Questionable Claims Rise 12% in Q3

Perhaps the enduring hard economic times for many Americans are having a less-than-desirable effect on insurers' claims departments. New research released today from the National Insurance Crime Bureau shows that the number of questionable claims (QC) rose sharply in the past year. The report examines six referral reason categories of claims: property, casualty, commercial, workers' compensation, vehicle and miscellaneous.   

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Through Q3 2010, NICB reports that it received 70,295 QC referrals from its member insurance companies, compared to 62,929 in Q3 2009—a 12% increase.  NICB  defines questionable claims as 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. 

Vehicle QC analysis disclosed that there were more than 1,700 more referrals for suspected auto glass fraud in Q3 2010—a 511% jump when compared to last year. Referrals for inflated towing and storage bills also rose by more than 200, accounting for a 103% increase from 2009.

"Criminals who commit insurance fraud believe in equal opportunity — they will commit fraud anytime and anyplace they choose," says NICB President and CEO Joe Wehrle. "Auto glass fraud and towing-related scams are occurring across the nation, but criminals also look for the path of least resistance, so increasingly they are choosing states like Florida and New York where 'no-fault' insurance provides a fertile environment for auto-related personal injury protection scams." 

Click here to read the full report. 

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