical expenses whether or not they were at fault. The law is designed to avoid lawsuits but insurers are saying that it is creating incentive for drivers to stage accidents. The Property Casualty Insurers Association of America, along with the Florida Chamber…

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The business of fraudulent insurance claims

Today, there are some that make a living specializing only in insurance fraud by submitting doctored up insurance claims. The false claims received may include life insurance, third-party policy, personal damage and car theft.  In many cases, the claim amounts asked for are considerably higher than the injuries, damage or loss that occurred – this can raise a red flag to potential wrong doing. Life insurance fraud is when someone makes false claims about faking an injury or death.  The false documentation used is usually police reports, medical cards, marriage…

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