fraudulent claims News

A.M. Best: Workers’ Comp Outpacing Rest of Property/Casualty Commercial Sector

Workers’ compensation insurers’ underwriting results continued to outpace the rest of the U.S. property/casualty (P/C) commercial sector in 2022, as they benefited from the long-term decline in workplace accidents and a reduction in fraudulent claims, according to an AM Best …

Viewpoint: Detecting Inflation-Driven Fraud in Insurance Claims

Following the easing of Covid pandemic restrictions, we are now facing a fresh “cost of living crisis” created by rising inflation and soaring energy bills. The Guardian newspaper reported that petrol stations in the United Kingdom face up to 3,000 …

Insurers, Consumer Groups Telling Different Stories About Smoke Damage Claims

Insurers and consumer advocates are conveying conflicting messages as both try to focus public attention on smoke damage claims. Mercury Insurance issued a press release Friday warning that an unidentified California public adjuster has been duping homeowners into submitting fraudulent …

Boy Scouts Victims’ Fund Unfair to Insurers, Companies Argue in Court

The Boy Scouts of America’s sexual abuse compensation fund may force insurers to make payments they can’t negotiate over, even if the claims are fraudulent, a group of the companies argued in court. Insurers, including American International Group, Liberty Mutual …

Requirements, Exceptions, and Considerations of an Insurer’s Right to Examinations Under Oath

An insurer’s right to examine its insured under oath in connection with evaluating a claim submitted under the insurer’s policy is well established under the law. Over 130 years ago, the United States Supreme Court in Claflin v. Commonwealth Insurance …

North Carolina Governor Criticized for Workers’ Comp Fraud Statement

Gov. Pat McCrory is taking heat after saying in his annual State of the State address earlier this week that nearly half of workers’ compensation claims paid to state employees are the result of abuse or fraud. “We all want …

More Staged Accidents Arrests in Florida

Three individuals in Fort Lauderdale were arrested for their involvement in a staged accident that resulted in fraudulent Personal Injury Protection (PIP) billings in excess of $80,000, according to an announcement by Florida Chief Financial Officer Jeff Atwater. He also …

Louisiana Parish Denies Allegations Over Gustav Cleanup

Attorneys say the Federal Emergency Management Agency’s threat to have Livingston Parish’s Hurricane Gustav debris removal monitors investigated for fraud is “gratuitous” and “improper.” FEMA has alleged that monitors hired by the parish to oversee the removal of leaning trees …

Florida Appeals Court Lifts Temporary Ban on Auto Law

A Florida appeals court on Wednesday cleared the way for the enforcement of a controversial auto insurance law that backers say was designed to curb fraudulent claims. The 1st District Court of Appeal ruled that Tallahassee Circuit Judge Terry Lewis …

7 Plead Guilty in Gulf Oil Spill Settlement Fraud

Seven people have pleaded guilty to stealing money from an oil spill settlement fund, Alabama Attorney General Luther Strange announced Monday. Five of the defendants were charged with theft of property. They’re collectively ordered to pay more than $20,000 in …