Fraud News

Why Analyzing Unstructured Data Benefits Every Claims Manager

If you’re just catching on to the fact that big data is shaking up the insurance industry in a big way, you’re a bit behind the curve. Across all industries, almost 90 percent of large companies say big data is …

As Insurance Fraud Surges, Insurers Fight Back by Automating Detection

Insurance fraud is rising and more insurers are responding forcefully by automating investigations with skilled technology, according to a study of insurer technology usage by the Coalition Against Insurance Fraud. More than 60 percent of insurers say fraud has climbed …

iovation Predicts New EMV Chip Cards Will Lead to Increase in Online Holiday Fraud

Iovation, a provider of device intelligence for authentication and fraud prevention, is predicting a significant increase in card-not-present fraud—fraudulent transactions where a credit card is not physically presented to a merchant—from Black Friday to Cyber Monday when compared to past …

Using Graph Analysis to Root Out Complex Fraud Rings

A new form of predictive analytics offers the ability to detect fraud committed by a group or ring in real time. According to Philip Rathle, vice president of products for California-based Neo4j, graph analysis dates back to 2000, when the …

Fraud News Around the Nation

Louisiana Man Sentenced Nearly 5 Years for Insurance Theft A federal prosecutor says a Lafayette, La., man has been sentenced to four years and eight months in prison for stealing more than a million dollars from his sister’s insurance settlement. …

Fraud News Around the Nation

Insurer Accuses Tennessee Recording Studio of Fraud After Fire An insurance company that paid more than $2.8 million in claims after an arson fire damaged an historic Memphis, Tenn., music recording studio has now accused a rock music label company …

Auto Insurers Need to Focus on Increasing EMG Abuse, Fraud

Electromyography (EMG), a diagnostic procedure used to assess muscle and nerve damage, has become a major area of concern and a potential gateway for medical fraud and abuse, particularly in auto insurance. Dr. John E. Robinton, medical director of Neurodiagnostics …

Texas Workers’ Comp Fraud Unit Boasts 40 Investigations Since Inception

Since its establishment five months ago, the new in-house fraud unit at the Texas Division of Workers’ Compensation has opened more than 40 investigations and hired additional fraud investigators to extend its reach. “It’s a huge benefit to have a …

Fraud News Around the Nation

RV Salesman Caught on Camera in Workers’ Comp Scam Must Repay State Over $81,000 A Washington recreational vehicle salesman who claimed he couldn’t work because of an on-the-job injury has been ordered to pay back more than $81,000 in state …

Fraud News Around the Nation

Texas Health Clinic Owner Pleads Guilty to Insurance Fraud The owner of a Houston, Texas, health clinic pled guilty to insurance fraud after billing for medical services – often provided to injured employees – despite having no licensed medical staff …