The NICB saw an 18 percent increase in questionable claims from 2010 to 2011
Earlier this month, the National Insurance Crime Bureau released its annual questionable claims referral reason analysis for Massachusetts. A questionable claim is one that is forwarded to the NICB based on various indicators of a possible fraud. The NICB receives these questionable claims and generally conducts a closer review and investigation of the possible fraud on behalf of its members.
In addition, every year the organization then conducts an review of insurance fraud trends for each state over a two-year period. Based on this year results, the NCIB sees claims on the rise in Massachusetts. For example, in 2009, Massachusetts had 1,629 questionable claims referred to the NICB from its member insurance companies. In 2010, however, the number decreased to 1,492 claims. By 2011, though, the number had risen back up to 1,768. As such, the NICB shows an eight percent (8%) decrease in questionable claims between 2009 and 2010 in Massachusetts, but an 18% increase between the years 2010 and 2011.
Top Five Massachusetts Cities With Questionable Claims Losses in 2011
In 2011, the top five cities in Massachusetts with the most questionable claims were Boston with 468, followed by Springfield (80), Worcester (57), Brockton (52), and Lynn (44). The following chart highlights the top 10 cities in the Commonwealth by number of questionable claims filed in 2011.
Questionable Claim Losses by County
The NICB’s report also took a look at the rise in questionable claims in each county of Massachusetts. Based on the information it gathered, unsurprisingly Suffolk County, which includes two cities on the top ten list, Boston and Chelsea, was the county with the most QC claims in Massachusetts. Middlesex County was the second county with the most claims due to the fact that it is the county for both Cambridge and Lowell, two cities that also made the top ten city list this year.
Massachusetts Questionable Claims By Loss Type
Collisions and Bodily Injury were the first two losses to log the most questionable claim referrals in 2011. On the opposite end, both Worker’s Compensation Indemnity and Vandilism & Malicious Mischief received the least amount of questionable claims referrals in comparison. The following shows the trends by each loss category over the two year period from 2009 through 2011.
Questionable Claims Trends by Policy Type
Overall, looking at the questionable claims by policy type, Personal Property: Homeowners has produced the least amount of questionable claims referrals over the last two years. While the 58 claims in 2011 is a significant increase over the 33 logged in 2010, it is still far less that than the personal automobile losses which have driven the most questionable claims to the NICB from member insurance companies in Massachusetts. As the chart shows, in 2011 alone, personal automobile received some 1,331 claims.
Questionable Claims by Policy and Loss Type
Finally, combining the questionable claims data by policy and loss type, the NICB has determined that it is personal property, collision losses which create the most questionable claims referrals in Massachusetts, with 324 referrals being sent in 2011. Coming in second were questionable claims involving Personal Automobile, Personal Injury Protection, with Personal Automobile, Bodily Injury being a close third. On the other end of the spectrum Worker’s Compensation and Employer’s Liability, Worker’s Compensation Indemnity logged the least amount of questionable claims with only 35 being reported in 2011.
For those interested in reading the official NICB report, please continue on to the association’s website here.
See a slideshow of the NICB’s charts on Massachusetts