New York doctors suspected of fraud to the personal injury protection system face possible decertification

New York has launched a meticulous statewide initiative to shut down medical offices that have been fraudulently billing for medical services for car accident victims under the no-fault personal injury protection (PIP) system in the state, when those services are either entirely unnecessary or were never administered in the first place. Under the new regulations of this initiative, any doctors who have taken part in these unscrupulous efforts to defraud the PIP system in New York will be committing professional suicide. The regulations are being issued by the Department of…

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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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Report shows the discrepancy of auto insurance claims in New York City

The Insurance Research Council of Pennsylvania has released a new report concerning auto claims and insured losses in New York City. New York has become infamous in the insurance industry for the multitude of auto claims that come from the state. In recent years, more claims have been coming in to insurers, many of which have been found to be fraudulent. The report highlights the differences in claiming behavior throughout the state and touches upon the discrepancies found in claims. According to the report, personal injury protection claims have risen…

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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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New York is fraught with insurance fraud

According to a new report by the National Insurance Crime Bureau (NICB), Buffalo, New York, is home to a staggeringly high amount of questionable medical insurance claims. Second only to New York City, Buffalo adds to the states already extensive history of insurance turmoil. The report takes into account all occurrences of claims that have been found as “faked or exaggerated,” as well as instances of “excessive treatment.” The 7,026 questionable claims were filed throughout the state last year. Buffalo accounts for 145 of those, with New York City taking…

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