A Car Submerged In Water Near A Stop Sign.

What is Catastrophe Fraud?

Catastrophe fraud occurs when there has been a natural or man-made disaster. Those that are insured need help quickly, and insurance companies respond fast to all claims to ensure the safety and wellness of the people they cover. Catastrophe fraud comes in several forms, but essentially it means that people are taking advantage of insurance companies when a natural or man-made disaster occurs.

Continue Reading
The Purpose And Process Of Pre-employment Screenings.

The Purpose and Process of Pre-Employment Screenings: New White Paper Available

Do you know how much a bad hire could cost you or your company? It can be tempting for businesses to skip the background investigations in certain situations, but it is never recommended. With nearly half of resumes including some kind of discrepancy, pre-employment screenings are vital for any business that values security, capital and morale.

Continue Reading
The Fraud Triangle

The Fraud Triangle Theory

Fraud is a crime that is more costly than most people realize. According to the FBI, non-healthcare related fraud alone is estimated to cost the U.S. over $40 billion a year! Yet fraud and other unethical behavior does not happen randomly. Certain factors must be present to allow most individuals to commit these crimes.

American criminologist Donald Cressey developed a theory – known as the Fraud Triangle – that explains the factors that lead to fraud and other unethical behavior. When businesses and organizations understand the Fraud Triangle, they can more effectively combat criminal behavior that negatively impacts their operations.

Continue Reading
A Businessman On The Phone In The Office.

S.I.B. Approach: Evaluating the Merit of a Claim

The success of properly processing an insurance claim requires due diligence/fiduciary duty as an insurance professional to evaluate each claim by conducting a preliminary investigation. We have found time and time again that using the SIB (Statement, Index [ISO], Background) approach to start an investigation yields the most useful and effective results. Following this preliminary approach ensures the most accurate results are obtained.

With the results obtained from the SIB portion of the claims investigation, we form a partnership that acts on these results in the most appropriate ways, such as investigating red flags more thoroughly, digging deeper into a person or entity’s background forming a plan of action to achieve cost effectiveness.

Continue Reading
A Cartoon Of A Bricklayer.

The Bricklayer’s Insurance Claim

“The Bricklayer’s Insurance Claim” is a hilarious story that shows how “creative” a claimant can be when recalling the events of their claim. Hopefully you’ve never come across a testimonial like this when looking into a workers compensation claim. (Unfortunately, they’re not uncommon.)

What is the most outrageous claim you’ve seen come across your desk? Share in the comments below!

Continue Reading