The potential for insurance fraud exists with any kind of property, particularly with expensive items like jewelry and cars.
Insurance companies saw a dramatic increase in questionable claims over the past few years, according to the National Insurance Crime Bureau.
From 2010 to 2012, there was a 26.7 percent increase in questionable claims referred to the NICB, from 91,797 in 2010 to 116,268 in 2012—a new record. In 2011, the total was 100,450.
Questionable claims are those claims that NICB member insurance companies refer to the 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.
In a recent report, the NICP examined six referral reason categories of claims: property, casualty, commercial, workers’ compensation, vehicle and miscellaneous referred in 2012, with those referred in 2010 and 2011.
Within the property category, “suspicious disappearance/loss of jewelry” had the highest percent change—up 86 percent, while “suspicious theft/loss (not vehicle)” had the highest increase in volume to 10,680 in 2012 from 7,152 reached in 2011.
In the vehicle category, “hail damage” with 1,505 referrals and “suspicious hit while parked” with 5,006 referrals were the top two referral reasons.
In 2012, the top five states generating the most questionable claims were: California (21,935), Florida (10,693), Texas (10,368), New York (9,059) and Maryland (4,296).
Although there have been year-to-year increases in questionable claims, they represent a small percentage of the overall claims processed.
Each year over 56 million claims are processed, making 2012 questionable claims just 0.20 percent of total claims. While questionable claims are by definition suspicious, at the time of referral they had not been identified as definitive acts of fraud.
Anyone with information concerning insurance fraud can report it anonymously by calling toll-free 1-800-TEL-NICB (1-800-835-6422), texting keyword “fraud” to TIP411 (847411) or by visiting our website at www.nicb.org. Or, iPhone or iPad users can download the NICB Fraud Tips app to make it easy to quickly send a tip and get a response.
