There was a 20 percent increase in QCs during the first half of 2012 compared with 2011, and a 25 percent increase when compared with the first half of 2010, according to the National Insurance Crime Bureau’s report of questionable claims (QC) referral reasons during the first half of 2012.
The report examines six referral reason categories of claims—property, casualty, commercial, workers’ compensation, vehicle and miscellaneous—for the first half of 2010, 2011 and 2012.
Questionable claims are claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud. A single claim may contain up to seven referral reasons.
During the first half of 2010, a total of 46,766 QCs were referred. That number increased to 48,887 in the first half of 2011 and to 58,523 in the first half of 2012.
Suspicious theft/loss (non-vehicle) generated the largest increase in volume for a single referral reason in property QCs (5,255) and contributed to the property category’s 40 percent rise in QCs compared to the first half of 2011. The miscellaneous QC category posted the smallest increase—10 percent—compared with the first half of 2011.
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