Given these continued hard times for Americans, insurers might want to be extra vigilant when scrutinizing customer's claims. New data issued today from the National Insurance Crime Bureau (NICB) in its report on questionable claims (QC) during the first half 2010, found that QCs have skyrocketed in the past two years. The report examines six referral reason categories of claims—property, casualty, commercial, workers’ compensation, vehicle and miscellaneous.

Overall, NICB reports that there was a 14% increase in QCs in four of the six categories in 2010 when compared to the first half of 2009. These are claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud. A single claim may contain up to seven referral reasons.

NICB especially took note of the 107% increase in questionable hail damage claims, and 527% increase in questionable auto glass claims so far this year when compared to the first half of 2009.

The release reflects findings previously published in a NICB ForeCAST report of hail loss claims. Among the conclusions of the previous report:  “Hail loss claims and QCs are generally concentrated in the central section of the U.S.," the report said. "However, seven of the top 10 states with the highest hail loss QC-to-claim ratio are not in the central section. This suggests that fraudulent hail losses can occur in any part of the country.”

“While there have been modest declines within a few categories of referrals, the 14% increase in the overall number of questionable claims for 2010 raises concerns,” says Joe Wehrle, NICB’s president and CEO. “We’ve been actively involved with our members and law enforcement in pursuing suspected unscrupulous roofing companies that take advantage of storms to fake or deliberately cause damage to roofs in an effort to get insurers to pay for a replacement roof that wasn’t damaged by a storm. And we’ve had tremendous success in putting pressure on staged accident rings by working with our law enforcement partners in regions like Tampa where this has become a major problem."

 

 

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