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.