The Fraud Triangle shows why there is an element of fraud that can and will arise out of this unfortunate crisis. All types of insurance claims are expected to be on the rise with the current COVID-19 pandemic and economic…
When natural disasters happen, having all the variables in place to ensure a smooth claims process is key. There are many times when, due to the severity of the disaster, claims adjusters become overloaded and fraud runs rampant. Here are just a few examples:
Memorial Day, 4th of July, Mother’s Day, Father’s Day, school vacation, family vacations, sports activities, beach activities and yard maintenance. What do all these things have in common? Summer! A time when people are outside, enjoying the good weather and sunshine.
This also means that it’s a great opportunity to gather critical information on your claimant’s activities outside of the home. Keep in mind that this season and these unique opportunities don’t last forever and cannot be recreated. Our Investigations Division is well equipped to schedule surveillance investigations on or around these critical summer months.
Each state has different requirements to effectively fight against fraud, and it is the responsibility of the insurer to stay up to date on the governing statues in the states in which they do business. To help combat increasing risk…
The season for Tropical Storms and Hurricanes are upon us. Hurricane Harvey dropped more than 50 inches of rain in Houston and went toward Louisiana, which was hit hard by Hurricane Katrina in 2005. This was the most rain ever recorded in the contiguous U.S. from a hurricane. Homeowners across Texas will soon be facing the challenges of re-building their homes from scratch.
In addition, Hurricane Irma is one of the strongest storms ever recorded in the Atlantic. It has already caused devastating effects in the Caribbean and is expected to hit Florida soon. According to Governor Scott, this storm is already larger and stronger than Hurricane Andrew which caused extensive damage to Floridians.
By Jeff Schneider, Gene Kissane and Robert Brumell. Originally published in Litigation Management Magazine, winter 2013. Slip and fall claims have been around since businesses first opened their doors. It may not even be surprising to think of Ugh, in…
Every corporation has a number of internal components that need extra scrutiny, and workers’ compensation fraud is one of these important components. Even as the economy seems to be on the rebound, this form of fraud continues to rise, which puts a strain on everyone involved.
Many people don’t realize, but there are only two questions that a business can ask someone who has a service animal. Because of this, there has been an increase in people bringing their pets into various businesses to entrap an employee or manager into asking the wrong question, only to file a lawsuit under the Americans with Disabilities Act (ADA).
Understanding and navigating the world of insurance fraud can be complicated. In almost every instance where insurance claims are a central focus, some kind of fraud is present. Although the economy is on the upswing, measuring those gains against the advantages fraudsters anticipate is difficult. The good news is that there are organizations in place that work to combat insurance fraud.
Working with a licensed fraud consulting service or Special Investigative Unit (SIU) that helps to spot the characteristics of fraudsters can save your organization a lot of money. There are some common traits of insurance fraudsters to be on the lookout for. We’ve put together the top 5 strategies that fraudsters use in insurance fraud:
The following is part of our ongoing Case Closed series, where we highlight specific cases that we investigated and saw through to the conviction and sentencing process. Our goal is to see cases closed and fraud put an end to, which is why we see these cases all the way to the end.