What is Insurance Fraud?

We’ll share our thoughts.

convey insurance fraud

Insurance Fraud is basically when one receives money from an insurance company through deception. The FBI reported in 2010 that insurance fraud costs were more than 40 billion dollars per year which equates to an average cost of $400-$700 for every US household.

Insurance fraud can occur in numerous forms and the bad guys are thinking of new ways to do this every day. We are going to talk about two forms of insurance fraud, automobile claims and injury claims.

Within each of these categories, there are still many subcategories in ways to commit fraud. With automobile claims for instance you can see the staged accident, a faked auto theft, an alleged arson, or many other instances. During the nearly three decades of conducting insurance investigations, we have seen all of these types of scams and a prevalent one is when a vehicle is allegedly stolen and then shows up later, in a field or on a dead end road where it was burned.

Retaining a good insurance investigator is vital with this type of claim in order to find the signs of a fraudulent claim. In this economy, one of the big warning signs is if an individual has financial difficulties or might be behind on their automobile payment. Also, look at any recent changes in their policy to cover exactly what occurred to the vehicle. Interviewing the owner of the vehicle and documenting the last known location of the vehicle as well as where the vehicle was found is also important.

The staged accident can occur with one vehicle “in the know” or several vehicles setting up a scenario. Many times when one vehicle contains the bad guy, he or she will also have at least one “witness” in their own vehicle to corroborate the story. If one vehicle is involved, many times the bad guy will pull in front of the unsuspecting victim and slam on the brakes. In our society most times the person in the back is assumed to be at fault for following to close. I recently saw a video of this manner of an accident where two vehicles were driving down a busy highway in one of the center lanes when the front vehicle slowed to a stop, put the vehicle in reverse, and hit the vehicle that was behind him. Unfortunately for the bad guy, the rear vehicle had a forward-looking camera in it which was rolling at the time and captured everything on videotape. If it had not been for that camera, who would have believed the one person in the rear vehicle, over the two people in the front vehicle, when he said “the front vehicle stopped and backed into me on the highway.”

Injury claims can also come in numerous forms, from the worker’s compensation claim to the slip and fall claim. With all of the businesses that now have video cameras inside and out, many times you will find somebody who has a videotape of the incident, alleged incident, or at the time and place that the incident was supposed to have occurred. Sometimes the legitimate worker’s compensation claim can turn into insurance fraud when the claimant gets greedy and begins to exaggerate the claim.

Insurance is there for people who legitimately deserve it and the fraudulent claims are hitting us all in the pocketbooks and need to be investigated and prosecuted. In most states insurance fraud can bring a felony conviction, meaning that the bad guy will spend time at the gray bar hotel.

A great source for insurance fraud information is the National Insurance Crime Bureau or www.nicb.org

The investigators of Colorado Private Investigations, LLC have been conducting insurance investigations in Colorado for over three decades and are here to help you with your case. Please also see our Investigation Stories tab on this web site.