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‘Questionable’ Insurance Claims on the Rise, Group Says

A recent report by the National Insurance Crime Bureau shows that the number of questionable claims is up during the first quarter of 2009 compared with the first quarter of 2008.

  • April 29, 2009
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A recent report by the National Insurance Crime Bureau shows that the number of questionable claims is up during the first quarter of 2009 compared with the first quarter of 2008, providing a snapshot of what claims analysts call “opportunistic fraud.”

A down economy and mounting unemployment level is causing some people to look at insurance fraud as a possible way to make money by taking advantage of a situation, according to the NICB, a not-for-profit group that partners with insurers and law enforcement to detect and prosecute insurance crime.

The report, released Tuesday, April 28, is an analysis of questionable claims submitted by more than 1,000 NICB member companies in the first quarter of 2009 versus the same period a year ago. A questionable claim is a claim that is reviewed by an insurance company and classified as possibly fraudulent.

During the first quarter of 2009, the number of slip-and-fall claims under commercial policies went up 77 percent compared with the first quarter of 2008, according to the Des Plaines, Illinois-based NICB.

Further, the number of suspected fraudulent claims related to workers’ compensation insurance was up 71 percent during the first quarter this year compared with last year.

Fire and arson commercial claims during the first quarter of 2009 are up 76 percent from last year’s first-quarter numbers, while cargo theft is down 20 percent and vehicle theft is down 23 percent, according to the NICB.

“Desperate times sometimes cause people to take desperate measures,” said Joe Wehrle, president and chief executive of the NICB, in a statement. “Some people think it is OK to cheat an insurance company, but the fact is they are breaking the law, risking jail time, and causing everyone else to pay more for their insurance coverage.”

 

Filed by Jeff Casale of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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