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What are signs of possible insurance fraud?

Insurance fraud is unfortunately an all-too-common occurrence. While most policyholders are honest when making claims, others may falsify information to receive compensation under fraudulent pretenses. That’s why it’s crucial for insurance companies to be on the lookout for potential red flags. Doing so can possibly heady off fraudulent claims and prevent payouts that aren’t warranted for legitimate reasons. 

A list of suspicious loss indicators was established by the National Insurance Crime Bureau to help insurance agents. These indicators should trigger a more thorough review of a claim, especially when multiple indicators are present in a single claim. For example, is the person reporting the claim in a calm manner even though the loss was substantial? Most people exhibit some level of stress when reporting a claim, especially when it involves their house or vehicle. Also, is the person attempting to provide handwritten receipts to establish proof of ownership? Was the insurance amount increased shortly before the claim was made? 

Insurance companies can also employ other tactics to verify the legitimacy of a person’s claim. This is most useful with injury or disability cases. For instance, a claimant might state that he or she is too injured to return to work, or that the injury was so severe they deserve monetary compensation. The picture painted on social media might be vastly different in this case. Instead of appearing bedridden and sickly, the person might post a video white water rafting. The person might also blatantly admit to wrongdoing in an effort to brag about the scheme. Either w, social media evidence is admissible when it comes to fraudulent insurance claims. 

Many agencies also employe special teams to perform more exhaustive searches. These people will look at the evidence provided by the claimant and compare it against other factors. For instance, a damaged vehicle will be investigated to verify that it matches the version of events provided. Medical records can also be used to determine the severity of injuries. With home insurance claims, investigators can even determine how a fire started and whether it was intentional.