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Insurers detect signs of fraud in growing number of insurance claims
By Insure.com staff

Insurance companies reported 8 percent more suspicious claims to the National Insurance Crime Bureau (NICB) in the first quarter this year than in the same period in 2010.

According to an NICB report, 24,497 questionable claims were referred for investigation in the first three months of 2011, up from 22,599 questionable claims in the first quarter last year, and up 23 percent from the 19,967 questionable claims referred in first quarter of 2009. The report covers property, casualty, commercial and workers compensation insurance.

Questionable claims are those that have one or more indicators of possible fraud. A single claim may contain up to seven referral reasons. Questionable claims provide a statistical snapshot of potentially fraudulent activity, which the NICB and insurance industry can use to direct fraud prevention and detention efforts.

Questionable medical-related claims were among the possible fraud indicators with the biggest two-year increases. Insurance companies reported 34 percent more claims indicating billed services that were never rendered and 38 percent more claims indicating excessive medical treatment.

"It is not surprising that this report finds increases in questionable medical-related claims," NICB President and CEO Joe Wehrle said in a statement. "In recent years NICB has expanded its medical fraud task force operations to address the rampant fraud associated with illegitimate medical claims."

 

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