In 2010, there were 1,566 Colorado questionable claims referred to the National Insurance Crime Bureau (NICB) from its member insurance companies. In 2011, the number dropped to 1,403, but rose in 2012 to 1,663—an increase of 6 percent from 2010’s figure.
Questionable claims (QC) are those 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. This report analyzes QCs by loss city, core-based statistical area (CBSA), policy type, loss type, policy and loss type combined and referral reasons.
The top five cities in Colorado generating the most QCs last year were Colorado Springs (334), Denver (305), Aurora (152), Littleton (58), and Pueblo (55). The top five CBSAs reporting QCs were Denver-Aurora, Colorado Springs, Pueblo, Boulder and Greeley. The top five loss types were: theft, collision, bodily injury, burglary and other perils.
QCs represent a fraction of overall claims traffic. Nationally in 2012, QCs totaled 116,268 out of an overall claims population of more than 70.5 million—or 0.164 percent. The volume of QC referrals can increase or decrease over a given period of time and may be caused by a number of factors, including better reporting by the industry and an increase or decrease in fraudulent activity, etc.
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