A comparison of third-quarter data from 2009, 2010 and 2011 reveals a notable increase in the number of questionable claims submitted, according to a new report issued by the National Insurance Crime Bureau, Des Plaines, Ill. In its third-quarter 2011 questionable claims (QC) referral reason analysis, the Bureau examined six referral reason categories of claims—property, casualty, commercial, workers' compensation, vehicle and miscellaneous—for the quarters listed above.
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. “Any given claim may have one referral reason or up to seven,” NICB strategic analyst Jason DiNovi, told Insurance Networking News.
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