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Michigan Auto Insurance Fraud is a Daily Part of Life

Posts Tagged ‘ insurance fraud ’

Michigan Auto Insurance Fraud is a Daily Part of Life

Wednesday, January 13th, 2016

Michigan auto insurance fraud is a daily part of life. Many of us give little if any though to auto insurance fraud as we go about our day. If the thought comes up, it is usually when we review our auto insurance premium. Unfortunately, there is a subculture in our state of bad operators who view accidents as economic opportunities. The reaction is not “thank goodness I was not injured”, rather it is one of relief that “free mailbox money” is on the way. As one of Michigan’s premier auto insurance fraud investigation agencies, we document it every day. From the claimant who insists she cannot work and needs household replacement services who goes out dancing for three hours to the claimant who alleges to be equally as limited who posts on Facebook that they will getting “big money” from their accident.

Michigan auto insurance fraud

One of the most interesting elements of Michigan auto insurance fraud is that everyday people who normally would not think about committing fraud dive in when they are involved in an accident and coached on the possibilities of quick money without any negative consequences. A great example of the Michigan auto insurance fraud was covered in the Bridge magazine. This story gives a great example of how this “victim-less” crime is so prevalent.

4th of July Weekend Excellent Opportunity for Insurance Claim Surveillance

Tuesday, July 1st, 2014

This year, the 4th of July falls on a Friday. This is the first time in four years that we have the holiday fall next to a weekend. With the automatic three day weekend for most of working America, it is expected that their will be a record number of people off of work and available to plan some serious recreation. For many casualty claimants who may not be working, but live and socialize with those who do, it is highly likely that you will be joining in on the fun. What better time to conduct surveillance to see what they are doing when everyone else is having fun?

Insurance claim surveillance is among the most powerful tools that an insurance carrier has to disprove fraud and embellishment. Sherlock Investigations is Michigan’s premier insurance investigative agency. If you have a last minute claim that merits investigation during this prime holiday weekend, please contact Dan Klimek, Fran Figurski, Brian Coykendall or Cara Booker. They are happy to help.

Top 5 Ways an Insurance Company Can Detect Insurance Fraud in Michigan

Thursday, June 26th, 2014

Insurance fraud in Michigan is a serious problem. Although most insurance carriers have a wide variety of ways to detect insurance fraud, particularly in the area of false casualty claims in auto accidents or workers compensation claims, but 5 common ways are tried and true and used most frequently. The top 5 ways an insurance company can detect insurance fraud in Michigan are as follows:

1. Review of medical bills, often via specialized computer applications, will note unusual billing patterns that are not consistent with a normal injury treatment protocol. Often times these are produced by doctors looking to get the maximum amount of money from the insurance company on a casualty claim and are not normally found in treatment of such and injury.

2. Personal injury mills. These are known lawyers or medical groups that have been identified as being potentially engaged in aggressive if not outright fraudulent practices aimed at getting money and keeping a claim going as long as possible. Once these types of mills are identified by the insurance carriers, many of the claims that include them will be reviewed closely for potential fraud.

3. Cross referencing of a claimant and or their address with other similar claims. Sources like ISO can be searched by insurance companies to see if you have a long history of filing casualty claims and potentially do this to make money. Statistically, it is nearly impossible for a person to end up having 5, 6, 7 auto accidents, slip and falls or the like, so those who do, need to be investigated for potential fraud.

4. A review of social media for the claimant is amazingly helpful in determining if someone is actually injured or potentially committing insurance fraud.

5. Tips from associates or the public are great ways to detect insurance fraud and are far more common than thought by many. Your little insurance fraud scheme may easily be disclosed by a friend who disapproves or an enemy who wants to see you in trouble.

Often times, once one of these types of potential insurance fraud is detected on a casualty claim in Michigan, the insurance carrier will have a firm like Sherlock Investigations assist them in investigating elements of the claim.


Padding, Inflating and Embellishing Insurance Claims

Sunday, October 20th, 2013

The reality is that most American’s will have to file a claim for insurance benefits at some point in their lives. The odds just work out that way. Unfortunately, insurance claims are constantly gamed by the claimant to not merely replace the value of the loss, but to benefit from it. This can be done in small ways and large but the reality is that this is a form of insurance fraud. This is done through tactics like padding, inflating and embellishing insurance claims. Padding is extremely common and involves increasing the amount of the claim by a small amount to make up for the deductible the policy holder has to pay. Seem like a small thing and is actually though of an an acceptable practice by many Americans. A March 2013 article in the Insurance Journal indicates that 28% of us believe it is acceptable to pad a claim, with an even higher percentage of young adult males thinking this is acceptable. Inflating an insurance claim is the act of increasing the amount of an insurance claim loss to not only cover the deductible, but to profit from the loss. Many who do this rationalize that they deserve to recoup much of the cost of their policy because insurance companies are rich and overcharge everyone, knowing that people will inflate their claims. They fail to see this as fraud, but fraud it is. When it comes to casualty claims like injuries sustained in a workers compensation loss, auto accident – bodily injury claims or liability claims like a slip and fall, many more of us feel that it is acceptable to “embellish” their injuries to reap benefits for pain and suffering, wage loss, replacement services and attendant care. These are frauds, but because they are considered “soft fraud” they are often viewed as victim-less crimes or even as an entitlement. Fabricating a job you were about to begin, having a friend vouch that they provide services or care for you and the lie are all common examples of soft insurance fraud. These frauds do hurt all of us and insurance carriers have no choice but to review all claims for potential fraud and to charge higher rates to offset the damages these criminals inflict.

MIIASIU Conference This Wednesday in Livonia Michigan

Monday, October 7th, 2013

This year the training is entitled “Fraud Wars – The SIU Strikes Back”. This is the 19th Annual Training day held by MIIASIU. This is always a great event. If you attending, please stop by and visit the Sherlock Investigations booth.

Auto Insurance Fraud on the Rise and Being Targeted by Law Enforcement

Sunday, September 22nd, 2013

Almost every month, we see another article about auto insurance fraud and the damage it is causes to auto insurance carriers, policy holders and the healthcare system. Michigan, the home of significant PIP fraud and abuses, and Los Angeles both announced new auto insurance fraud fighting initiatives just this past week. LA is intent on spending $ 6.9 millions in a renewed effort to help the DA’s office to put more offenders behind bars. Michigan has launched a massive new effort to try and combat fake vehicle registrations and false auto insurance coverage. Michigan residents have seen rates go so high that a growing portion of the population is using false documents to register vehicles and commit auto insurance fraud. Sherlock Investigations specializes in Michigan PIP claims investigations arising from auto insurance fraud and often requiring surveillance to verify the extent of any injuries alleged.

Property Claims Investigations Begin With Solid Interviews

Wednesday, August 28th, 2013

Property claims fraud is often viewed as a small time or minor variety of insurance fraud. The policy holder inflates the value of this item a bit, adds one of two things to a stolen property claim; whats the harm in that? The reality is that this type of insurance fraud costs everyone to have to pay much higher premiums for coverage each year.

In the extreme, property claims fraud can be committed by someone over and over for a decade as reported in a recent California case where one claimant is alleged to have orchestrated 65 fraudulent insurance claims.

Although supporting documentation like receipts and police reports are important to the property claims investigations process, interviewing, and claimant interview in particular, is the crucial element of a solid property claims investigation. A properly trained investigator with experience in interviewing is needed to ask the right question in the right way.  When neighborhood canvassing is also required during property claims investigations, again interviewing skill and experience is essential to asking the right questions the right way.

For more information on property claims investigations solutions in Michigan and elsewhere, please call us at 888-989-2800 or check us out on Facebook.

Insurance Fraud, Exaggerated Injury Claims Continue to Grow in 2013

Friday, May 31st, 2013

One breakout growth industry these days is insurance fraud and exaggerated or fake injury claims lead they way. According to NICB (National Insurance Crime Bureau) the past three years have seen an increase in the number of Questionable Claims referred to them by insurers grow from 91,652 to  116,171. Auto insurance claims lead the way followed by home owners claims and the workers compensation loses.  States like California, Florida, Texas, new York and Maryland account for the bulk of questionable claim referrals but smaller states like Kentucky, Vermont, Rhode Island and Maryland have seen the largest percentage growth. getting more specific, the top cities producing questionable claims are New York, Los Angles, Miami, Houston and Baltimore. Most frightening is the fact that falsified or exaggerated injury claims, like those we specialize in investigating, are the largest portion of the referrals.

P&C Insurance Fraud Escalates

Friday, April 5th, 2013

Questionable claims numbers and fraud costs expected to grow through 2016.

Justin Stephani of the Insurance Networking News reports:  As the industry attempts to keep up with the growth in insurance fraud and deploy more effective anti-fraud technologies, spending by U.S. P&C carriers on fraud solutions, split roughly evenly between analytics and scoring products and services, is projected to grow by 44 percent between 2011 and 2016, according to a new study on fraud.

ISO ClaimSearch Exceeds 800 Million Claims

Tuesday, June 26th, 2012

ISO, a Verisk Insurance Solutions company, a firm dedicated to collecting property and casualty claim related information for the insurance industry, announced that it has exceeded collecting records on more than 800 million claims. The ISO database has redefined how the insurance industry investigates claims and fights insurance fraud. ISO now indicates that it has over 87,000 subscribers. Full press release