As you may have guessed, the country’s economic conditions have caused a nationwide spike in insurance fraud. A recently released report by the Coalition Against Insurance Fraud points to the economy and continuous pressures on state budgets as the reason for a spike in fraud cases.
Overall, the economy in 2009 appears to have had a significant impact on the incidence of fraud. On average, fraud bureaus reported the number of referrals received and cases opened increased in all 15 categories of fraud included in the survey.
Those 15 categories of fraud are:
- Agent fraud
- Auto – staged
- Auto – padding/false claim
- Auto – give up
- Commercial – arson
- Disability
- Drug diversion
- Homeowners – arson
- Homeowners – padding/fake
- Liability – false claim
- Life insurance
- Medical – false claims
- Work comp – worker
- Work comp – employer
- Bogus health insurance/discount health plans
The biggest number of fraud cases occurred in the area of bogus health insurance. The report pointed to the reported rise in unauthorized entities selling fake coverage combined with the emergence of medical discount plans as the reason for the dramatic spike in this area. Drug diversion came in second with survey respondents pointing to the fact that fraud involving the diversion of prescription drugs, mainly painkillers, appears to continuously increase — a trend over the last few years.
The breakdown is as follows (courtesy of the Coalition Against Insurance Fraud):
CAIF notes that the weighted averages were calculated from the responses to the question of change in the number of referrals and cases received in each category as follows:
Lower = 1 | Same = 2 | Slightly Higher = 3 | Much Higher = 4
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Emily Holbrook is co-editor of Risk Management Monitor and editor of Risk Management magazine, where she has worked since 2008. You can follow her on Twitter @RiskMgmtMonitor.
