Tag Archives: fraud
Fraud levels rising
Let’s be honest. There’s always been a problem with fraud. Most people are easy to trick into parting with their money. But, when you look around, it’s often not so easy to get close enough to wealthy individuals. But you have big companies in every city and most of them are also easy to trick. For those with inefficient accounting departments, you just send them invoices that look convincing and, by routine, most will pay. With insurance companies, all you have to do is submit claims supported by documentation that looks reasonable and the money comes back. The fact that all this costs us money is not a factor. Criminals want their life of comfort and we can go hang. Why are we given the bill? Well, when companies look at their overheads, they adjust their prices to cover them and stay in profit. So the more they pay out to fraudsters, the more we pay for those goods and services.
So what do the criminals need to get the best results out of the insurance industry? The answer comes in the staged accident. You set up two drivers with modest vehicles and put passengers inside. Then at a time when there are likely to be a good number of independent witnesses around, you stage an accident. With reliable people to confirm the accident has occurred, we then get into the professional level of crime. The insurance industry in combination with the FBI and other professional investigators have been identifying clinics that issue fake medical reports. Some are just fronts and only process fake claims. The criminals who plan for the longer term set up genuine clinics that put through one or two fake claims a month. These are harder to identify because the doctors could be the victims of deceptions. Some injuries are difficult to verify and, if their patients are convincing enough, they will sign off on neck and back injuries. Everyone with a convincing medical report then claims damages for their injuries and, because it save on court costs, many insurers settle rather than fight.
The problem is worst in Florida where medical expense claims are set to rise to $1.5 billion in the current year ending 2011. This represents about $100 on every driver’s auto insurance quotes right now. If the level of fraud continues to rise at this rate, every driver could be facing a surcharge of $170 by the end of the year. Just stop and think about this. If the insurance companies were prepared to recruit fraud investigators, your premium rates could be reduced by at least $50 by the end of 2011. But, of course, this would require the insurers to invest in new staff and their training. In the short term, this would hit their bottom line. Less profit would upset the stockholders. So it’s cheaper for the insurers to keep making a profit by passing on the cost of the fraud to us through higher premiums. So this is a real political issue across the US. Everyone’s auto insurance rates are being affected by the rising level of fraud. If the insurance industry will not protect consumers, the state should make resources available to investigate fraud.