Coinciding with the nation’s economic downturn there has been a clear increase in the number of questionable insurance claims related to possible fraud, according to a National Insurance Crime Bureau report.

The NICB said an analysis of questionable claims submitted by the more than 1,000 NICB member companies in the first quarter of 2009 versus the first quarter of 2008 shows a definite increase in claims related to what is termed “opportunistic fraud.”

Hail damage, vehicle fires, slip and fall accidents, and workers’ compensation were all areas that saw increases in questionable claims, the NICB said.

The bureau reported that questionable claims for hail damage increased 407 percent in 2009 compared with 2008. Explaining where fraud comes in, NICB said a homeowner with limited hail damage to a section of shingles on a house deliberately causes more extensive damage to obtain payment for a new roof.

Claims related to suspicious vehicle fires/arsons were up 27 percent in 2009 compared to 2008, and owner vehicle abandonment “give-ups” increased 24 percent.

NICB reported insurers submitted 60 percent more questionable claims related to slips and falls under casualty policies and 77 percent more under commercial policies. Suspected fraudulent claims related to workers' compensation insurance were up 71 percent, said the bureau.

NICB mentioned that when it examined owner give-ups from 2004 through March 2008, there was a correlation between an increase in the number of give-ups and the rising cost of gasoline during that period.  A large number of the give-ups, said NICB, involved less fuel-efficient sport utility vehicles and pickup trucks.

The NICB report covers only questionable claims submitted by member insurance companies. These claims have already been reviewed by the companies and classified as possibly fraudulent.  The full report is available online at www.nicb.org.

"The NICB's report is in line with much of the data and anecdotal information we've gathered from our insurer members and other sources,” said Dennis Jay, executive director of the Coalition Against Insurance Fraud.

"The poor economy may be driving normally good people to do bad things. Hardcore insurance criminals also have more opportunity to entice normally honest people into their fraudulent schemes," Mr. Jay added.

 NU Online News Service, April 28, 2:39 p.m. EDT
Coinciding with the nation’s economic downturn there has been a clear increase in the number of questionable insurance claims related to possible fraud, according to a National Insurance Crime Bureau report.

The NICB said an analysis of questionable claims submitted by the more than 1,000 NICB member companies in the first quarter of 2009 versus the first quarter of 2008 shows a definite increase in claims related to what is termed “opportunistic fraud.”

Hail damage, vehicle fires, slip and fall accidents, and workers’ compensation were all areas that saw increases in questionable claims, the NICB said.

The bureau reported that questionable claims for hail damage increased 407 percent in 2009 compared with 2008. Explaining where fraud comes in, NICB said a homeowner with limited hail damage to a section of shingles on a house deliberately causes more extensive damage to obtain payment for a new roof.

Claims related to suspicious vehicle fires/arsons were up 27 percent in 2009 compared to 2008, and owner vehicle abandonment “give-ups” increased 24 percent.

NICB reported insurers submitted 60 percent more questionable claims related to slips and falls under casualty policies and 77 percent more under commercial policies. Suspected fraudulent claims related to workers' compensation insurance were up 71 percent, said the bureau.

NICB mentioned that when it examined owner give-ups from 2004 through March 2008, there was a correlation between an increase in the number of give-ups and the rising cost of gasoline during that period.  A large number of the give-ups, said NICB, involved less fuel-efficient sport utility vehicles and pickup trucks.

The NICB report covers only questionable claims submitted by member insurance companies. These claims have already been reviewed by the companies and classified as possibly fraudulent.  The full report is available online at www.nicb.org.

"The NICB's report is in line with much of the data and anecdotal information we've gathered from our insurer members and other sources,” said Dennis Jay, executive director of the Coalition Against Insurance Fraud.

"The poor economy may be driving normally good people to do bad things. Hardcore insurance criminals also have more opportunity to entice normally honest people into their fraudulent schemes," Mr. Jay added.

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