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You are here: Home / Insurance Law | Massachusetts / MA Insurance Law | Insurance Fraud / National Insurance Crime Bureau Reports a 19 Percent Rise in Questionable Claims for 2011

National Insurance Crime Bureau Reports a 19 Percent Rise in Questionable Claims for 2011

February 29, 2012 by Owen Gallagher

NICB Says Referrals Break 100,000 Ceiling for First Time

Questionable claims broke the 100,000 mark for 2011 reaching a record-level of 100,450 claims says The National Insurance Crime Bureau. Each year the NICB conducts a Questionable Claims Analysis to compare the Property, Casualty, Commercial, Worker’s Compensation, Vehicle and Miscellaneous Referral reasons for claims.

In 2009, the NICB had 84,407 Questionable Claims (QC) referred to it from its member insurance companies. In 2010, that number reached 91,797. The 100,450 claims logged in 2011 represents a new record says the organization and a 9.4 percent increase from 2010. Comparing the numbers from 2009, the increase is 19 percent.

“We are encouraged by the trend in auto glass questionable claims,” said Joe Wehrle, NICB president and chief executive officer. “Our efforts to publicize this problem and to make insurers, law enforcement and the American public more aware of the potential fraud in the auto glass repair arena is hopefully having an impact. As we see trends showing an increase in questionable claims in a particular segment of insurance coverage, we can focus our efforts on investigating some of those claims and putting a stop to the criminals that are taking advantage of insurers and the public.”

Some highlights from the report include the following:

  • Staged/Caused accident was the only Casualty referral reason to decrease from 2010 to 2011.
  • In the Casualty category, “faked/exaggerated injury” and “excessive treatment” posted the highest number of 2011 referrals with 17,581 and 8,485 respectively;
  • Slip and Fall increased by 14% from 2010 to 2011, and notably has the highest volume;
  • In the worker’s compensation category, “claimant fraud” received the highest number of referrals – 2,085;
  • In the vehicle category, “questionable vehicle theft” had the most referrals for 2011 at 11,451. The NICB says this number is noteworthy because it represents a 450% increase over the referrals logged for 2010 which were 2,182;
  • “Auto glass fraud” saw the steepest decline across all categories dropping to 817 referrals in 2011, a decrease of 1,365 from 2010.

Agents can access the full National Insurance Crime Bureau Report here.

 

 

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