Fraud Investigator Not Surprised with Accenture Report

February 24, 2003

The statistics contained in an Accenture Ltd. insurance fraud study didn’t surprise Tim Fargo, president of Florida-based investigation firm Omega Insurance Services.

Accenture found that:

*Nearly 25 percent of Americans surveyed think it’s okay to defraud an insurance company;
*Nearly half the respondents said that people commit insurance fraud because they can get away with it;
*Nearly 25 percent of respondents think it’s either “quite acceptable” or “somewhat acceptable” to overstate the value of a claim;
*Nearly 40 percent of the respondents were “not very likely” or “not likely at all” to report someone who committed insurance fraud.

“Claims fraud is a huge issue, with a tremendous impact on the U.S. economy,” Fargo said. “The Coalition Against Insurance Fraud has calculated that the cost of fighting fraud raises insurance premiums as much as $1,100 per policyholder per year.”

Fargo’s company investigated approximately 15,000 cases of workers’ compensation and disability cases alone last year. That was up 45 percent from the previous year.

“The study results are somewhat consistent with a weak economy,” Fargo continued. “But they also reflect a general deterioration of our ethical underpinnings, as well as excessively lax penalties for fraud.”

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