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Auto insurance fraud: it’s no accident
By Insure.com

Traffic accidents are traumatic enough.  Imagine if in addition, you were the target of fraud.  Staged auto accidents are a major problem facing police and insurance companies. 

If you are involved in a traffic accident, watch for these signs of possible fraud:

The staged accident. You're driving along a heavily traveled street when the driver in front of you brakes suddenly, for no apparent reason. You hit the vehicle in a rear-end collision. The driver seems unusually calm and suggests simply exchanging insurance information "just in case," insisting there's no need to call the police. Two months later you find out a claim has been filed against you for vehicle damages and injuries the driver claims he sustained in the collision.

Scam artists sometimes cause traffic accidents on purpose, so they can file fraudulent car insurance claims.

After an accident, you should always call the police immediately.  Then you should call your insurance company. Never say anything to the other driver that could imply you are at fault — even if the exchange seems friendly. Suggesting you're at fault could lead to big liability claims against you.

Good Samaritan or illicit advisor? You've just been broadsided at a major intersection and are waiting for the police to show up.  Someone approaches you and says he knows just the lawyer, doctor, auto body shop, or tow-truck company to help you. He's very convincing, and promises if you make an insurance claim you'll get a big payout for this accident.

This is known as a "capper" or "runner" scheme. “Cappers” learn of car crashes from police scanners, and then show up at the scene with unsolicited advice for victims. Their motivation is usually to create business for the lawyer, doctor, repair shop, or towing company.  The “capper” or “runner” usually receives a portion of any insurance settlement.

In many states, it's illegal for an attorney to approach people involved in an accident at the scene, and the runner scheme is also illegal. Be highly skeptical if you have this kind of interaction right after an accident.

Is your doctor or lawyer working in your best interest? You've taken unsolicited advice from a bystander, and now you want to make sure the doctor or lawyer they recommended was a sound choice.

Some medical providers commit insurance fraud by padding your medical bill or suggesting extensive treatment that might seem out of line with the extent of your injuries. Often these providers are working with an attorney who steers his clients to the providers following an accident. The National Insurance Crime Bureau offers these tips for avoiding "medical mills" that can take advantage of injured accident victims to make bogus insurance claims:

  • Check your doctor's or lawyer's credentials: Contact your state's medical licensing board to find out whether your doctor is licensed and whether a patient has ever filed a complaint against him. Similarly, the American Bar Association can tell you whether your lawyer has a record of ethical behavior.
  • Watch for referrals: Attorneys allied with fraudulent medical providers might insist a specific doctor treat an accident victim. The insistence by an attorney that you see a particular medical provider might indicate fraud.
  • Be suspicious if your doctor talks you into injuries: A doctor participating in an insurance fraud scheme will suggest excessive treatment for injuries you didn't know you had. It's one thing to be prudent about post-accident medical care. On the other hand, if your doctor is prescribing treatment for "severe back pain" you don’t feel, it could signal fraud.
  • Keep records of your office visits: Keep a file with records of your doctor visits and prescribed treatments. Dishonest medical providers sometimes try to pad medical bills with treatments and diagnoses you did not receive, giving the patient one bill and submitting a different version to the insurer.

"Cases of this kind prove that greed knows no bounds,” says Gregory Serio, insurance commissioner for the state of New York. Serio urges anyone who suspects accident fraud to notify police, prosecutors or their state’s insurance department. “Working together we will win our fight against auto insurance fraud," Serio says.

 

Last Updated Feb. 6, 2003
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