3/29/2016

Is there anything new in the insurance fraud arena, or are things status quo?

Frank Goldstein and three other insurance industry leaders respond to this month's question.

By Bevrlee J. Lips

“The corporate practice of medicine (also known as ‘straw ownership’) is as pervasive as ever. The real owners of medical clinics purchase doctors’ medical licenses to avoid state licensure requirements and then stage accidents, pay runners (‘patients’), and submit fraudulent medical records and bills.”

1. FRANK S. GOLDSTEIN, Partner, Goldstein Law Group. CLM Member since 2012.


 “It is not status quo for insurance fraud. New technology allows for new ways to commit insurance fraud as well as how to investigate it.  Smartphones and social media are the new tools of the investigator.”

2. RICHARD L. DUFFY, Director, Investigative Services, Travelers. CLM Fellow since 2014.


 “With social media, Internet searches, and cellphone location information, the tools for finding fraud continue to improve. The risk of being wrong about a conclusion that a claim is fraudulent remains high, but technology continues to provide more tools to find the truth.”

3. GENE A. WEISBERG, Founder, GladstoneWeisberg ALC. CLM Member since 2010.


 “I expect to see an increase in questionable claims arising out of the new sharing environment. You can now ‘share’ your car and home over the Internet without ever meeting the person and, sometimes, with no connection between the individuals.”

 4. ROBERT A. LUSKIN, Esq., Partner, Goodman McGuffey Lindsey & Johnson LLP. CLM Member since 2011.


 2 Billion

Number of smartphone users globally.

Source: SMSGlobal

37%

Percent of organizations being hit by economic crime, including fraud.

Source: PriceWater-houseCoopers

10%

Percent of total expenditures estimated to be from health care fraud.

Source: Insurance Information Institute

$0.40

Cost to buy a hacked Uber account, down from $1 in 2015.

Source: Motherboard

38

Number of states participating in the National Motor Vehicle Title Information System, which was created to combat title washing.

Source: Department of Justice

$700 

Estimated amount in increased premiums the average U.S. family pays per year due to insurance fraud.

Source: FBI



Bevrlee J. Lips was managing editor of Claims Management magazine (now CLM Magazine) from January 2012 until March 2017.

Top Industry News

Powered by : Business Insurance


jacobson