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Suspicious insurance claims rise 27 percent in two years
By Insure.com staff

Suspicious insurance claims referred to the National Insurance Crime Bureau for investigation increased 26.7 percent from 2010 to 2012, according to a new bureau report.

Last year, insurers asked the bureau to investigate 116,268 questionable claims, a record number, compared to 91,797 in 2010 and 100,450 in 2011.

Questionable claims are those that the bureau's member insurance companies refer for closer review, based on one or more indicators of possible fraud. A single claim may contain up to seven reasons for getting flagged.

The bureau's report examines six categories of claims -- property, casualty, commercial, workers' compensation, vehicle and miscellaneous.

In the property category, the number of suspicious claims for disappearance or loss of jewelry jumped 86 percent in one year, from 2,036 in 2011 to 3,791 in 2012. Suspicious theft claims for property other than vehicles also increased significantly, rising 49 percent from 7,152 in 2011 to 10,680 in 2012.

In the vehicle category, 1,505 hail damage claims raised a red flag, and 5,006 "hit while parked" claims were referred for investigation.

The five states generating the most suspicious insurance claims in 2012 were:

  • California (21,935)
  • Florida (10,693)
  • Texas (10,368)
  • New York (9,059)
  • Maryland (4,296).

Although the number of questionable claims has grown year over year, suspicious claims still represent a tiny percentage of the 56 million insurance claims processed. Last year's questionable claims made up just 0.2 percent of the all claims processed. Despite their questionable nature, not all of the claims referred for investigation turn out to be fraudulent, the bureau says.



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