Common Schemes in Insurance Fraud

The Total Cost of insurance fraud (non-health insurance) is estimated to be more than $60 Billion per year.

NSIU specializes in surveillance and other services catered to risk managers and insurance professionals.

5 Most Common Types of Insurance Frauds You Should Know Of

Surprisingly, insurance fraud is viewed as a victimless offense. When insurance companies are cheated, it is the people who pay premium on a timely basis that suffer the most. This is because their insurance cost goes up. It’s saddening to know that the losses suffered by insurance companies because of perpetrators are in turn borne by honest people.

According to statistics, around $80 billion losses are incurred annually on account of insurance frauds.

However, not many people know that we, as individuals, can play an essential role in preventing insurance frauds. For this, we need to be aware of the most common types. Stated below are the 5 most common types of insurance frauds:

1.     Stolen Cars

Offenders make use of stolen cars to commit an insurance fraud in two ways. Firstly, if a legitimate owner sells the car to a body shop owner for spare parts, it could be considered stolen. Since the body shop is also a faction of the scheme, the legal authorities wouldn’t  be able to find out that an insurance fraud has been committed. Secondly, criminals hide their car and make claims that it has been stolen. Moreover, the insurance company wouldn’t be able to draw out money from the car owner even after the car is located.

2.     Car Accidents

Many of the accidents that happen around us are actually insurance frauds taking place. Insurance fraud accidents are staged where the driver and the victim are co-conspirators. Sometimes, the fraud is planned on such a massive level that it involves fake witnesses and insurance investigators as well. Moreover, in such fraud claims, the value of the car that got hit and the value of the car that hits the victim’s car are greatly hiked. Likely so, the cost of the damages is also inflated.

3.     Health Insurance Billing Fraud

It is quite appalling to know that healthcare professionals are often involved in such conspiracies. Some basic examples of common frauds they commit include billing the insurance company for treatments that was never provided, or hiking the value of the work that was done. For instance, if a patient comes in for a regular checkup, the doctor would bill the insurance company for an in-patient surgery. Here, the patient may be the real victim of fraud but would have no knowledge of it.

4.     Unneeded Medical Procedures

If you ever come across a situation where your doctor is prescribing you tests unnecessarily, or ones you feel don’t pertain to your condition, you might be a victim of insurance fraud. For example, if you are suffering from a leg sore and your doctor asks you to get some blood and stool tests done, you are likely to get confused as to the reason behind this test.

5.     Faked Death

This is one fraud that has stemmed from movies, books and TV shows. In such kind of insurance frauds, the criminal will file an insurance policy of his own life, making the spouse as the only beneficiary. After months, the fraudster will fake his/her own death and all the money and benefits will go to the spouse. Post funeral, the spouse may relocate where they reunite and enjoy the claimed money.

Have you been a victim of a ruthless insurance fraud? If yes, then you surely need the assistance of an insurance fraud investigator such as National SIU. This private investigations firm has a special investigations unit so that you can be provided with evidences that reveal the real side of the case. Browse their website http://www.nsiu.com/home for more information.

Medical Record Canvass

What is Medical Record Canvass?

Our Medical record canvass is a time-saving service that provides insurance companies with complete contact information about an insured person. We provide complete medical history of the subject to insurance companies, thus reducing the chances of false insurance claims.

Identifying the Real Victim in Insurance Fraud

It may seem from the outside that the insurance company is always the victim in an insurance fraud; but the reality is somewhat different. According to the Coalition against Insurance Fraud, on average, every American family pays as much more than $1000p.a in the form of increased premium costs to cover the losses of insurance frauds. Furthermore, the additional cost that businesses bear in insurance is the added expenditure that’s passed onto the consumers in the form of inflated prices. Consequently, the cost of fraudulent claims is being indirectly passed onto the end user as higher premiums and increased value of goods.

However, the big question that arises is, ‘what exactly is insurance fraud?’ Is it the criminals that plot against insurance companies to extract millions of dollars or an ordinary citizen that lies just in order to obtain some extra in insurance claims than what they really ought to have?  The answer is a blend of both!

To clearly identify the victims in an insurance fraud, it’s imperative to have a basic idea of types of insurance frauds. Typically, there are two kinds of frauds: Hard Fraud and Soft Fraud.

Hard Fraud

Typically, a hard fraud is conducted by an individual or a team of individuals that intentionally set out their motive to fraudulently grab money from an insurance company. The schemes that they plot can be categorized as orchestrated auto accidents, fake medical bills and even murder.

Soft Fraud

On the other hand, soft fraud is when a sincere and normal person decides to deceive the insurance company just to reduce his/her premium costs or inflate the settlement of its claim. Simple and basic lies such as veiling a speed ticket to suppress insurance costs falls under the category of soft fraud. In other cases, soft fraud is also when a person unreasonably exaggerates a claim just to earn more money from it.

It is important to understand that the purpose of developing insurance was to compensate or reimburse people; not multiply their wealth just because they were a part of the loss. It is surprising to know that many people think and believe that soft fraud is not a crime and that it’s justified. They commit soft fraud by presuming that the insurance company is raking millions of dollars by manipulating the general public. So, to get their fair share of the pie, they shamelessly commit soft frauds.

Fortunately or unfortunately, this inference is totally flawed. People must understand that the cost of these fraudulent claims is further passed onto the end-user in the form of higher premium costs. Hence, the real sufferer of an insurance fraud is the end user.

If you’re seeking justice for insurance frauds, then head to National SIU, leading private investigation firm that houses the best insurance fraud specialists to offer customers with the finest results in a timely manner. Visit their website http://www.nsiu.com/ for more information.

Medical Records Canvass

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When do you Require Undercover Investigation?

There can be a number of situations in everyday business that require owners to seek the help of private investigations firms. But some of these situations can be a bit too much for ordinary investigators and require a firm that has extensive experience with unorthodox investigative techniques, like undercover investigations.

NSIU has highly trained and certified investigators on board that have extensive experience in conducting undercover investigations. If you are wondering what kinds of situations require an undercover investigation, then you should peruse the following information:

Drugs at the Office

If you suspect that your employees have been using or distributing drugs at the office, then an undercover surveillance operation is what you require. NSIU’s investigators are skilled and have the ability to blend into any type of environment. They will conduct their investigation swiftly and bring you the evidence that you require.

Theft or Embezzlement

Financial matters are another reason business owners may request an undercover investigative service. It can be because of theft of company funds or equipment, whether external or internal, and when someone is embezzling company funds.

Sabotage

Some nefarious elements can try and harm your company or employees, for the purpose of sabotaging your organization. In this type of a situation, an undercover investigator can be exactly what you need to identify the saboteurs.

Information Leak

Data and electronic information is one of the most valuable things that modern businesses have. If someone is leaking information, either inadvertently or on purpose, then an undercover investigation can reveal the relevant party.

Security Gaps

When a business deals in sensitive materials or information, keeping the whole facility secure is the owner’s number one priority. Undercover investigators can take a deep look at the security procedures at your company and how they are being implemented.

Operational Hurdles

This isn’t a very common reason for starting an undercover investigation at your company, but it isn’t unheard of. To find out if something or someone is hindering the production process in your organization, you can request an undercover investigation.

These are the most common reasons that require undercover investigations in an organization. If you are dealing with a similar situation at your place of work, then contact NSIU and request an undercover investigation immediately.

About the Company

National SIU (Special Investigation Unit) is a professional investigation firm that specializes in surveillance and other services specifically for risk managers and insurance professionals. The organization’s main goal is to provide their clients with effective evidence which can be used to uncover the truth.

For more information, please visit http://www.nsiu.com/home

Most Common Types of Insurance Fraud

Workers' compensation insurance fraud occurs in simple and complex schemes that often require difficult and lengthy investigations.

Are you a victim of Insurance Fraud?

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Insurance investigators and surveillance restrictions

When investigating for an insurance fraud, trained investigators with access to camouflage suits, cameras and other surveillance equipment, observe suspects over an extended period of time in order to document proof of fraud. Clients inform the investigating agency of insurance claimants who they suspect of fabricating or exaggerating injuries or material losses. The agency investigators move on to identify, tail and film the suspect, remaining in close contact with the clients to make sure that they are investigating the right person and to report progress.

These investigations can yield significant savings for insurance companies – every dollar spent in an anti-fraud effort returns an average of $6.10 in saved claims. Insurance fraud is the second most expensive white-collar crime in the U.S. (after tax evasion). Even if there is a small suspicion over an injury claim – it could either be repetitive, or the claimant may be defaulting on a loan and needs the insurance money – the funds saved from being fraudulently claimed almost always offset the cost of investigation.

Operation

Of course, these investigators cannot find proof of wrongdoing if the claimant is genuine, or if they are pursuing the wrong person. It is therefore important for the clients to furnish as many details about the suspect as possible – the appearance description, for example, should include eye color, scars, tattoos and any other details the client can recall.

It is also important to allow at least three days for an effective investigation to be conducted. This is because the information procured in the earlier stages is used cumulatively near the end of the investigation. This means that while most of the work is done on the third day, it could not have been done without the groundwork laid on the first and second days. Furthermore, as subjects are observed over a prolonged period, there are greater chances of them committing an error and proving the fraud – such as walking freely despite claiming to have a fractured leg.

Restrictions

As described earlier, investigations cannot “create” the crime, but an investigation may not capture any proof despite a fraud being committed. It is possible for the targets to simply be fortunate enough to not be observed for the maximum number of days ordered for investigation by the clients. Even when proof of fraud has been documented, the claimants may be able to wiggle their way out of a case by citing an unusually good/bad day for their slip-up. It is highly recommended that clients don’t stop their investigation after proof has been found, and to conduct multiple investigations to trap the fraudsters repeatedly, so that a “good day/bad day” defense does not hold in court.

Other limitations of the investigation are tied to the inability to continuously observe the target. It is difficult to discreetly follow targets, particularly in small towns and rural areas, where it becomes hard to blend in convincingly. Crime zones are difficult areas as well, because many people are on the lookout for law enforcement agencies. In certain areas, privacy laws legally prevent investigators from filming the subject. These restrictions should be kept in mind by clients before ordering an investigation.

Social Media Sites a Fraud Investigator's new Best Friend!

Interesting Facts about Insurance Fraud

A shocking truth that many people don’t realize is that insurance fraud has become a ‘norm’ in our society. You read news stories about insurance fraud and watch them on TV regularly. The number of people making fraudulent claims is increasing every year. As a result, insurance companies raise their premiums and every policyholder has to pay the price of damage a few black sheep inflict.

It is not possible for every person to hire an insurance fraud specialist every time they suspect someone is committing insurance fraud, but you can learn more about insurance fraud, so you can protect yourself. You can contact NSIU, one of the top private investigation firms in the country, when the occasion calls for it.

Facts about Insurance Fraud

• It is estimated that in the U.S. about $80 billion worth of fraudulent claims are filed every year.
• $50 billion of these can be attributed to medical insurance fraud.
• This costs every policy holder about $400 each year, because of increased premiums.
• Most common type of insurance fraud is premium diversion; insurance agents don’t send the premiums to underwriters and keep them for themselves.
• Natural or accidental disasters can often invite fraudulent claims. People try to take advantage of the disaster and make fabricated claims about their property damage and lost possessions.
• Many states, or state fraud bureaus, offer rewards to individuals for reporting ongoing insurance scams.
• Sometimes a service provider will offer free service to you, but later bill your insurance company for the same service. This type of insurance fraud can commonly go unchecked.
• A large number of insurance fraudsters pose as insurance agents and scam people out of their money, while they never actually provide any insurance.
• Contacting the insurance company regarding the insurance agent who has contacted you will help to mitigate this type of scam.
• A mechanic or body shop worker may exaggerate the damage and charge the insurance company more, making you an unwitting insurance scammer.

The information above will help you learn more about insurance fraud schemes around you and how it will hurt you as a policy holder. If you suspect that you or your organization is being targeted for insurance fraud, then you should contact NSIU immediately.

Company Introduction

National SIU (Special Investigation Unit) is a professional investigation firm that specializes in surveillance and other services specifically for risk managers and insurance professionals. The organization’s main goal is to provide their clients with effective evidence which can be used to uncover the truth.

Steps for Detecting Fraud

Stopping insurance scams is no small task; the governmental agencies alone cannot tackle this menace on their own. They require the help of individuals taking a stand against insurance fraud, because it affects every policyholder. Individuals can be more attentive about their insurance policies and how and where they are utilizing them. When you start paying attention, you will realize that there a large number of opportunities for fraudsters to take advantage of your or your business’s insurance policies.

If you think that you have been a victim of insurance fraud or there is someone committing insurance fraud using your or your company’s name, then you should get in touch with an insurance fraud investigation unit, like NSIU, as soon as possible. However, if you aren’t sure about the fraudulent scheme, then you can utilize the information below to learn how to detect insurance fraud.

Detect Fraud

• When you suspect someone of fraud, don’t delay and start looking for clues immediately. If you delay fact-finding, the fraudster will be long gone, with your insurance money.
• Collect photographic evidence, if required, in case of accidents.
• Don’t take the suspected scammer for their word, confirm every piece of information that they provide you with.
• Training your staff with up to date procedures and processes will help them avoid being duped.
• At this stage, you will have some sort of proof about the insurance fraud. This would be the time to contact certified insurance fraud specialists, like NSIU.
• Refer your case and suspicions to the professionals and they will start an investigation.
• They will start off by looking at the financial situation of the person in question.
• An investigation firm will also look at their history of insurance claims to find out if there is a pattern of false or fraudulent claims.
• They will collect the relevant evidence and find out the truth.

With the help of a professional investigation firm, you can avoid becoming an unsuspecting insurance scammer and identify the individuals who are trying to use your insurance policies to commit insurance fraud.

Company Introduction

National SIU (Special Investigation Unit) is a professional investigation firm that specializes in surveillance and other services specifically for risk managers and insurance professionals. The organization’s main goal is to provide their clients with effective evidence which can be used to uncover the truth.

Insurance fraud investigation experts

How can you Protect Yourself from Insurance Fraud?

Contrary to what some people will have you believe, insurance fraud is not a victimless crime. It negatively affects the whole insurance industry, which can indirectly affect every policy holder. Not to mention that the elaborate fraud schemes can put the people in the vicinity at risk.

So everyone should know how they can avoid being roped into an insurance fraud scheme or receiving physical or financial damage in the process. You can get the aid of NSIU, one of the top private investigation firms, to protect yourself and reveal the truth about the suspect insurance fraud scheme. Here are a few ways through which you can protect yourself from insurance fraud:

Tips on Protecting Yourself

1. Whenever you are confused about an insurance procedure or a transaction, ask questions until you are completely satisfied. You can contact the insurance company representatives as well.
2. As a general rule, do not sign anything regarding your insurance before reading the document.
3. Whenever you make claims against your insurance policy, make sure that you get a copy of the bill that is being sent to your insurance company and check it for any discrepancies.
4. Practice caution when purchasing insurance, many fake insurance companies can land you in trouble.
5. Whenever a policy seems too good to be true, it doesn’t hurt to double check things, just in case.
6. Make enquiries about the insurance company or agent you are purchasing your insurance policy from, contact the state insurance department for this purpose.
7. Be careful with you insurance ID number.
8. Be wary of businesses or individuals who try to persuade you to ‘beef up’ your insurance claim.

To avoid fraudulent insurance companies, deal with companies that are well known and are easy to research. Even then, you should read all the insurance policy documents carefully, so you don’t make any false claims by mistake. And if you find yourself in the situation where you need the help of a certified insurance fraud specialist, then you can contact NSIU. They have years of experience investigating insurance fraud cases.

Insurance Fraud – How it affects you

The people who commit insurance fraud are under the impression that the only one they are hurting is the insurance company; nothing can be farther from the truth. The perpetrators are not only costing the insurance company, they are also causing a ripple effect that can usually impact others around the community. Here a few ways in which insurance fraud can affect every individual, without even being involved:

Cost of Insurance

Insurance fraud is a growing concern in US; the number of insurance fraud cases in the country has been increasing every year. It has actually become a multi-billion dollar industry, with no signs of slowing down. As a result, insurance companies are raising the cost of premiums. The honest policy holders have to pay for the claims that are fraudulent; this is putting basic insurance coverage beyond the reach of average Americans.

Rise in Costs

The high premium costs affect people in two different ways; first the actual high premium costs that policy holders have to pay. Second, the insurance companies charge businesses more as well. These raised costs eventually filter down to the consumers as well. Businesses raise the costs of their products and services, which the consumers have to pay. So, once again insurance fraud can indirectly impact every individual.

Jeopardizing Peoples’ Lives and Property

People who commit insurance fraud often come up with dangerous and risky schemes to achieve their goals. These schemes can also endanger their coworkers, neighbors and the community at large.

• Staging auto accidents for insurance can put the lives of other drivers on the road at risk.
• Selling fake health insurance is another dangerous insurance fraud.
• Burning down a property, home or business, to collect the insurance money is a very serious and dangerous fraud. There is no way to control or predict the behavior of the fire; it has the potential to engulf whole neighborhoods.
• People often harm members of their family or business partners to claim their life insurance.

The information above clearly reveals the negative impact insurance fraud can have on every individual. It also shows the importance of a certified insurance fraud specialist, who can expose such individuals and protect the people. Firms like NSIU provide an excellent insurance fraud investigation service specially tailored for insurance professionals, so the community can be protected from fraudulent individuals.

Company Introduction

National SIU (Special Investigation Unit) is a professional investigation firm that specializes in surveillance and other services specifically for risk managers and insurance professionals. The organization’s main goal is to provide their clients with effective evidence which can be used to uncover the truth.

For more information, please visit http://www.nsiu.com/Home