The Top States, Cities for Questionable Insurance Claims

June 28, 2011

Five states—California, Florida, Texas, New York and Michigan—generate almost half of all suspicious claims to property/casualty insurance companies, a new report says.

These states account for 49 percent of all “questionable claims” as tabulated by the National Insurance Crime Bureau (NICB).

Questionable claims are those claims that NICB member insurance companies refer to NICB for closer review and investigation based upon one or more indicators of possible fraud. NICB just released its three-year analysis of questionable claims in the United States from January 1, 2008 through December 31, 2010.

New York, Los Angeles, Houston, Tampa and Detroit are the cities generating the most QCs. Florida has three cities in the top 10 for QCs—Tampa, Miami and Orlando.

When analyzed by core based statistical areas, the top five are Los Angeles-Long Beach-Santa Ana, Calif.; New York-Northern New Jersey-Long Island, N.Y., N.J., Pa.; Miami-Fort Lauderdale-Pompano Beach, Fla.; Detroit-Warren-Livonia, Mich.; and Chicago-Naperville-Joliet, Ill., Ind., Wis.

In 2008, a total of 74,676 QCs were referred. The number increased to 85,018 in 2009 and to 91,730 in 2010—a 23 percent increase from 2008.

Personal automobile was the policy type with the most QCs for all three years while faked/exaggerated injury and questionable vehicle theft were the QC referral reasons most cited for all three years.

NICB is supported by more than 1,000 property/casualty insurance companies and self-insured organizations.

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