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…
By Howard Kaplan, Robert H. Brumell III - Originally published on TheCLM.org Businesses and insurers often deal with fraudulent lawsuits. Two recent lawsuits, aggressively using the Racketeer Influenced and Corrupt Organizations Act (RICO), may be the new model for fighting back. In a…
Ever had one of those claimants who just won’t settle no matter what you do? Ever have one of those claimants that you just can’t figure out or have that inner nagging feeling that things just don't add up? We all have…
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.
Here’s a little insurance fraud humor for you to enjoy!
A lawyer purchased a box of very rare and expensive cigars, then insured them against, among other things, fire. Within a month, having smoked his entire stockpile of these great cigars and without yet having made even his first premium payment on the policy the lawyer filed a claim against the insurance company.
As part of our Case Closed series, we highlight cases that we were able to investigate and see through to a conviction and sentence. Our goal is to always see these cases ended, which is why we are determined every step…
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:
Did you know that insurance companies have, in good faith, a fiduciary duty to report fraud to the state if they suspect fraud is being or has been committed? FL Statutes Ch 626, Sec 989(6) says:
“…any insurer, agent, or other person licensed under the code, or an employee thereof, having knowledge or who believes that a fraudulent insurance act or practice…is being or has been committed shall send to the Division of Insurance Fraud a report or information pertinent to such knowledge or belief…”
There are two basic ways to report this type of fraud: as “Information Only” or as “Fraud”. The evidence collected determines the most appropriate way to file the claim.
It’s that time again! Summer is ending and back-to-school days are fast approaching. Tax-free weekends/days, back-to-school clothes shopping, school supply roundup, and school open houses/orientations, are going on throughout the country. These events bring the chances of claimant activity out in public.