NICB Reports Drastic Increase in Questionable Claims Referrals

There was a 20-percent increase in questionable claims (QCs) during the first half of 2012 compared with 2011, according to a new report issued by the National Insurance Crime Bureau. In its mid-year 2012 QCs referral reason analysis, NICB examined six referral reason categories of claims—property, casualty, commercial, workers' compensation, vehicle and miscellaneous—for the quarters listed above.

During the first half of 2011, a total of 48,887 QCs were referred. That number increased to 58,523 in the first half of 2012.

Questionable claims comprise those claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud.

Suspicious non-vehicle theft/loss generated the largest increase in volume for a single referral reason in property QCs (5,255) and contributed to the property category’s 40 percent rise in QCs compared to the first half of 2011. Casualty QC referral reasons increased 12 percent; commercial increased by 23 percent; workers’ comp increased 20 percent and vehicle increased 20 percent. The miscellaneous QC category posted the smallest year-over-year increase—10 percent.