S.I.B.S. Approach: Evaluating the Merit of a Claim
First Published 3/10/2015, Updated 5/6/2021 The success of properly processing an insurance claim requires due diligence/fiduciary duty as an insurance professional to evaluate each claim
Catastrophe Fraud: Learning from the Past
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
Summer: The Season of Justice
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
Keys to a Successful Workers Comp Investigation
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
How Brumell Group’s Case Analysis™ Helps Close More Cases
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
How to Identify Malingering
In the world of insurance claims, medical assessments, and disability cases, malingering is a very important factor to consider. Being able to identify malingering is
Case Study: Helping Retail Stores Fight Fraud
When Jeff Schneider started as the Senior Manager of Liability in 2011 at a large Southeast grocery store chain, the company was suffering from an
Skipping Pre-Employment Background Checks (Due Diligence) Could Cost Your Company
There is a rise of “negligent hiring” lawsuits in the U.S. The courts are finding that companies, even small businesses, have “duty of care” responsibility
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
Red Flags of Fraud
By definition, fraud is “a false representation of a matter of fact – whether by words or by conduct, by false or misleading allegations, or