Insurance Fraud
What is Fraud?
A study done by the FBI shows, the total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums, according to the data.
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There are two categories of fraud: soft and hard, that we deal with. Soft fraud is sometimes referred to as opportunity fraud, which is when a policyholder or claimant exaggerates a legitimate claim. For example, lying about the value of a lost or stolen item for much more than it's worth. Hard fraud is more serious and occurs when someone deliberately invents or plans a loss. Premeditated damage to their house, themselves, or belongings, would be categorized as hard fraud.
Worker's Compensation
Workers' compensation (comp), is paid to an employee when they are injured on the job. Most of the time there is no reason to suspect fraud however, there are people that abuse this system. Often times it's an individual with a history of making large claims or consistently getting injured at every job they work. Our job is to investigate the claim and help you fight back against fraudulent claims.
Signs that someone filed a fraudulent claim
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Has a history of filing claims
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Knows an individual who is known to file claims
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There were no witnesses when the injury happened
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Refuses Treatment
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Late Reporting
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Disgruntled employee
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Symptoms that don’t seem to fit the injury
What we can investigate:
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Health insurance
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Car insurance
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Home insurance
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Life insurance
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Workers compensation insurance